Do you wake up in the morning still feeling tired? Are you drowsy, irritable or have difficulty concentrating? And is your snoring habit a running joke around your household?
If you mostly answered yes, you may have obstructive sleep apnea (OSA). This condition is more than an irritation—it could also have major health implications if not addressed.
OSA occurs when the airway becomes temporarily blocked during sleep. The tongue (or other mouth structures like tonsils or the uvula) is often the cause as it relaxes and covers the back of the throat. Although you’re asleep, the brain notices the drop in oxygen and initiates arousal to unblock the airway. As this action usually only takes a few seconds, you may not fully awake every time; but because it can occur several times a night, it can rob you of the deep sleep you need for well-being.
If you’re diagnosed with OSA, your doctor may recommend continuous positive airway pressure therapy (CPAP). This treatment uses a pump device to supply continuous pressurized air through a hose connected to a face mask worn during sleep. The elevated pressure helps keep the airway open.
While this approach is quite effective, many people find wearing the equipment uncomfortable or confining, and may choose not to use it. If that describes you, a qualified dentist may be able to provide you with an alternative called oral appliance therapy (OAT).
OAT uses a custom-made plastic oral appliance you wear while you sleep. The most common snaps over the teeth and uses a hinge mechanism to move the lower jaw (and the tongue with it) forward.
OAT is recommended for people with mild to moderate OSA, or those with severe symptoms who can’t tolerate CPAP. If you’d like to see if an OAT appliance could help you, contact us for a complete oral examination. Either treatment can improve your sleep and daily lifestyle, as well as help prevent certain health issues in the future.
If you would like more information on treatments for 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 “Oral Appliances for Sleep Apnea.”
Teeth lost to tooth decay can have devastating consequences for a child’s dental health. Not only can it disrupt their current nutrition, speech and social interaction, it can also skew their oral development for years to come.
Fortunately, we have a number of preventive tools to curb decay in young children. One of the most important of these, dental sealants, has been around for decades. We apply these resin or glass-like material coatings to the pits and crevices of teeth (especially molars) to help prevent the buildup of bacterial plaque in areas where bacteria tend to thrive.
Applying sealants is a simple and pain-free process. We first brush the coating in liquid form onto the teeth’s surface areas we wish to protect. We then use a special curing light to harden the sealant and create a durable seal.
So how effective are sealants in preventing tooth decay? Two studies in recent years reviewing dental care results from thousands of patients concluded sealants could effectively reduce cavities even four years after their application. Children who didn’t receive sealants had cavities at least three times the rate of those who did.
Sealant applications, of course, have some expense attached to them. However, it’s far less than the cost for cavity filling and other treatments for decay, not to mention future treatment costs resulting from previous decay. What’s more important, though, is the beneficial impact sealants can have a child’s dental health now and on into adulthood. That’s why sealants are recommended by both the American Dental Association and the American Academy of Pediatric Dentistry.
And while sealants are effective, they’re only one part of a comprehensive strategy to promote your child’s optimum dental health. Daily brushing and flossing, a “tooth-friendly” diet and regular dental cleanings and checkups are also necessary in helping to keep your child’s teeth healthy and free of tooth decay.
While crooked teeth are usually responsible for a malocclusion (poor bite), the root cause could go deeper: a malformed maxilla, a composite structure composed of the upper jaw and palate. If that’s the case, it will take more than braces to correct the bite.
The maxilla actually begins as two bones that fit together along a center line in the roof of the mouth called the midline suture, running back to front in the mouth. The suture remains open in young children to allow for jaw growth, but eventually fuses during adolescence.
Problems arise, though, when these bones don’t fully develop. This can cause the jaw to become too narrow and lead to crowding among the erupting teeth and a compromised airway that can lead to obstructive sleep apnea. This can create a cross-bite where the upper back teeth bite inside their lower counterparts, the opposite of normal.
We can remedy this by stimulating more bone growth along the midline suture before it fuses, resulting in a wider maxilla. We do this by installing a palatal expander, an appliance that incrementally widens the suture to encourage bone formation in the gap, which over time will widen the jaw.
An expander is a metal device with “legs” extending out on both sides and whose ends fit along the inside of the teeth. A gear mechanism in the center extends the legs to push against the teeth on both sides of the jaw. Each day the patient or caregiver uses a key to give the gear a quarter turn to extend the legs a little more and widen the suture gap. We remove the expander once the jaw widens to the appropriate distance.
