Posts for category: Oral Health
Millions of people have obstructive sleep apnea—and some don’t even realize it. That’s because even though these airway-blocking episodes can occur several times a night, they may only last a few seconds. The brain rouses the body just long enough to open the airway but not long enough to awaken the person to consciousness.
Even though a person with sleep apnea might not remember what happened to them, they can still experience the effects of sleep disturbance: drowsiness, irritability or an inability to focus. Over time, the accumulation of “bad sleep” could increase their risk for heart disease or other life-threatening conditions.
But there are effective ways to alleviate or lessen obstructive sleep apnea. The main “go-to” treatment is a method called continuous positive airway pressure (CPAP). CPAP utilizes an electric pump that supplies a constant flow of pressurized air through a mask worn by the patient while sleeping. The increased air pressure around the throat helps keep the airway open.
But although it’s effective, CPAP is unpopular with many people who have tried it. Many find the hose and other equipment cumbersome, or the mask too uncomfortable or restrictive to wear. As a result, quite a number simply avoid using it.
If you’ve had a similar experience with CPAP or would rather explore other options, we may have an alternative: an oral appliance you wear while you sleep. It can help prevent or lessen symptoms in cases of mild to moderate airway obstruction caused by the tongue or other forms of tissue.
Sleep apnea appliances come in two basic forms. One uses metal hinges to help move the lower jaw and tongue forward. The other form has a compartment that fits around the tongue and applies suction to help keep the tongue moved forward.
These appliances may not be suitable for patients with severe sleep apnea or whose cause is something other than a physical obstruction like abnormal neurological signaling patterns. But where they are appropriate, they can be an effective alternative to CPAP and the key to a better night’s sleep.
If you would like more information on this dental solution 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 “Oral Appliances for Sleep Apnea.”
What makes a beautiful smile? Beautiful teeth, for sure. But there's also another component that can make or break your smile, regardless of your teeth's condition: your gums. Although their primary function is to protect and stabilize the teeth, your gums also enhance them aesthetically by providing an attractive frame.
But just as a painting displayed in an oversized frame can lose some of its appeal, so can your smile if the size of your gums appears out of proportion with your teeth. Normally, a smile that displays more than four millimeters of gum tissue is considered “gummy.”
There are some things we can do to improve your gum to teeth ratios. What we do will depend on which of the following is the actual cause for your gummy smile.
Excess gum tissue. We'll start with the obvious: you have excess gum tissue that obscures some of the visible tooth crown. We can often correct this with a surgical procedure called “crown lengthening,” which removes some of the excess tissue and then reshapes the gums and bone to expose more teeth length.
Teeth that appear too short. The problem may not be your gums — it could be your teeth appear too short. This can happen if the teeth didn't erupt fully, or if they've worn down due to aging or a grinding habit. One option here is to “lengthen” the tooth cosmetically with veneers, crowns or other bonding techniques.
Higher lip movement. Rather than your teeth and gums being out of size proportion, your upper lip may be rising too high when you smile, a condition known as hypermobility. One temporary fix is through Botox injections that paralyze the lip muscles and prevent their movement from overextending. We could also use periodontal surgery to perform a lip stabilization procedure that permanently corrects the upper lip movement.
Overextended jaw. Your gums may seem more prominent if your upper jaw extends too far down and forward. In this case, orthognathic (jaw straightening) surgery might be used to reposition the jaw relative to its connection with the skull. Setting the jaw up and back in this way would reduce the prominence of the gums when you smile.
As you can see, treatments range from cosmetic techniques to moderate surgical procedures. A full dental exam will help determine which if any of these measures could reduce gumminess and improve your smile.
If you would like more information on correcting gummy smiles, 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 “Gummy Smiles.”
You already know the basics for healthy and attractive teeth and gums: brush and floss every day; and have your teeth cleaned and checked by a dentist every six months. But there are also some lesser known things you can do to improve what you're already doing—and some of them may go against popular wisdom.
Here then are 3 counter-intuitive tips for turbo-boosting your teeth and gum health.
Avoid brushing too hard and too often. While it may not seem like it, “The more, the better” isn't necessarily a good thing when it comes to brushing your teeth. Vigorous brushing several times a day could actually damage both your teeth enamel and your gums, eventually leading to problems like sensitive teeth. So, easy does it on the brushing pressure—let the mild abrasives in your toothpaste do the work removing disease-causing dental plaque. Likewise, avoid brushing more than twice a day.
Wait on brushing right after eating. If your first instinct right after a meal is to head to the sink to brush your teeth, curb your enthusiasm. Your enamel is actually in a slightly softened state right after eating and drinking because of an increase in mouth acid (especially if you've consumed sodas, sports drinks or juices). Saliva restores the mouth's pH balance and helps remineralize enamel in about an hour. If you brush before then, you could be sloughing off microscopic bits of enamel—an eventual problem if this is a regular habit.
