Posts for: March, 2012
Getting enough sleep is necessary for good health. We all know how energetic we feel when we are sleeping well at night. Yet, many of us do not feel rested, even after seven or eight hours of sleep. Let's answer some common questions about snoring and sleep apnea, problems that are often called sleep related breathing disorders (SRBD).
What is the purpose of sleep?
Scientists know we need sleep, at a particularly deep level, to be rested, but they are not sure why we need sleep. Sleep may have evolved as a way to conserve energy in the body, to conserve food supplies, or to reduce our risk during darkness. Sleep appears to give the brain a chance to store and organize its information and the body a chance to recuperate. Sleep studies have shown that in order to get the full benefits of sleep we need to sleep long and deeply enough to enter into a series of sleep cycles including Rapid Eye Movement (REM) and Non-Rapid Eye Movement (NREM) sleep.
What kinds of problems get in the way of the type of sleep we need?
There are eight main categories of sleep disorders, but the ones affecting the largest numbers of people are insomnia, SRBD, and Circadian Rhythm Sleep Disorders. SRBDs include snoring and Obstructive Sleep Apnea (OSA), which is a serious health problem.
How do I know if I have OSA or another SRBD?
Often, your bed-partner will tell you that you snore. Chronic loud snoring is an indicator of OSA. To make a diagnosis your physician must take a thorough sleep and medical history. The diagnosis may then be confirmed by a study in a sleep lab.
What causes sleep apnea or OSA?
Snoring and OSA happen when your tongue and other soft tissues in the back of your throat collapse backwards and block airflow through your upper airway or windpipe. You may briefly awaken as many as 50 times per night because of these breathing lapses. These brief awakenings, called micro-arousals, keep you from reaching the deep stage of sleep your body needs.
What are the treatments for sleep apnea?
Treatments include CPAP therapy, in which patients wear a mask while sleeping. The mask pushes air through the airway, keeping it open. In Oral Appliance Therapy (OAT) patients wear a device that moves the lower jaw forward, allowing more room for air to move down the airway. Oral surgical procedures and orthodontic approaches also have the goal of moving the tongue away from the throat. These are all treatments that can be carried out by a dentist who has training and experience in treatment of sleep disorders.
Contact us today to schedule an appointment to discuss your questions about sleep disorders and their treatments. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Sleep Apnea Frequently Asked Questions.”
If you think your child is too young to need root canal treatment, think again — there is no age limit for this treatment. If his/her primary (baby) teeth have been injured, or if decay has advanced deep into the roots of your child's teeth, a root canal treatment to stabilize teeth may be needed. Root canal treatment removes infection from the pulp, the living tissue that is found inside the tooth's roots. The pulp contains the tooth's nerves, so tooth pain is often an indication that decay has moved into the pulp.
When performing root canal treatment on primary teeth, we must keep in mind that the primary teeth's roots will be resorbed as part of the normal process in which the body makes room for the growing permanent teeth that will take their place.
If a child experiences tooth pain that is related to changes of temperature or pressure, or exposure to sweet or acidic foods, the infection is likely to be minor and easily repaired. But if he or she feels a constant or throbbing pain regardless of stimulation, it may indicate an extensive infection of the pulp and surrounding area.
If the infection is advanced, the baby tooth may have to be removed. But if baby teeth are lost prematurely, a malocclusion (from “mal” meaning bad and “occlusion” meaning bite) can easily result; so we make every effort to keep the baby teeth in place to guide the permanent teeth that are forming underneath them, inside the child's jaw. In such cases an endodontist (from the root “endo” meaning inside and “dont” meaning tooth) or pediatric dentist may perform root canal treatment, removing the diseased and infected pulp from within the tooth's roots and replacing it with a substance that can be absorbed when it is time for the baby tooth's roots to be resorbed naturally.
When baby teeth are injured through a fall or blow to the face (referred to as traumatic injury) they may develop discoloration varying from yellow to dark gray. This is a sign of damage to the pulp tissues inside the tooth's roots. Dark gray discoloration often indicates that the pulp tissues have died. In such cases root canal treatment is needed to remove the dead tissue. If a tooth is completely knocked out of the child's mouth, most dentists agree that it should not be replanted because of the risk of damage to the developing tooth underneath.
Root canal treatment for baby teeth is a better choice than tooth removal if at all possible. It helps a child retain full function of their teeth, jaws and tongue, preventing speech problems, and it helps guide the permanent teeth into their proper places.
Contact us today to schedule an appointment to discuss your questions about treatment for children's teeth. You can also learn more by reading the Dear Doctor magazine article “Root Canal Treatment for Children's Teeth.”
More than 2,000 years ago, an ancient Greek physician, Hippocrates, often called the father of Western medicine, devised a mouth rinse of herbs and wine to sweeten bad breath. This problem has been around a long time, and it is still a major problem for many people. According to some studies it is one of the three main reasons people seek dental treatment.
Here are some facts you may not know about bad breath:
- Bad breath is sometimes called halitosis, which comes from the Latin halitus (exhalation) and the Greek osis (a condition or disease-causing process).
