Posts for: October, 2016
For millions of Americans, sleep apnea is a serious health condition. Not only can it impair your day-to-day living, you might be more susceptible to high blood pressure, heart disease or stroke.
Sleep apnea occurs when you stop breathing for short periods while asleep. When blood oxygen drops too low, your body automatically wakes you to take a breath. This can disrupt your sleep several times a night. Chronic symptoms like drowsiness, irritability or headaches during the day, or indications you're a loud snorer, are all possible signs of sleep apnea.
Fortunately, we can treat sleep apnea. One way is continuous airway pressure therapy (CPAP), a pump device that supplies pressurized air through a mask to keep the airway open during sleep. Although CPAP is effective, some people find it uncomfortable to use.
There's a more comfortable option for sleep apnea caused by mouth structures like the tongue or tonsils obstructing the airway. It involves a custom-fitted oral appliance worn while you sleep that moves these structures out of the way.
Such appliances come in two basic types. One type fits over the upper and lower teeth and uses tiny metal hinges to move the lower jaw and tongue forward away from the airway. The other fits around and presses the tongue down like a tongue depressor to move it forward.
Before starting treatment, we need to first find out if you actually have sleep apnea and what's causing it (some cases may be more acute and require advanced treatments like jaw surgery). We'll need to perform medical and oral exams and take a history, and we'll likely refer you to a sleep medicine specialist for further testing.
If you have obstructive sleep apnea, a custom-fitted appliance could be a good solution. We'll create and adjust it according to your particular mouth and jaw contours for maximum comfort. Besides the appliance, you might also lose excess weight, adjust your sleep position, seek treatment for allergies, and quit smoking. All these could help reduce sleep apnea.
In any event, your first step is to find out if you have sleep apnea. From there we'll help you find the right treatment to improve your overall health and well being.
If you would like more information on treatments for sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”
People often put a premium on appearance when deciding whether or not to replace a missing tooth. There's more motivation to replace one in the “smile zone,” where the teeth are more visible, than one that's not.
But even if your missing tooth is in the back out of sight, there are still good reasons to replace it. That's because even one lost tooth can have a cascading ill effect on other teeth, the underlying bone or eventually your entire facial structure.
The chief problems caused by a missing tooth occur first with the bone. The act of chewing generates pressure around the teeth. The teeth transmit this pressure through the roots to the bone, which stimulates the bone to grow and remain strong in support of the teeth. When you lose a tooth, the bone no longer receives this growth stimulation.
In time, the replacement rate for older bone cells will slow down and cause the bone volume to decrease. It's possible to detect a change just months after losing a tooth: you can lose an estimated 25% of bone width in the first year.
As the bone diminishes, the jaw loses height and then more width. The gum tissues will also gradually decrease. As a result you may not be able to chew or even speak as well as you once could. Depending on the number of teeth you've lost, the foundational portion of the jawbone — the basal bone — may also decline. The distance between nose and chin may decrease and the cheeks sink in. Without bone support in the rear, the bite can collapse and push the teeth forward out of their normal position.
The best way to avoid this debilitating spiral is to replace a tooth as soon as practical. There are many options, but perhaps the best choice is a dental implant: not only will it provide a life-like appearance, but its affinity with bone will stop bone loss and even encourage new growth.
So, don't neglect replacing that “invisible” tooth if it's lost. Your mouth and ultimately your appearance will be better for it.
If you would like more information on tooth loss and restoration options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”
Dental implants are widely considered the most durable tooth replacement option, thanks in part to how they attach to the jaw. But durable doesn't mean indestructible — you must take care of them.
Implants have a unique relationship to the jawbone compared to other restorations. We imbed a slender titanium post into the bone as a substitute for a natural tooth root. Because bone has a special affinity with the metal, it grows to and adheres to the implant to create a secure anchor. This unique attachment gives implants quite an advantage over other restorations.
It isn't superior, however, to the natural attachment of real teeth, especially in one respect: it can't match a natural attachment's infection-fighting ability. A connective tissue attachment made up of collagen fibers are attached to the tooth root protecting the underlying bone. An elastic gum tissue called the periodontal ligament lies between the tooth root and the bone and attaches to both with tiny collagen fibers. These attachments create a network of blood vessels that supply nutrients and infection-fighting agents to the bone and surrounding gum tissue.
