We all know how much better we feel after a good night’s sleep: refreshed, energized and ready to handle — even excel at — our day-to-day responsibilities. Yet millions of people, young and old, are robbed of a good night’s rest by sleep-related breathing disorders such as sleep apnea, in which the soft tissues in the back of the throat block the airway during sleep. This temporarily disrupts airflow, causing numerous “micro-arousals” (sleep interruptions) that we may not even be aware of. A lack of sleep can make us drowsy, irritable and unfocused. In children, these typical symptoms of sleep apnea can lead to mistaken diagnoses of Attention Deficit Hyperactivity Disorder (ADHD).
The relationship between sleep apnea and behavioral problems has been highlighted in several recent scientific journal articles, including a major study published several years ago in Pediatrics, the official journal of the American Academy of Pediatrics. The lead author, Dr. Karen Bonuck, said at the time: “We found that children with sleep-disordered breathing were from 40 to 100 percent more likely to develop neurobehavioral problems by age 7, compared with children without breathing problems. The biggest increase was in hyperactivity, but we saw significant increases across [other] behavioral measures.” Therefore, an accurate diagnosis of a child’s behavioral problems — leading to the right treatment — is crucial. While sleep apnea must be diagnosed by a physician, treatment for the condition is often provided by a dentist.
What can be done for children suffering from sleep apnea? The most common treatment is surgical removal of the tonsils or adenoids. This treatment can sometimes be performed by an oral and maxillofacial surgeon, a dentist who has received several years of post-graduate surgical training. There are several other procedures oral surgeons can perform to open the airway, depending on what anatomical structures are blocking it.
Sometimes a child with sleep apnea can benefit from a procedure to expand the palate (roof of the mouth) to enlarge the airway. This is not a surgical treatment but rather an orthodontic one. An orthodontist (a dentist who specializes in moving teeth) will fit the child with a palatal expander, a butterfly-shaped device that gradually separates the two bones that form the upper jaw and roof of the mouth. This is often done to prevent crowding of teeth and other bite problems, but has been shown in some cases to improve airflow.
There is another dental approach used to treat adults and older children, whose jaw growth is complete. It’s called oral appliance therapy, and it involves wearing a custom-made device during sleep that resembles a sports mouthguard or orthodontic retainer. An oral appliance can maintain an opened, unobstructed, upper airway during sleep in various ways, including: repositioning the lower jaw, tongue, soft palate and uvula; stabilizing the lower jaw and tongue; increasing the muscle tone of the tongue.
If your child has been diagnosed with sleep apnea, we can help you find the best treatment approach. For more information, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders & Dentistry” and “Snoring & Sleep Apnea.”
Multi-platinum recording artist Janet Jackson has long been known for her dazzling smile. And yet, Jackson admitted to InStyle Magazine that her trademark smile was once a major source of insecurity. The entertainer said, “To me, I looked like the Joker!” It was only after age 30 that the pop icon came to accept her unique look.
Jackson is not alone. A study commissioned by the American Association of Orthodontists found that more than one third of U.S. adults are dissatisfied with their smile. But there’s good news—modern dentistry can correct many flaws that can keep you from loving your smile, whether you’re unhappy with the color, size, or shape of your teeth. Here are some popular treatments:
Professional teeth whitening: Sometimes a professional teeth whitening will give you the boost you need. In-office whitening can dramatically brighten your smile in just one visit.
Tooth-colored fillings: If you have silver-colored fillings on teeth that show when you smile, consider replacing them with unnoticeable tooth-colored fillings.
Dental bonding: If you have chipped, cracked, or misshapen teeth, cosmetic bonding may be the fix you’re looking for. In this procedure, tooth colored material is applied to the tooth’s surface, sculpted into the desired shape, hardened with a special light, and polished for a smooth finish.
Porcelain veneers: Dental veneers provide a natural-looking, long-lasting solution to many dental problems. These very thin shells fit over your teeth, essentially replacing your tooth enamel to give you the smile you desire.
Replacement teeth: Is a missing tooth affecting your self-confidence? There are several options for replacing missing teeth, from a removable partial denture to a traditional fixed bridge to a state-of-the-art implant-supported replacement tooth. Removable partial dentures are an inexpensive way to replace one or more missing teeth, but they are less stable than non-removable options. Dental bridges, as the name implies, span the gap where a tooth is missing by attaching an artificial tooth to the teeth on either side of the space. In this procedure, the teeth on both sides of the gap must be filed down in order to support the bridgework. Dental implants, considered the gold standard in tooth replacement technology, anchor long-lasting, lifelike replacements that function like natural teeth.
After coming to embrace her smile, Jackson asserted, “Beautiful comes in all shapes, sizes, and colors." If you don’t feel that your smile expresses the beauty you have inside, call our office to schedule a consultation. It’s possible to love your smile. We can help.
For more information, read Dear Doctor magazine article “How Your Dentist Can Help You Look Younger.”
They seemingly pop up out of the blue inside your mouth: tiny sores that are sometimes painful — and always annoying. Then, in about a week to ten days these small, irritating lesions are gone.
