Snoring & Sleep Apnea: How a Dental Appliance Can Help

A person who has sleep apnea stops breathing for ten or more seconds while sleeping, then wakes enough to start breathing again and falls back asleep. This can happen as many as 60 times a night. It's a problem because sleep isn’t simply a blackout: it runs in cycles of lighter and deeper sleep, which are disrupted when breathing stops. Someone suffering from sleep apnea can be in bed for 8 hours but wake up exhausted, because of the frequent disruption of his or her sleep cycles.

If someone who sleeps with or near you has sleep apnea, you’ll probably hear loud snoring, then an abrupt silence, then a snorting or choking sound as the person starts breathing again. On the other hand, if you’re the one with the problem you may not realize it: people with this sleep disorder often don’t remember waking up in the night. You will nevertheless feel the effects of lack of sleep, which include morning headaches, excessive sleepiness during the day, and irritability. Left untreated, sleep apnea can make you unable to function well during the daytime and can lead to high blood pressure, heart attack, or stroke.

The way to find out if you have sleep apnea is to visit a physician specializing in sleep disorders, who will make a diagnosis based on your medical history, a physical examination, and an overnight sleep study to find out the number of times your sleep is interrupted during the course of a night.

How is sleep apnea treated? That depends on the reasons for the apnea. The milder form—fortunately also the most common— is obstructive apnea, in which the muscles of the throat relax so much that the airway collapses. Your physician may suggest not sleeping on your back, losing weight, or quitting smoking. For some, a simple dental appliance that repositions the lower jaw and tongue may be all that's needed. This same dental appliance is, incidentally, used to prevent or lessen snoring.

Sleep apnea is a condition that must be diagnosed by a physician, not a dentist. If a physician confirms that you have the problem, or if you snore and want to stop, I’ll be happy to make a custom-fitted dental appliance and adjust the fit to make it work as effectively as possible.

If you have general questions about dentistry that you'd like to see addressed on this blog, feel free to email me at sdurante@earthlink.net . The information on this blog is presented for general education only: consult a dentist for advice on specific problems, diagnoses and treatment.

 

 

 

Why Replace a Lost Tooth?

The obvious reason to replace a lost tooth is so you can eat as efficiently as you did previously. If you lose one of your molars, you lose the chewing area between it and the corresponding molar above it: a quarter of your chewing surface. If you lose a canine, you’ll have to tear at that beef jerky with the other side of your mouth.

Besides the loss of function, there is the fact that your other teeth may shift to fill in the gap: that’s what usually happens. Of course, statistics don’t determine what will occur in your particular case, but there’s a reason for the statistics. Teeth push and lean against each other, both within the same arch and from the opposing arch (that is, your upper and lower teeth). If the lost tooth is “missed” by the adjacent teeth or opposing teeth, the teeth that remain will shift until the forces are in balance again. The results of that are unpredictable. Molars may end up not meeting the opposing molars as neatly. New gaps between teeth can become traps for food particles, leading to tooth decay and gum disease, hence to loss of more teeth.

 The most common ways to fill spaces left by missing teeth are bridges and implants. These have different maintenance requirements from your own teeth, but the amount of time you need to maintain them is small, compared to the number of times you probably use the teeth in a day. If you’re a candidate for either one, we can discuss which is best suited to you.

 If you have general questions about dentistry that you'd like to see addressed on this blog, feel free to email me at sdurante@earthlink.net. The information on this blog is presented for general education only: consult a dentist for advice on specific problems, diagnoses and treatment.

Air Abrasion

There ought to be a more attractive name for air abrasion: it sounds a scrape, but in fact it’s the most wonderful invention in decades for patients who hate dental drills. And that would be about 100% of the patients I’ve seen in my 25 years of practice.

Air abrasion uses a fine stream of aluminum oxide to scour away decay. Think of it as a sandblaster geared to the scale of an ant: it’s extremely small and precise. When I use air abrasion, I usually don’t have to give you an anesthetic injection (no needle!), and you can eat or drink as soon as the filling is set, without worrying about whether your numb lip is hanging down to your chin.

Air abrasion is also much quieter than drilling and produces no vibration. The worst that can be said about it is that it produces a fine dust, which I mostly vacuum away as I work. Whatever isn’t vacuumed out, you simply rinse out with water. In the 12 years I’ve been using this technique, not a single patient has said he wished I'd used the drill.

What’s the catch? Air abrasion usually can only be done on cavities that are not already causing pain. I’m able to use air abrasion on more than half the cavities I treat. You can increase your chances of being treated with air-abrasion by having regular check-ups, so that we catch and treat cavities early.

If you have general questions about dentistry that you'd like to see addressed on this blog, feel free to email me at sdurante@earthlink.net . The information on this blog is presented for general education only: consult a dentist for advice on specific problems, diagnoses and treatment.

 

 

 

Dental Check-Ups: How Often Should You Have One?

The standard recommendation for dental check-ups is every six months. Why? Because in 6 months, a new cavity is less likely to eat through the tooth into the nerve, causing you serious pain. Also, if you have your teeth professionally cleaned every six months, it's less likely that plaque and tartar will cause gum disease.

That said, 6 months is an average. Several factors affect how often you, as an individual, should have a routine check-up.

1. Dental hygiene

Are you diligent about brushing and flossing? Cavities are caused by bacteria feasting on the sugars in food remnants. If you brush and floss every 24 hours or so, fewer food particles and bacteria will be there to cause damage. As you get older, you may have to up your dental-hygiene routine. For example, if your gums are receding or your teeth have become crooked, there may be new places vulnerable to cavities that need to be carefully cleaned.

My family uses a toothpaste that has prescription-strength fluoride and an electric toothbrush that runs for two minutes and beeps at 30-second intervals, to tell the user when to start brushing a new section of the mouth. I also floss with dental tape rather than plain floss (round in cross-section). If you want, ask me for the latest name-brand recommendations when you come for your check-up; they change too often to put up on the web.

2. Heredity

All teeth are not created equal. Some people are born with grooves in their molars that are too narrow for toothbrush bristles to reach into. If you have that sort of teeth, minute food particles will get stuck there even if you brush and floss meticulously, and it's likely that you’ll eventually develop cavities in your molars. Catching such cavities sooner rather than later will prevent pain and help preserve your natural teeth.

3. Food & Drink

As I mentioned in the post on sealants, the absolute worst thing for your teeth is food or drink that’s full of sugar, and that stays in your mouth a long time or that you munch for hours on end. Unless you buy sugar-free versions, all the following can have significant amounts of sugar:

• Sodas
• Fruit juice
• Lollipops, boxes of M&Ms, breath mints
• Cough drops
• Hostess Twinkies and similar snacks

The list of ingredients on packaged food is given in order from the most prevalent to the least. If one of the first 3 ingredients is sugar, corn syrup, fructose, or dextrose, I don’t buy it as a snack and we don’t keep it in the house. An exception now and then (at a party or at a friend’s, for example) won’t have a big effect if you avoid sugars most of the time.

You probably know if you’re cavity prone for any of the above reasons. If you don’t, ask me to tell you based on your existing records, and we’ll talk about how often you should come in for check-ups.

The money spent on check-ups is considerably less than the cost of filling major cavities. And one of the great benefits of catching cavities early—before they become too expansive—is that they can be fixed with a relatively new technique, air abrasion. Air abrasion involves no needles and no numbness. More on that in a future post, or read the Academy of General Dentistry’s description here.

 If you have general questions about dentistry that you'd like to see addressed on this blog, feel free to email me at sdurante@earthlink.net . The information on this blog is presented for general education only: consult a dentist for advice on specific problems, diagnoses and treatment.