Fatigue, irritability and family complaints about snoring — all tell-tale signs you may have sleep apnea. There’s more to this condition than being grouchy the next day — the long-term effect could increase your risks for life-threatening diseases.
But how do you know if you actually have sleep apnea? And if you do, what can you do about it?
Undergo an exam by a physician trained in “sleep medicine.” Sleep apnea occurs when the airway becomes blocked while you sleep, dropping the body’s oxygen levels; your body awakens to re-open the airway. The event may only last a few seconds, but it can occur several times a night. Even so, sleep apnea is one potential cause among others for snoring or fatigue. To know for sure if you have sleep apnea you’ll need to undergo an examination by a physician trained to diagnose this condition. He or she may then refer you to a dentist to make a sleep appliance if you have mild to moderate apnea.
Determine the level of your apnea’s intensity. Not all cases of sleep apnea are equal — they can range in cause and intensity from mild to advanced, the latter a reason for concern and focused intervention. Your physician may use different methods for determining the intensity of your case: review of your medical history, examining the structures within your mouth or having your sleep observed directly at a sleep lab. Getting the full picture about your sleep apnea will make it easier to develop a treatment plan.
Match the appropriate treatment to your level of sleep apnea. If you have moderate to advanced apnea, you may benefit from continuous positive airway pressure (CPAP) therapy, an electrical pump that delivers pressurized air through a mask worn while you sleep that gently forces the airway open. It’s quite effective, but uncomfortable to wear for some people. Advanced cases may also require surgery to alter or remove soft tissue obstructions. If, you have mild to slightly moderate apnea, though, your dentist may have the solution: a custom-fitted mouth guard that moves the tongue, the most common airway obstruction, down and away from the back of the throat.
If you suspect you may have sleep apnea, see a trained physician for an examination. It’s your first step to a good night’s sleep and better overall health.
If you would like more information on sleep apnea treatments, 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 “If You Snore, You Must Read More!”
While most dental problems are caused by disease or trauma, sometimes the root problem is psychological. Such is the case with bulimia nervosa, an eating disorder that could contribute to dental erosion.
Dental erosion is the loss of mineral structure from tooth enamel caused by elevated levels of acid in the mouth, which can increase the risk for decay and eventual tooth loss. While elevated acid levels are usually related to inadequate oral hygiene or over-consumption of acidic foods and beverages, the practice of self-induced vomiting after food binging by bulimic patients may also cause it. Some of the strong stomach acid brought up by vomiting may remain in the mouth afterward, which can be particularly damaging to tooth enamel.
It’s often possible to detect bulimia-related erosion during dental exams. The bottom teeth are often shielded by the tongue during vomiting, so erosion may be more pronounced on the unshielded upper front teeth. The salivary glands may become enlarged, giving a puffy appearance to the sides of the face below the ears. The back of the mouth can also appear red and swollen from the use of fingers or objects to induce vomiting.
Self-induced vomiting may not be the only cause for dental erosion for bulimics. Because the disorder causes an unhealthy focus on body image, bulimics may become obsessed with oral hygiene and go overboard with brushing and flossing. Aggressive brushing (especially just after throwing up when the tooth enamel may be softened) can also damage enamel and gum tissue.
Treatment must involve both a short — and long-term approach. Besides immediate treatment for dental erosion, a bulimic patient can minimize the effect of acid after vomiting by not brushing immediately but rinsing instead with water, mixed possibly with a little baking soda to help neutralize the acid. In the long-term, though, the eating disorder itself must be addressed. Your family doctor is an excellent starting point; you can also gain a great deal of information, both about eating disorders and treatment referrals, from the National Eating Disorders Association at their website, www.nationaleatingdisorders.org.
The effects of bulimia are devastating to mental and physical well-being, and no less to dental health. The sooner the disorder can be treated the better the person’s chance of restoring health to their mind, body — and mouth.
If you would like more information on the effect of eating disorders on 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 “Bulimia, Anorexia & Oral Health.”
When is the best time to floss your teeth: Morning? Bedtime? How about: whenever and wherever the moment feels right?
For Cam Newton, award-winning NFL quarterback for the Carolina Panthers, the answer is clearly the latter. During the third quarter of the 2016 season-opener between his team and the Denver Broncos, TV cameras focused on Newton as he sat on the bench. The 2015 MVP was clearly seen stretching a string of dental floss between his index fingers and taking care of some dental hygiene business… and thereby creating a minor storm on the internet.
Inappropriate? We don't think so. As dentists, we're always happy when someone comes along to remind people how important it is to floss. And when that person has a million-dollar smile like Cam Newton's — so much the better.