- Chronic bad breath is usually caused by certain types of oral bacteria. These particular bacteria are present in about 25% of the population.
- Bad breath has spawned a major industry in the United States. Americans spend nearly three billion dollars a year on gum, mints, and mouth rinses to sweeten their breath. About 60% of women and 50% of men say they use breath freshening products.
- Diseases in the oral cavity such as tooth decay and periodontal (gum) disease can often cause bad breath. If either of these diseases are your cause for bad breath, treatment would be necessary to eliminate this problem.
- The tongue is the most common location for bad breath. Bacteria are relatively sheltered on the back of the tongue, where they live on remnants of food, dead skin cells and post-nasal drip. These bacteria can generate volatile sulfur compounds (VSCs) that are also found in decaying animal or vegetable matter. VSCs are known by an unpleasant rotten egg smell.
- Bad breath can also be caused by dry mouth (xerostomia). This condition affects millions of people and can result from smoking, alcohol or coffee drinking, and it is sometimes a side effect of medications. Another cause may be mouth breathing.
- Halitosis can also originate in other parts of the mouth besides the tongue. These include inter-dental (between teeth) and sub-gingival (under the gums) areas.
- When people are starving (and sometimes when they are dieting to lose weight), their bodies begin burning their fats causing their breath to develop the smell of ketones — which smell like acetone, similar to nail polish remover. If people are not eating or drinking the coating on their tongue increases as well, making VSCs more prominent.
At our office, we want to fight bad breath or halitosis by making sure our patients understand how to clean their teeth, gums, the back of the tongue, and dentures.
Dental implants are replacements for missing teeth. They are very stable and can be made to look as good as or better than the teeth they replace. How do we do it? Here are seven frequently asked questions.
What are the parts of a dental implant?
The implant consists of a root, usually made of a titanium alloy, which extends below the gum tissue into the bone; and a crown, which emerges from the gum and resembles the crown of the original tooth.
Why is a dental implant so stable?
Titanium has a property of fusing with the bone of the jaw, so that it actually becomes part of the bony structure. The new implant's stability depends on having the needed volume of bone and gum tissue in the right position to anchor the implant.
How can you make sure I have enough bone?
When a tooth is lost, the bone in which it was anchored will resorb or melt away if care is not taken. It is important to minimize trauma during tooth removal to preserve bone tissue. If tissue has been lost it can be built up by bone grafting techniques.
What factors make a crown on an implant look real?
How real the crown looks depends on its shape, particularly as it emerges through the gum tissues, its color and its position relative to the teeth around it.
What is the emergence profile?
This term refers to the way the crown emerges through the gum tissue. It involves both the shape of the implant and how far it is placed into the gum and bone tissues.
How do you match the color of the crown?
We analyze your tooth color using shade guides and/or photography to provide the dental lab with as much information as possible to create the best color match. This is part of the artistry of reconstructive dentistry.
How will my gums look with my dental implant in place?
When people use the word “gums” they are often referring to the small pink triangles of tissue that fill in the spaces between teeth, called “papillae.” An implant must be placed at the correct distance from adjacent teeth and at the correct depth below the gum tissue for natural looking papillae to form.
You can see that success in matching of color, shape, and location of an implant is not simple and depends on the skill, artistry, and experience of your dental team.
The best method for permanently replacing a missing tooth is with a dental implant. But did you know that there are two main techniques for placing implants? Implants can be placed either using a one stage or a two stage surgical technique, and as their names suggests, one is performed in one step while the other requires a second surgery.
With a one-stage procedure, a healing abutment is placed at the time of surgery. An abutment is a connector that attaches the implant from the bone into the mouth and which protrudes through the gum tissues. Following a 3 to 6 month healing period in which the implant fuses to the bone, a crown is then placed on the implant restoring the immediate appearance of a healthy, normal tooth. One-stage implant systems are generally used when the bone quality is good, guaranteeing good initial implant stability. They are also used when cosmetics is not a concern, such as the back areas of the mouth.
Under special conditions an implant can be placed and a crown placed on top of it at the same time. However, this is a very special circumstance requiring ideal conditions and surgical experience as well as crown fabrication know-how. It is generally safer and wiser not to subject an implant to biting forces until it is fully healed and integrated with the supporting bone.
A two-stage procedure is typically used for replacing teeth where there is no immediate need for a cosmetic solution and when more of a margin of safety is required. With this approach, the implant(s) are placed into the jawbone and the gum tissues cover them. They are not exposed to the mouth, but stay buried and left to heal. Once healed, a second surgery is performed to attach an abutment for securing the crown in place. This approach is used when there is poorer bone quality or quantity. This may make it necessary to regenerate bone around the implant at the time of its placement. There may also be other health considerations dictating that a two-stage approach may be indicated.
Depending on your individual situation and medical status, our implant team will determine which approach is best for you. To learn more about these two procedures, read the Dear Doctor article, “Staging Surgery In Implant Dentistry.” You are also welcome to contact us to discuss your questions or to schedule an appointment.