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.”
Even though an implant is now as close to life-like as modern dentistry can produce, it won’t surpass the function of your own natural tooth. That’s not to say implants are an inferior choice—in fact, it’s often the best one if a tooth is beyond reasonable repair. But first, let’s consider saving your existing tooth.
We first need to know why your tooth is diseased—more than likely either from tooth decay or periodontal (gum) disease. Although different, these infections both begin with bacteria and can eventually lead to tooth loss.
While your mouth is teeming with millions of harmless bacteria, a few strains that live in dental plaque (a thin biofilm on your teeth) can cause disease. As they proliferate—feeding mostly on leftover sugar—they produce acid, which can erode the protective enamel on teeth. This can create cavities, which must be cleared of decayed material and filled.
Sometimes, though, the decay spreads deep within the pulp and through the root canals putting the tooth in danger. We may be able to save it, though, with a root canal treatment. In this common procedure we access the pulp chamber and clean out all the diseased or dead tissue. We then fill the empty chamber and root canals with a gutta percha filling and then seal the tooth. We later cap the tooth with a crown to further protect it.
Dental plaque can also give rise to a gum infection that triggers chronic inflammation. The inflammation can cause the gums to weaken and detach from the teeth to form large, infection-filled voids called periodontal pockets. This could lead to bone deterioration, further loosening the tooth’s hold.
But we can effectively treat gum disease by removing the plaque, which is fueling the infection. We normally do this with special hand instruments, but may also need to use surgical measures for more advanced cases. After plaque removal the inflammation subsides, giving the tissues a chance to heal and strengthen. We may also need to provide further assistance to these tissues to regenerate through gum or bone grafting.
These efforts can be quite involved, but if successful they could give your tooth another lease on life. And that could be a much better outcome for your dental health.
If you would like more information on the best treatment choices for your dental 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 “Save a Tooth or Get an Implant?”
Professional Hockey player Keith Yandle is the current NHL “iron man”—that is, he has earned the distinction of playing in the most consecutive games. On November 23, Yandle was in the first period of his 820th consecutive game when a flying puck knocked out or broke nine of his front teeth. He returned third period to play the rest of the game, reinforcing hockey players’ reputation for toughness. Since talking was uncomfortable, he texted sportswriter George Richards the following day: “Skating around with exposed roots in your mouth is not the best.”
We agree with Yandle wholeheartedly. What we don’t agree with is waiting even one day to seek treatment after serious dental trauma. It was only on the following day that Yandle went to the dentist. And after not missing a game in over 10 years, Yandle wasn’t going to let a hiccup like losing, breaking or cracking nearly a third of his teeth interfere with his iron man streak. He was back on the ice later that day to play his 821st game.
As dentists, we don’t award points for toughing it out. If anything, we give points for saving teeth—and that means getting to the dentist as soon as possible after suffering dental trauma and following these tips:
- If a tooth is knocked loose or pushed deeper into the socket, don’t force the tooth back into position.
- If you crack a tooth, rinse your mouth but don’t wiggle the tooth or bite down on it.
- If you chip or break a tooth, save the tooth fragment and store it in milk or saliva. You can keep it against the inside of your cheek (not recommend for small children who are at greater risk of swallowing the tooth).
- If the entire tooth comes out, pick up the tooth without touching the root end. Gently rinse it off and store it in milk or saliva. You can try to push the tooth back into the socket yourself, but many people feel uneasy about doing this. The important thing is to not let the tooth dry out and to contact us immediately. Go to the hospital if you cannot get to the dental office.
Although keeping natural teeth for life is our goal, sometimes the unexpected happens. If a tooth cannot be saved after injury or if a damaged tooth must be extracted, there are excellent tooth replacement options available. With today’s advanced dental implant technology, it is possible to have replacement teeth that are indistinguishable from your natural teeth—in terms of both look and function.
And always wear a mouthguard when playing contact sports! A custom mouthguard absorbs some of the forces of impact to help protect you against severe dental injury.
If you would like more information about how to protect against or treat dental trauma or about replacing teeth with dental implants, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dental Implants: A Tooth-Replacement Method That Rarely Fails” and “The Field-Side Guide to Dental Injuries.”
