Posts for: August, 2018
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.”
While gum recession is a common occurrence related to aging, it’s not just an “old person’s disease.” It can happen to anyone, even someone with a relatively healthy mouth. And this detachment and shrinking back of the gums from the teeth may not be a minor problem—your dental health is definitely at risk.
Here then are 4 things you should know about gum recession, and what you can do about it.
The most common cause: periodontal (gum) disease. A bacterial infection triggered by built-up dental plaque, gum disease weakens the gums’ attachment to teeth that leads to recession. To help prevent it, clean away plaque with daily brushing and flossing and visit a dentist regularly for more thorough plaque removal. If you already have gum disease, prompt treatment could stop the infection and reduce any resulting damage including recession.
…But not the only one. There are other factors that contribute to recession besides disease. In fact, it could be the result of “too much of a good thing”—brushing too hard and too frequently can damage the gums and lead to recession. You might also be more susceptible to recession if you’ve inherited thin gum tissues from your parents. Thin gums are at increased risk of recession from both disease and over-aggressive hygiene.
Best outcomes result from treating gum disease and/or recession early. The earlier we detect and treat a gum problem, the better the outcome. See your dentist as soon as possible if you see abnormalities like swollen or bleeding gums or teeth that appear larger than before. Depending on your condition there are a number of treatment options like plaque removal or techniques to protect exposed teeth and improve appearance.
Grafting surgery could regenerate lost gum tissue. While with mild cases of gum recession the gums may respond well to treatment and actually rejuvenate on their own, that might not be possible with advanced recession. We may, however, still be able to restore lost tissue through grafting. Using one of a number of techniques, a graft of donor tissue can foster new replacement growth. It’s a meticulous micro-surgical approach, but it could be a viable answer to extreme gum recession.
If you would like more information on gum recession, 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 “Gum Recession.”
Teeth crowding is a difficult bite problem (malocclusion) that often involves the entire jaw structure to be evaluated. Normally occurring when the jaw doesn’t have adequate space for normal tooth eruption, teeth coming in later put pressure on other teeth, causing them to develop improperly.
Crowding also makes it difficult to realign teeth with braces because there’s simply not enough room for sufficient movement to take place. The solution may then be to consider the removal of some of the teeth to create enough space for orthodontic treatment.
Not just any tooth can be removed, however — we must first conduct a careful analysis to determine which can be removed to facilitate optimum movement of the remaining teeth without disrupting normal mouth function or affecting appearance. The teeth most frequently removed for this purpose are the bicuspids, located between the cuspids or eyeteeth (which are positioned directly under the eyes) and the molars, the largest teeth in the back of the mouth. Sometimes one premolar tooth on each side of the jaw can be removed without sacrificing future form or function.
There are a few important considerations we must keep in mind when extracting teeth for orthodontic reasons; perhaps the most important is preserving bone at the extraction site. Because continuing bone growth depends on the forces generated by teeth when we bite or chew, bone near a missing tooth socket will tend to diminish over time. If there’s insufficient bone during orthodontic treatment, it may result in gum recession and root exposure — not only damaging to the teeth themselves but also to a person’s smile appearance. To avoid this, we sometimes will consider inserting a bone graft, which will stimulate bone growth, into the empty socket immediately after extraction. While this isn’t commonly done, it’s being considered if the patient’s bone is thin and a concern during healing.
We must also consider how to accommodate other, unrelated tooth loss to assure the final result is visually appealing. It may be necessary in these cases to maintain the space at the missing tooth site for a future restoration once the orthodontics is completed. This takes planning as well as the use of restorations like dental implants, bridges or partial dentures.
Regardless of your bite issues, the field of orthodontics has the appliances and techniques to overcome even the most complicated condition. When necessary, using procedures like tooth extraction can help turn an unappealing, dysfunctional bite problem into a beautiful smile.
If you would like more information on orthodontic teeth extractions, 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 “Tooth Removal for Orthodontic Reasons.”