Posts for: September, 2019
When you awake in the morning do you still feel exhausted? Are you irritable during the day, unable to think or focus clearly? Is your loud snoring bothering your bed partner?
If you answered affirmatively to any of these questions, you may have sleep apnea. This happens when an obstruction (usually the tongue) blocks the airway during sleep, preventing you from breathing. Your brain notices the drop in oxygen and wakes you to re-open the airway. The arousal lasts only a few seconds, and you may not even notice. But because it can happen many times a night, these waking episodes can rob you of the deep sleep your body needs.
Sleep apnea is more serious than simply waking up grumpy. Over time, it could contribute to dangerous health conditions like high blood pressure or heart disease. If you’re noticing any of these signs, it’s important then that you undergo a complete examination by a physician or dentist trained in sleep-related issues.
Fortunately, there are ways to reduce sleep apnea. One of the most common is continuous airway pressure (CPAP): This method uses a small pump that pushes pressurized air through a face mask worn while the patient sleeps. The forced air keeps the airway open and reduces apnea episodes.
While it’s an effective method, it can be uncomfortable and cumbersome to use—some people can’t tolerate wearing the mask while they sleep. But if your sleep apnea symptoms are mild to moderate, your dentist may be able to provide an alternative therapy with a specially designed oral appliance.
Similar to a mouthguard or retainer, a sleep apnea appliance worn during sleep holds the lower jaw forward, which helps move the tongue away from the airway. It’s much less cumbersome (and noisy) than a CPAP machine. And your dentist can custom design and fabricate your appliance for a comfortable fit.
Not all cases of sleep apnea can benefit from such an appliance, or even from CPAP therapy. Extreme cases could require surgery to remove tissues blocking the airway. But most sleep apnea patients don’t require this invasive intervention. Getting checked by a qualified medical professional could open the door to a more convenient and effective way to a better night’s sleep.
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
One of the key parts to an effective oral disease prevention plan is practicing daily oral hygiene to remove dental plaque. Both brushing and flossing are necessary for cleaning your teeth of this thin biofilm of bacteria and food particles most responsible for tooth decay and periodontal (gum) disease.
But as important as they are, these two essential hygiene tasks aren’t the end-all-be-all for lowering your disease risk. For the best protection, you should also visit your dentist at least twice a year for thorough dental cleanings. That’s because plaque you might have missed can turn into something much more difficult to remove: calculus.
Also known as tartar, calculus is hardened deposits of plaque. The term comes from the Latin word meaning “small stone,” an apt description of its texture on tooth surfaces. Although not the same as the branch of mathematics that bears the same name, both derive from the same Latin word: Merchants and traders centuries ago used small stones to “calculate” their various transactions.
Over time soft and pliable dental plaque hardens into calculus, in part due to a reaction with saliva. Because of the difficulty of accessing all tooth surfaces, calculus can form even if you have an effective daily hygiene practice.
Once formed, calculus can adhere to teeth so tenaciously, it’s impossible to remove it with brushing and flossing. But dentists and hygienists can remove calculus safely with special tools called scalers.
And it should be removed or it will continue to foster bacterial growth. This in turn increases the chances for infections that attack the teeth, gums or underlying bone. Keeping it under control will therefore diminish your risk for developing dental disease.
Although there are other factors like heredity that can affect your disease risk, keeping your mouth clean is the number one thing you can do to protect your teeth and gums. A daily hygiene practice and regular dental visits will help ensure plaque and its calcified form calculus won’t be a problem.