Posts for: September, 2018
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!”
Living here in Denver, we see a bit more central sleep apnea and other disorders related to our thin air. More can be said for people who go to the mountains. Many get "altitude sickness", but most have difficulty sleeping until they are acclimated. That can commonly be said for mountain climbers. Because sleep is altered at high altitude, many mountain climbers to use hypnotics to improve sleep efficiency.
But what does that do to alter their cognitive function? They constantly do early waking-up rituals on little sleep which could have residual adverse effects.
A study was recently done to see if zolpidem intake at high altitude would alter cognitive function 4 hours after drug intake.
It turns out that even though it did have an effect on sleep apnea, acute zolpidem intake at high altitude alters cognitive functions and postural control during early wakening which may be deleterious for safety and performances of climbers.
Question: What oral health issue do teenagers who wear orthodontic retainers and older folks who wear dentures have in common?
Answer: Both need to pay particular attention to cleaning their oral appliances.
The same goes for anyone who wears a nightguard to control tooth grinding, a mouthguard to protect teeth while playing sports, or a clear aligner for orthodontic treatment. Yet many people aren’t sure how to properly clean their appliances — so here are a few handy tips:
- Use toothpaste on your appliance — the ingredients in toothpaste, which are designed to polish the hard enamel of your teeth, are too abrasive for the soft plastic of oral appliances, and will cause scratches.
- Boil your appliance, or use bleach to clean it — both will end up breaking down and destroying the appliance. Don’t even use very hot water, as it can deform the plastic and make the appliance useless.
- Leave your appliance out on the nightstand, or anywhere else — pets and small children have been known to find (and destroy) oral appliances left lying around. Instead, store it properly in its special case.
- Use liquid dish detergent or hand soap to clean your appliance. A little mild soap plus warm water will do a great cleaning job. While you’re at it, get a brush just for the appliance — because, while it’s fine for plastic, you don’t want to brush your teeth with soap!
- Put a towel in the sink basin when you clean your appliance. Soapy appliances (especially dentures) can be slippery, and can be damaged by dropping — and that’s an expensive mishap.
- Consider investing in an ultrasonic cleaner. These inexpensive countertop devices are an excellent way to get the tiny ridges and crevices of your appliance really clean.
Whether you rely on dentures for everyday use, or just need to wear a retainer for a period of time, your oral appliance serves an important function. It may also represent a significant investment. That’s why it’s worthwhile to spend a few minutes each day giving these important items the care they need.
Children's permanent teeth normally erupt over several years after first forming below the gum line. All their permanent teeth should come in by the time they reach early adolescence.
Unfortunately, this process doesn't always happen as it should. If the erupting teeth become crowded due to a poor bite (malocclusion), teeth still to come in may not have enough room to fully erupt. They become impacted, a condition in which the visible crown remains partially or completely submerged below the gum line.
Impacted teeth create consequences for other teeth and dental health overall. They more readily cause abscesses (a localized infection within the gum tissue) and can damage the roots of nearby teeth. Impacted front canine (eye) teeth can interfere with bite function and their visual absence mars an otherwise attractive smile.
If your child's canine teeth have failed to erupt properly, there is a way to help them fully come in if you act before their mouth structure fully matures. The first step is an orthodontic evaluation of their entire bite. This will determine if there's enough space to move other teeth to make room for the impacted canines.
If so, we would then find the exact position of the impacted teeth using x-rays and possibly cone beam CT scanning for a detailed three-dimensional image. The teeth could be in a variety of positions, such as angled toward the roof of the mouth or cheek or buried high in the jawbone. If the teeth are too far out of position the best course of action may be to remove them and replace them later with a dental implant.
If the impacted teeth, though, are in a feasible position for retrieval, we first expose each tooth through the gums with a minor surgical procedure and bond a small bracket to it. We then attach a small gold chain to the bracket that loops over an orthodontic appliance attached to other teeth. The appliance will exert pressure over several months to pull the tooth into proper position.
If successful, your child will gain the use of these important teeth and a more attractive appearance. But don't delay — this desired outcome will become much harder if not impossible to attain as their teeth and jaws continue to develop.
If you would like more information on treating impacted teeth, 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 “Exposing Impacted Canines.”