A palatal expander is an effective, cost-efficient way to improve a bite caused by a narrow jaw, but only if attempted before the bones fuse. Widening the jaw after fusion requires surgery to separate the bones — a much more involved and expensive process.
To make sure your child is on the right track with their bite be sure to see an orthodontist for an evaluation around age 6. Doing so will make it easier to intervene at the proper time with treatments like a palatal expander, and perhaps correct bite problems before they become more expensive to treat.
If you would like more information on treating malocclusions, 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 “Palatal Expanders: Orthodontics is more than just Moving Teeth.”
Mayim Bialik has spent a good part of her life in front of TV cameras: first as the child star of the hit comedy series Blossom, and more recently as Sheldon Cooper’s love interest — a nerdy neuroscientist — on The Big Bang Theory. (In between, she actually earned a PhD in neuroscience from UCLA…but that’s another story.) As a child, Bialik had a serious overbite — but with all her time on camera, braces were just not an option.
“I never had braces,” she recently told Dear Doctor – Dentistry & Oral Health magazine. “I was on TV at the time, and there weren’t a lot of creative solutions for kids who were on TV.” Instead, her orthodontist managed to straighten her teeth using retainers and headgear worn only at night.
Today, there are several virtually invisible options available to fix orthodontic issues — and you don’t have to be a child star to take advantage of them. In fact, both children and adults can benefit from these unobtrusive appliances.
Tooth colored braces are just like traditional metal braces, with one big difference: The brackets attached to teeth are made from a ceramic material that blends in with the natural color of teeth. All that’s visible is the thin archwire that runs horizontally across the teeth — and from a distance it’s hard to notice. Celebs like Tom Cruise and Faith Hill opted for this type of appliance.
Clear aligners are custom-made plastic trays that fit over the teeth. Each one, worn for about two weeks, moves the teeth just a bit; after several months, you’ll see a big change for the better in your smile. Best of all, clear aligners are virtually impossible to notice while you’re wearing them — which you’ll need to do for 22 hours each day. But you can remove them to eat, or for special occasions. Zac Efron and Katherine Heigl, among others, chose to wear clear aligners.
Lingual braces really are invisible. That’s because they go behind your teeth (on the tongue side), where they can’t be seen; otherwise they are similar to traditional metal braces. Lingual braces are placed on teeth differently, and wearing them often takes some getting used to at first. But those trade-offs are worth it for plenty of people. Which celebs wore lingual braces? Rumor has it that the list includes some top models, a well-known pop singer, and at least one British royal.
So what’s the best way to straighten your teeth and keep the orthodontic appliances unnoticeable? Just ask us! We’d be happy to help you choose the option that’s just right for you. You’ll get an individualized evaluation, a solution that fits your lifestyle — and a great-looking smile!
For more information about hard-to-see (or truly invisible) orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Orthodontics for the Older Adult” and “Clear Aligners for Teenagers.”
Not long ago the dental bridge was the alternative treatment of choice to partial dentures for restoring lost teeth. Over the last few decades, however, dental implants have nudged bridgework out of this premier spot.
That doesn’t mean, though, that bridgework has gone the way of the horse and buggy. In fact, it may still be a solid restorative alternative to partial dentures for certain people.
A traditional bridge consists of a series of porcelain crowns affixed to each other like pickets in a fence. The end crowns are fitted onto the teeth on either side of the empty tooth space; known as abutment teeth, they support the bridge. The crowns in the middle, known as pontics (from the French for “bridge”), replace the teeth that have been lost.
Bridges have been an effective and cosmetically pleasing method for tooth replacement for nearly a century. To achieve those results, though, a good portion of the abutment teeth’s structure must be removed to accommodate the crowns. This permanently alters these teeth, so they’ll require a restoration from that point on.
Dental implants, on the other hand, can be installed in the missing space without impacting any neighboring teeth. What’s more, implants provide greater support to the underlying bone than can be achieved with bridgework.
But not everyone is a viable candidate for implants, and ironically the reason most often has to do with the bone. If a patient has suffered significant bone volume loss, either because of disease or the long-term absence of the natural teeth, there may not be enough bone to properly support an implant. Unless we can adequately restore this lost bone volume through grafting, we’ll need to consider another type of restoration.
That’s where bridgework could be a viable option for patients in this or similar situations. With continuing advances in materials and new applications, the traditional bridge still remains an effective and important means to restore a smile marred by missing teeth.
If you would like more information on dental restoration options, 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 “Crowns & Bridgework.”
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