Posts for: September, 2019
Fatigue, a “foggy” mind, and irritability are all signs you’re not getting enough sleep—and neither might your sleeping partner from your continuous snoring. You might have a common form of sleep-related breathing disorder (SRBD) known as obstructive sleep apnea.
Sleep apnea occurs when the airway becomes obstructed (usually by the tongue), resulting in a lack of oxygen. The body rouses from sleep just enough to correct the obstruction. This can occur and interrupt deep sleep several times a night, causing the aforementioned problems as well as personality changes, high blood pressure or increased stomach acid reflux. If the problem persists, sleep apnea could also become a long-term factor in the development of heart disease, diabetes or other serious conditions.
Fortunately, we can do something about it. While some may require more invasive intervention, most cases of sleep apnea can be alleviated through continuous positive airway pressure (CPAP) therapy. In this therapy, an electrical pump supplies pressurized air into a face mask worn while sleeping. The increased air pressure helps to keep the airway open.
For some patients, however, CPAP can cause discomfort like claustrophobia, nasal congestion and dryness. If that’s a concern for you, you might want to consider an oral appliance provided by your dentist.
Customized to your own individual mouth contours, this appliance is usually a two-part hinged device that draws the lower jaw and the tongue forward to open the airway. Easily adjustable, these appliances are usually more comfortable to wear than a CPAP and don’t require electricity or have the attendant noise of a CPAP pump.
They do, however, have a few drawbacks: they can disrupt saliva flow, causing either too much or too little; they may result in some morning soreness; and they can stimulate unnecessary tooth or jaw movements. For most, though, these side effects are minor compared to a better night’s sleep.
If you suspect you may have some form of SRBD, you’ll need to have it confirmed through a physical examination and possibly sleep lab testing. If it is sleep apnea, your physician and dentist can work together to help you find the right therapy to regain the benefits of a good night’s sleep.
If you would like more information on 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.”
There are two basic facts about tooth decay: 1) next to the common cold, it’s the world’s most prevalent infectious disease; and 2) with modern dentistry, it’s preventable.
Getting from Fact 1 to Fact 2 requires the daily hygiene habits of brushing and flossing. You probably learned these tasks when you could barely peer over the bathroom sink; but the real question is: are you getting the most benefit from your efforts? It’s not merely doing them, but doing them the right way.
For example, bearing down on your teeth and brushing vigorously isn’t just unhelpful, it’s damaging. Instead, you should hold your brush with perhaps just two fingers at a 45-degree angle relative to your gum line and “gently” scrub with short circular or “wiggly” strokes. Continue this action around each arch brushing all tooth surfaces, which should take about two minutes.
Your toothbrush itself is also important: most people (unless otherwise directed by their dentist) should use a multi-tufted brush with soft bristles. If you brush with the proper pressure it should last 4 to 6 months before replacing it. You should also replace it if the bristles become worn or splayed.
Flossing once a day is important for removing the plaque between teeth your toothbrush bristles can’t reach. The best technique is to form a “C” with the floss that wraps around each tooth and move it up and down gently three or four times until you hear a squeaky clean sound on both sides of the tooth.
The ultimate test of your efforts comes during your regular dental checkups. You can get a check now, though, on how you’re doing by using your tongue to feel your teeth at the gum line. If they feel smooth and slick, you’re probably doing a good job of plaque removal; but if they feel a bit rough and gritty, you’re missing some of the plaque and need to be more thorough when brushing. You can also use floss by running it up and down the tooth surface — if it squeaks, they’re clean!
Your particular dental condition may require specific treatment or the use of other dental products like antibacterial mouthrinses. But learning and practicing proper brushing and flossing is key to keeping teeth and gums healthy and disease-free.
One of the most widely used forms of dental imaging is the bitewing x-ray. So called because of the shape of the device that holds the exposable film a patient clenches between their back teeth, the bitewing x-ray is an effective means for detecting the earliest stages of tooth decay.
These early signs are small lesions on a tooth surface caused by mineral loss in the enamel. While we can identify them on front teeth through visual examination or bright lighting, they’re nearly impossible to see on the biting surfaces of back teeth. The bitewing x-ray solves this problem.
During the procedure, a narrow beam of x-rays is directed at the back teeth area. Since X-rays can transmit through solid matter, they pass through the teeth and gums to expose the film attached to the bitewing assembly.
X-rays pass through matter at different rates depending on the density of the tissue — a slower rate for harder tissues like teeth and bone and a faster rate for soft tissues like the gums. As a result, x-rays through teeth expose less of the film and appear as a lighter image than the gums. This difference is so precise even a tooth’s softer dentin appears slighter darker than its harder outer enamel.
This precision helps us identify decay lesions. Because the lesions on the enamel are less dense than the normal enamel, they’ll appear as dark spots. By detecting them at this stage we have a better chance for reversing the effects of decay or at least minimizing damage that’s already occurred.
Because x-rays emit radiation, there’s a natural concern about over-exposure and we go to great lengths to reduce it. Children may undergo a bitewing x-ray twice a year for developing teeth, while adults with healthy teeth are typically x-rayed just once a year. Advances in digital film and other technology have also helped lower the exposure rate.
Today’s standard 4-film bitewing x-ray produces about four days worth of what we receive on average from normal background radiation, so the health risk is quite negligible. The benefit, on the other hand, is much greater — the early detection of tooth decay could ultimately save a tooth.