Posts for: August, 2011
Sleeping disorders impact people in different ways. For some people, they may feel they do not have a problem — except for the fact that their sleeping partner complains about their snoring. For others, they may know they have a snoring issue because they constantly wake themselves up gasping for air. This is a dangerous condition known as Obstructive Sleep Apnea OSA (“a” – without; “pnea” – breath). If any of these scenarios sound like your experience, then you may have OSA or another type of Sleep Related Breathing Disorder (SRBD). However, before jumping to conclusions, you need to obtain a thorough examination from a primary-care physician who is trained in sleep medicine in conjunction with our office. We have received training in the diagnosis and treatment of sleep disorders. But the good news is that sleep apnea is a treatable condition.
As for your question, yes, there are many things we can do to treat your snoring after the cause of your problem is properly established. One helpful approach is through the use of a specially designed oral appliance that we custom make and fit to your mouth. It is easy to use during sleep. Once in place, it will keep your lower jaw in a forward position so that your tongue is held forward to stop blocking your upper airway (i.e. the back of your throat and area causing your snoring and hindering your breathing while you sleep). Another option is to use a Continuous Positive Airway Pressure (CPAP) machine. This specialized machine requires you to sleep with a mask that covers your mouth and/or nose. While you sleep, it delivers continuous pressure to your windpipe so that your tongue is forced away from your airway.
If your snoring is keeping you or your loved ones awake, we are a good place to start. Contact us today to discuss your questions about snoring or to schedule an appointment. You can also learn more about snoring and sleep disorders when you continue reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”
Grinding, clenching, and gritting your teeth are common reactions to stress — but their results can be quite complex. Here are some questions and answers that will fill you in on what you may not know about this widespread problem.
My dentist said I was bruxing. What does that mean?
Bruxing means that your teeth are grinding upon each other. Many people carry out this habit subconsciously and are not even aware that they are doing it.
Is bruxing or gritting harmful?
Such habits are called “parafunctional” (from para, meaning outside, and function, meaning purpose). This is because these stress habits exert much larger biting forces — as much as ten times more — than in normal biting and chewing activities. This excess pressure can cause damage to jaw joints and muscles, resulting in muscle spasm and pain; and to the teeth, resulting in wear, fractures or looseness. They can also cause headaches, earaches, and even neck and backaches because of the pressures on various structures in the face and mouth.
What is the usual treatment for problems arising from these stress habits?
The first thing we want to do is relieve your pain and discomfort. Second, we want to stop future damage. Application of heat or cold is helpful, and mild anti-inflammatory and muscle relaxant drugs are prescribed for pain and muscle spasm. To prevent future occurrences, we may treat you with biofeedback or refer you to someone who can offer psychotherapy.
What is a night guard and how can it help?
A night guard is an unobtrusive thin plastic appliance that is made to fit over the biting surfaces of your upper teeth. These guards are so unobtrusive that they can even be worn during the day if your stress level is so high that you grind your teeth during the day. The guard is adjusted to leave the lower teeth free to move against the surface of the guard, but they cannot bite into the upper teeth. This prevents wear on the teeth and lets the jaw muscles relax, preventing the pain of muscle spasm.
It is important to brush your teeth every day to remove plaque (that sticky white film, composed of bacteria, on your teeth near your gums), but it is possible to overdo it — particularly if you find that your teeth are becoming sensitive to hot and cold or to variations in pressure.
Brushing your teeth too hard or too many times per day can aggravate tooth sensitivity, which can range from a mild twinge to a severe pain. You can accomplish the goal of tooth brushing — plaque removal — by using a soft brush with a very gentle action. Repeated aggressive brushing with a hard brush is not required and can even be harmful to your teeth and gums.
To understand how teeth become sensitive, you need to know about the internal structure of your teeth. Teeth are covered by enamel, a hard mineralized coating that protects them from changes in temperature and pressure. If the enamel is worn away, it exposes the next lower layer of the tooth, the dentin. The dentin is a living tissue containing nerve fibers that connect to the nerves in the tooth's root.
Excessive tooth brushing can irritate your gums and cause them to shrink away from your teeth, particularly if you have thin gum tissues. The thickness or thinness of your gum tissues is something you inherit from your parents, so you can't change it. Hard brushing can begin to wear away the enamel covering of your teeth. Exposure to acids or sugars in the foods you eat and drink can continue the damage.
Acidic foods and drinks such as fruit juices dissolve some of the minerals in your teeth by a process called “demineralization.” Fortunately, your saliva can interact with the enamel and bring back minerals that are leaving the tooth's surface. This process is called “remineralization.” It is important to let your healthy saliva wash your teeth's surfaces for a while before brushing so that dissolved minerals get a chance to be returned to your enamel. It takes between twelve and twenty-four hours for plaque to form on your teeth, so you don't need to brush more than twice a day.
The best way to make sure you are brushing your teeth properly is to have us evaluate your brushing technique at your next dental appointment. We will be able to tell you whether you need to change the angle of your brush or the pressure you are applying for the most effective removal of plaque with the least wear on your teeth and gums. Tooth brushing serves an important purpose, but remember that you can actually have too much of a good thing.
When you have your teeth bleached in a dental office, the results almost seem like magic. Let's push aside the magician's cape and see what is really happening in professionally-applied, in-office tooth whitening.
How do teeth become discolored?
A tooth's enamel covering is mostly composed of mineral crystals. At a microscopic level, you can see a framework or matrix of organic (living) matter interspersed between the crystals of enamel creating a very irregular surface capable of retaining stains. Chromagenic (color generating) organic compounds can become part of this organic matrix resulting in tooth staining. They can be bleached without affecting the mineral structure of the tooth's enamel.
As people get older and their teeth wear, the enamel loses its youthful translucency and the underlying layer, called dentin, thickens and becomes more yellow. Such changes to the actual tooth structure are called intrinsic staining. Other causes of intrinsic discoloration are exposure to high levels of fluoride or tetracycline antibiotic administration during childhood, tooth decay, or root canal problems, among others. Discoloration can also be caused by external staining from certain foods, drinks, or tobacco products. Such surface stains are called extrinsic staining.
Behind the Magic
Materials used for tooth bleaching are hydrogen peroxide and carbamide peroxide. Peroxides are commonly used as bleach, and you may have seen them used as hair bleaches, for example. Hydrogen peroxide is a strong oxidizing agent that attacks the organic molecules responsible for tooth discoloration, bleaching them until they lose their color. Carbamide peroxide also contains urea, which is a compound that permits the peroxide to remain in contact with the teeth for longer amounts of time without harming them.
Often called power bleaching, the in-office technique uses a high concentration of peroxide solution (35-45% hydrogen peroxide), placed directly on the teeth in the form of a gel. A heat or light source may enhance the peroxide release. The gel is applied with trays custom fitted to your mouth, and specific barriers are applied to protect sensitive gum tissue from the solution. Results show teeth becoming up to ten shades lighter in about an hour.
In-office bleaching under the supervision of my staff and me is recommended if you have severely stained teeth, and particularly if you are about to have veneers or crowns made. It's a way to rediscover the pearly translucency of your youthful smile.