Stop snack “grazing.” If you're one of those that likes to munch on food throughout the day, you could be thwarting your overall efforts to maintain good dental health. Remember saliva? As mentioned, it effectively neutralizes acid in a few minutes. But continuous snacking maintains a constant high level of acid in the mouth—saliva has little chance to catch up. As a result, your mouth stays acidic, which can lead to higher risk of dental disease. If possible, limit your snacking to mealtimes.
These tips might be surprising, but they're based on sound science and research. Incorporating them into your regular, ongoing dental care, could increase your chances of healthy teeth and gums.
If you would like more information on how best to clean and care for your teeth, 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 “10 Tips for Daily Oral Care at Home.”
Dental visit anxiety is a serious problem: Half of all Americans admit to some level of dental fear, while 15% avoid dental care altogether due to acute anxiety. The harm this can cause to dental health is incalculable.
But dentists have a number of sedation techniques that can relax anxious patients and allow them to receive the care they need. Although often used together, sedation is slightly different from anesthesia, which aims to deaden pain sensation. The aim of sedation is to calm the emotions and state of mind.
Sedation isn't a new approach: Physicians have used substances like root herbs or alcohol to relieve anxiety since ancient times. Modern dentistry also has a long history with sedation, dating from the early 1800s with the first use of nitrous oxide gas.
Modern dental sedation has expanded into an array of drugs and techniques to match varying levels of anxiety intensity. At the milder end of the scale are oral sedatives, taken an hour or so before a dental appointment to produce a calmer state. This may be enough for some patients, or it can be used in conjunction with nitrous oxide.
For those with more intense anxiety, dentists can turn to intravenous (IV) sedation. In this case, the sedative is delivered directly into the bloodstream through a small needle or catheter inserted in a vein. This causes a quicker and deeper reaction than oral sedatives.
Although similar to general anesthesia, IV sedation does differ in significant ways. Rather than unconsciousness, IV sedation places a patient in a “semi-awake” state that may still allow them respond to verbal commands. And although the patient's vital signs (heart rate, breathing, blood pressure, etc.) must be monitored, the patient doesn't need breathing assistance as with anesthesia.
There's one other benefit: The drugs used often have an amnesic effect, meaning the patient won't remember the treatment experience after recovery. This can be helpful in creating more pleasant memories of their dental experience, which could have its own sedative effect in the future.
Whether oral, gas or IV, sedatives are a safe and effective way to calm dental fears during treatment. That could help someone with anxiety maintain their oral health.
If you would like more information on reducing dental anxiety, 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 “IV Sedation in Dentistry.”
Recurring episodes of severe pain along your face could mean you have trigeminal neuralgia (TN). Although not always curable, TN can be managed effectively with the right strategy.
TN affects a specific pair of nerves called the trigeminal that signal pain in the face or jaws. They originate from the brain stem through the skull on either side of the face, with each nerve having upper, middle and lower branches. TN can affect one or more of these branches and cause anywhere from a mild twinge to excruciating pain.
Causes for TN differ in individual patients. Though it could be linked to a tumor, lesion or cold sore, it most often seems to arise from a blood vessel impinging on the nerve and damaging its outer coating. This causes it to be hypersensitive: chewing, speaking or even lightly touching the face can set it off. The damaged nerve may also fail to "shut off" when the triggering stimulation stops.
If you have these types of symptoms, your first step is to obtain an accurate diagnosis. You'll need a thorough examination to rule out other possibilities like jaw joint problems or a tooth abscess. Once we've determined it's definitely TN, we can then devise a treatment strategy.
We usually begin with conservative measures like medication to block pain transmission to the brain or anticonvulsants that stabilize the nerve and decrease abnormal firing. If medication isn't enough, we may then consider an invasive procedure to control symptoms.
Percutaneous treatment — often recommended for older patients or those in poor health — involves inserting a thin needle into the nerve to selectively damage certain fibers that will prevent the nerve from signaling pain. We might be able to move an impinging blood vessel aside from the nerve with a microsurgical procedure. As an alternative to surgery, high-dose radiation could also be aimed precisely at the pain site with a controlled beam to alter the nerve's ability to transmit pain.
TN can be a source of great discomfort that lowers your quality of life. But employing treatment techniques that best suit your situation, we can greatly reduce the misery it inflicts.
If you would like more information on facial pain caused by trigeminal neuralgia, 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 “Trigeminal Neuralgia: A Nerve Disorder that Causes Facial Pain.”