Of course, there has been a lot of discussion lately about flossing. News outlets have gleefully reported that there's a lack of hard evidence at present to show that flossing is effective. But we would like to point out that, as the saying goes, “Absence of evidence is not evidence of absence.” There are a number of reasons why health care organizations like the American Dental Association (ADA) still firmly recommend daily flossing. Here are a few:
- It's well established that when plaque is allowed to build up on teeth, tooth decay and gum disease are bound to follow.
- A tooth brush does a good job of cleaning most tooth surfaces, but it can't reach into spaces between teeth.
- Cleaning between teeth (interdental cleaning) has been shown to remove plaque and food debris from these hard-to-reach spaces.
- Dental floss isn't the only method for interdental cleaning… but it is recognized by dentists as the best way, and is an excellent method for doing this at home — or anywhere else!
Whether you use dental floss or another type of interdental cleaner is up to you. But the ADA stands by its recommendations for maintaining good oral health: Brush twice a day for two minutes with fluoride toothpaste; visit your dentist regularly for professional cleanings and checkups; and clean between teeth once a day with an interdental cleaner like floss. It doesn't matter if you do it in your own home, or on the sidelines of an NFL game… as long as you do it!
In October, the American Dental Hygienists’ Association sponsors National Dental Hygiene Month to remind everyone that having good oral health is directly related to practicing good oral hygiene at home. This includes brushing twice each day with fluoride toothpaste and flossing at least once per day. But sometimes we forget that dental hygiene applies not just to your teeth but also to anything you regularly wear in your mouth. This includes removable dentures (full or partial), clear aligners, nightguards, mouthguards and retainers. If you (or your kids, or seniors you know) wear any of these, please review the three appliance-care tips below.
1. CLEAN IT. Just like natural teeth, an oral appliance worn every day needs daily brushing. But toothpaste isn’t an appropriate cleanser for these devices; it’s too abrasive. The grainy particles it contains are great for scrubbing plaque and bits of food from the hard enamel coating of teeth—but they can actually leave little nicks in the plastic of your oral appliance, creating areas for bacteria to hide. This can eventually cause odors and stains. Instead, clean appliances with liquid dish soap or denture paste. Buy a separate brush for your appliance—don’t use the same one that you use on your teeth. It can be a very soft regular toothbrush, nail brush or denture brush.
2. RINSE IT. After cleaning your appliance, rinse it thoroughly. But don’t use hot water—and never boil an oral appliance to sterilize it! Your device was custom-made for your mouth, and it needs to fit precisely to do its job. Hot water can warp the appliance and change the fit, possibly rendering it useless or even harmful. For example, a warped orthodontic aligner might not move teeth into the correct position. Remember: the goal is to kill bacteria, not your appliance!
3. STORE IT. Keep your appliance in a safe place—away from curious pets and toddlers. When you are not wearing it or cleaning it, your device should be packed away in its case or soaking overnight in water or a cleaning solution according to your original instructions.
If you have any questions about oral appliance care or oral hygiene, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “10 Tips for Cleaning Your Oral Appliance” and “10 Tips for Daily Oral Care at Home.”
Along with thumb sucking, childhood teeth grinding is one of the top concerns anxious parents bring to their dentists. It’s so prevalent, though, many providers consider it normal behavior—the sleep-disturbing sound it can generate is often the worst consequence for the habit.
But that doesn’t mean you should brush aside all concern, especially if the habit continues into late childhood. Long-term teeth grinding could eventually damage the teeth and gums.
Teeth grinding (or clenching) is the involuntary movement of the jaws when not engaged in normal functions like chewing, speaking or swallowing. The action often produces higher than normal chewing forces, which over time can accelerate tooth wear, cause fractures, or contribute to loose teeth, all of which could increase the risk of dental disease. While it can occur at any time it’s most common among children during nighttime sleep.
While stress is the usual trigger for teeth grinding in adults, with young children the causes for the habit are more complex and less understood. Most doctors hold to the theory that most pediatric teeth grinding arises during shifts from lighter to heavier, rapid-eye-movement (REM) sleep. The child’s immature neuromuscular chewing control may engage involuntarily during this shift. Teeth grinding is also prevalent among children who snore or mouth-breathe, or who take anti-depressant medication.
But as mentioned before, there’s usually no cause for concern unless the habit persists beyond about age 11. If the habit isn’t fading, you should speak to your dentist about ways to reduce it or its effects. One way is with a custom-made night guard worn during sleep. The smooth, plastic surface of the appliance prevents teeth from making solid contact with each other during a grinding episode.
You might also seek treatment from an ear, nose and throat (ENT) specialist if your child is having issues with airway obstruction, which could also relieve teeth grinding. And children experiencing stressful situations or events may find relief both emotionally and physically from psychological therapy.
At younger ages, you can safely regard your child’s grinding habit as normal. But if it persists, it’s worth looking for ways to reduce it.
If you would like more information on your child’s teeth grinding habit, 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 “When Children Grind Their Teeth: Is the Habit of ‘Bruxism’ Harmful?”
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