Boston Bruins defenseman Zdeno Chara had a rough Stanley Cup final against the St. Louis Blues this past June. Not only did the Bruins ultimately lose the championship, but Chara took a deflected puck shot to the face in Game Four that broke his jaw.
With the NHL season now over, the 42-year-old Bruins captain continues to mend from his injury that required extensive treatment. His experience highlights how jaw fractures and related dental damage are an unfortunate hazard in hockey—not only for pros like Chara, but also for an estimated half million U.S. amateurs, many in youth leagues.
Ice hockey isn't the only sport with this injury potential: Basketball, football (now gearing up with summer training) and even baseball players are also at risk. That's why appropriate protective gear like helmets and face shields are key to preventing injury.
For any contact sport, that protection should also include a mouthguard to absorb hard contact forces that could damage the mouth, teeth and gums. The best guards (and the most comfortable fit) are custom-made by a dentist based on impressions made of the individual's mouth.
But even with adequate protection, an injury can still happen. Here's what you should do if your child has an injury to their jaw, mouth or teeth.
Recognize signs of a broken jaw. A broken jaw can result in severe pain, swelling, difficulty speaking, numbness in the chin or lower lip or the teeth not seeming to fit together properly. You may also notice bleeding in the mouth, as well as bruising under the tongue or a cut in the ear canal resulting from jawbone movement during the fracture. Get immediate medical attention if you notice any of these signs.
Take quick action for a knocked-out tooth. A tooth knocked completely out of its socket is a severe dental injury. But you may be able to ultimately save the tooth by promptly taking the following steps: (1) find the tooth and pick it up without touching the root end, (2) rinse it off, (3) place it back in its socket with firm pressure, and (4) see a dentist as soon as possible.
Seek dental care. Besides the injuries already mentioned, you should also see a dentist for any moderate to severe trauma to the mouth, teeth and gums. Leading the list: any injury that results in tooth chipping, looseness or movement out of alignment.
Even a top athlete like Zdeno Chara isn't immune to injury. Take steps then to protect your amateur athlete from a dental or facial injury.
If you would like more information about dealing with sports-related dental injuries, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Athletic Mouthguards” and “The Field-Side Guide to Dental Injuries.”
Other than tooth decay, children don't encounter dental disease to the extent adults do. But injuries are another story: More than 5 million teeth are knocked loose each year, and a high percentage involve children. Roughly a third of these and similar children's injuries are sports-related.
April is National Facial Protection Month: Several oral and facial health organizations, including the American Association of Orthodontists, have joined together to raise awareness about the risks of injury to the face and mouth, especially among children. Many of these injuries have long-term consequences with lifetime treatment costs in the thousands of dollars.
But as the name implies, this awareness month is also about protection—what you can do to help your child avoid a costly and devastating dental injury. Top of the list: Have your child wear an athletic mouthguard during all contact sports activities (including practices).
The National Federation of State High School Associations mandates mouthguard wear for football, lacrosse, and ice and field hockey. But those aren't the only sporting activities where a mouthguard should be standard equipment: In fact, basketball has more orofacial injuries each year than any other sport. Generally, mouthguards should be worn for any sports activity that involves potential contact with other players or objects.
There is a variety of mouthguard choices, but most fall into two basic categories, “boil and bite” and custom-made. The former, readily available in retail sports stores, get their name from the procedure employed when first purchased to adjust their fit to an individual player. Out of the package, they should be soaked in hot or boiling water until softened, and then placed in the wearer's mouth to bite down on. After they cool, they'll retain that bite pattern.
Boil and bite guards are relatively inexpensive, but the fit isn't as precise as a mouthguard that is custom-made by a dentist. This can lead to comfort issues—and players are less likely to wear an uncomfortable mouthguard.
Custom mouthguards, on the other hand, have a more accurate fit, allowing them to be thinner and more comfortable. They also provide the highest level of protection against blows to the face and mouth. These are more costly than boil and bite guards, and younger athletes may need a replacement every few years to accommodate jaw growth development. But compared to the physical, emotional and financial cost of a dental injury, custom mouthguards are worth the investment.
A mouth or face injury can happen in an instant and result in damage that can have lingering effects for years. For the best protection, see that your star athlete has and wears a custom mouthguard.