Implants don't have this connective tissue or ligament attachment or its benefits. Of course, the implants are made of inorganic material that can't be damaged by bacterial infection. However, the gums and bone that surround them are: and because these natural tissues don't have these same biologic barriers to infection and perhaps access to the same degree of antibodies as those around natural teeth, an infection known as peri-implantitis specific to implants can develop and progress.
It's therefore just as important for you to continue brushing and flossing to remove bacterial plaque that causes infection to protect the gums and bone around your implants. You should also keep up regular office cleanings and checkups. In fact, we take special care with implants when cleaning them by using instruments that won't scratch their highly polished surfaces. Such a scratch, even a microscopic one, could attract and harbor bacteria.
There's no doubt dental implants are an excellent long-term solution for restoring your smile and mouth function. You can help extend that longevity by caring for them just as if they're your natural teeth.
If you would like more information on caring for dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implant Maintenance.”
Your teeth are meant to last a lifetime. Even with wear and tear from years of eating and biting they can continue to function properly and look attractive well into your senior years.
Teeth are resilient thanks in part to enamel, the hardest substance in the human body. But the gums also contribute to this resilience: besides attractively framing the teeth, they protect the dentin and roots below the enamel covering.
Unfortunately, the gums can shrink back or “recede” from their normal place. Not only does this look unattractive, the recession can also expose teeth to disease and cause tooth sensitivity to temperature changes or biting pressure.
There are a number of causes for gum recession, some of which you may have little control over. If, for example, your teeth come in off center from their bony housing, the gum tissues may not develop around them properly. You might also have inherited a thinner type of gum tissue from your parents: thinner tissues are more delicate and susceptible to recession.
But there are other causes for which you have more control. Over-aggressive brushing (too hard for too long), ironically, does more harm than good as it can injure your gums and cause them to recede. More likely, though, your recession is a direct result of neglecting proper hygiene for your teeth and gums.
When teeth aren't properly cleaned through daily brushing and flossing, a thin film of bacteria and food remnant called plaque builds up on tooth surfaces. This can trigger periodontal (gum) disease, which subsequently causes the gum tissues to detach from the teeth and often recede.
To reduce your risk of gum disease, you should gently but thoroughly brush and floss daily, and visit us for cleanings and checkups at least twice a year. If you have a poor bite (malocclusion), consider orthodontic treatment: malocclusions make it easier for plaque to accumulate and harder to remove.
Above all, if you begin to see signs of gum problems — swelling, bleeding or pain — see us promptly for an examination and treatment. Dealing with these issues early is the best way to ensure your gums continue to do their jobs for the long-term.
Mention “bacteria” and people begin looking for the germicide. The truth is, though, only a few strains cause disease — the rest are benign or even play a beneficial role.
This may shock you, but your body both inside and out is home to around 100 trillion single-celled organisms, exceeding the number of your native cells by 10 to 1. You won't notice them, though: bacteria are so small they only make up 1 to 3% of your total body mass. And each of us has a unique “microbiome” of micro-organisms: they influence a variety of processes like digestion and metabolism, and some even “teach” our immune systems to distinguish between helpful and harmful bacteria.
Of the 10,000 or more species of bacteria that inhabit the body, perhaps the most studied and understood are in the mouth. We even have a database that catalogs the gene sequences of oral bacteria. And what we've learned has enlarged our understanding of dental disease and how to prevent or treat it.
This new knowledge, for example, confirms that many of our modern lifestyle habits adversely affect oral health. For example, researchers have found higher concentrations of Streptococcus mutans, the bacteria most responsible for tooth decay, in current samples of biofilm than in those from preindustrial eras. The culprit seems to be the modern diet rich with carbohydrates like sugar that bacteria eat. Cigarette smoking can also make the mouth friendlier to disease-causing bacteria.
On the bright side, our growing knowledge of oral bacteria is helping us devise better prevention and treatment strategies. One example is the use of antibiotics to reduce the populations of disease-causing oral bacteria.
The broad, traditional approach kills not only malevolent bacteria, but beneficial strains as well. The approach may also be helping bad bacteria become resistant to common antibiotics. A newer approach targets specific bacteria with custom-designed antibiotics that won't kill other bacteria. There's also increased focus on ways to re-balance a person's normal microbiome if it's become skewed.
As we come to understand bacteria better — both good and bad species — these and other dental care efforts will benefit. With our increasing knowledge of these microorganisms that surround us the future looks bright for better oral health.
If you would like more information on the role of bacteria in oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “New Research Shows Bacteria Essential to Health.”