They're known as canker sores: the most common break out in the linings of the mouth, including the cheeks, lips, under the tongue or even the back of the throat. Medically known as aphthous ulcers, you'll recognize these round lesions by their yellow-gray center surrounded by a red “halo.”
You might feel a tingling sensation a couple of days before an outbreak. Once they appear they usually last a week to ten days; during that time they can cause discomfort especially while eating or drinking.
We don't know fully what causes canker sores, but it's believed they're related to abnormalities in the immune system, the processes in the body that fight infection and disease. High stress or anxiety and certain acidic or spicy foods like citrus fruit or tomato sauce also seem to trigger them.
Most people experience canker sores that range in intensity from slight discomfort to sometimes severe pain. But about 20-25% of people, mostly women, have an acute form known as recurrent aphthous stomatitis (RAS). Thought to be hereditary, RAS produces clusters of ulcers that are almost always painful, and which come and go on a regular basis.
Our main treatment goal with canker sores is to decrease discomfort while the outbreak runs its course and promote rapid healing. There are over-the-counter ointments that often prove effective. For more resistant symptoms we can also prescribe topical or injectable steroids or other medications.
Canker sores are rarely concerning as a significant health issue. You should, however, take an outbreak seriously if it hasn't healed within two weeks, if the outbreaks seem to be increasing in frequency or severity, or you're never without a sore in your mouth. In these cases, we may need to take a tissue sample of the lesion to biopsy for signs of cancer, pre-cancer or some other skin disease.
More than likely, though, the canker sore will be benign albeit annoying. With effective treatment, though, you can get through the outbreak with only a minimal amount of discomfort.
If you would like more information on treating canker sores, 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 “Mouth Sores.”
Some things in life look worse than they really are. A condition known as “geographic tongue” is a good example: while it may look serious, it’s not a cause for real concern.
If you’ve never heard of geographic tongue it’s because it’s not a common ailment: it only affects one to three percent of the population. The name comes from patches of redness on the top surface of the tongue surrounded by grayish white borders, which gives the red patches a look similar to land masses on a map.
It’s known formally as “benign migratory glossitis,” which tells us more about the condition: “benign” means the patches aren’t cancerous; “migratory” indicates the patches tend to move and take different shapes along the surface of the tongue. In fact, it’s possible for them to appear, disappear, and then reappear over the course of a few days.
The exact causes of geographic tongue haven’t been fully substantiated. Researchers believe emotional stress, psychological problems or hormonal disturbances (especially women during pregnancy or ovulation) could be triggers for its occurrence. Certain dietary deficiencies like zinc or vitamin B, or acidic foods are also believed to be factors.
While geographic tongue isn’t painful, it can leave your tongue feeling more sensitive with a mild burning or stinging sensation. If you’re prone to having geographic tongue, there are some things you can do to reduce the irritation. Try to avoid eating acidic or spicy foods like tomatoes, citrus fruits or mint, as well as astringent substances like alcohol or certain mouthwashes. We may also prescribe anesthetic mouthrinses, antihistamines or steroid ointments to help ease any discomfort.
The good news, though, is that this harmless condition is more irritating than anything else. With a little care and forethought you won’t even know you have it.
If you would like more information on geographic tongue, 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 “Geographic Tongue.”
If you’re thinking about getting dental implants, you’re in good company. Dentists have placed more than 3 million of these popular devices since their introduction in the early 1980s.
But if you have multiple missing teeth, you might think the cost of all those individual implants could put them out of your league. Yes, replacing multiple teeth with individual implants can be quite expensive—but implant technology isn’t limited to one tooth at a time. A few well-placed implants can impart their proven durability and stability to other types of restorations.
For example, we can incorporate implants into a bridge for a series of missing teeth. Conventional bridges are normally fixed in place by altering and then crowning natural teeth on each side of the missing teeth gap with a fixed row of prosthetic (false) teeth in the middle to fill it. Instead, two implants placed at the ends of the gap can support the bridge rather than natural teeth. This not only provides greater stability for the bridge, it also avoids permanent altering the natural teeth that would have been used.
Implants can also support a fixed bridge to restore complete tooth loss on a jaw. The new bridge is attached to a few strategically placed implants along the jaw line to equally distribute biting forces. This can result in a strong hold with excellent durability.
We can also use implants to improve traditional dentures. Dentures normally rest directly on the gums’ bony ridges, depending on a snug fit for stability. But bone loss, a natural consequence of missing teeth, can still occur while wearing dentures, which may in fact accelerate the rate of loss due to the appliance’s constant pressure and friction against the gums.
Instead, just a few implants placed along the jaw can, with attachments built into the denture, hold it securely in place. This not only decreases the pressure on the gums, but the natural bone growth that occurs around the implant may even deter bone loss.
Depending on your situation, there could be a viable restoration solution involving implants. Visit our office for a complete examination and evaluation to see if implants could help change your smile forever.
If you would like more information on implant restorations, 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 “Dental Implants 101: the Most Significant Innovation in the Past Century.”
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