Sleep apnea, a form of sleep-related breathing disorders that is estimated to affect some 22 million Americans, is sometimes thought of as the “quiet culprit” lurking behind many other maladies. But ask anyone who sleeps alongside a sufferer, and you'll get a different response: It isn't quiet at all! Instead, it's often marked by loud snoring and scary episodes where breathing seems to stop. If you've ever worried that you or someone you care about may have this condition, here are five facts you should know.
1) Sleep apnea is a potentially deadly disease
For one thing, it leads to chronic fatigue that can make accidents far more likely — a special concern in potentially dangerous situations, like operating machinery or driving a vehicle. It also appears to be related to heart conditions such as high blood pressure, irregular heartbeat, coronary artery disease, and even stroke. Plus, it can lead to weight gain, depression and mood disorders.
2) People with sleep apnea may wake hundreds of times every night
These “micro-arousals” may occur 50 or more times per hour, and may keep a person from getting any relaxing sleep — even though they retain no memory of the episodes. That's why people who suffer from sleep apnea often go through their days on the verge of exhaustion. And they aren't the only ones who suffer: Their bed partners may also be kept up throughout the night, becoming anxious and irritable.
3) Persistent snoring can be a symptom of sleep apnea
Snoring is caused when breath being drawn into the lungs is obstructed by soft tissue structures in the upper airway. Most everyone snores sometimes… but chronic loud snoring is a common symptom of obstructive sleep apnea (OSA) — and the louder and more frequent the snoring, the greater the likelihood of OSA. To confirm a diagnosis of sleep apnea, a sleep study using special monitors may be conducted in a clinical setting, or an at-home test may be used.
4) Your dentist may be able to help diagnose and treat sleep apnea
What does dentistry have to do with sleep apnea? For one thing, sleep apnea is a disease that involves structures in the oral cavity — an area dentists are quite familiar with. Sometimes, fatigued folks who suffer from OSA begin snoring when they recline in the dental chair, showing their symptoms firsthand. But even if their patients don't fall asleep, dentists with proper training are recognized by the American Academy of Sleep Medicine (AASM) as being able to provide first line therapy for mild to moderate sleep disorders.
5) An oral appliance is a good step to try before more invasive treatments
If it's appropriate in your situation, your dentist can custom-fabricate an oral appliance that may alleviate sleep-related breathing disorders. This device, worn while you're sleeping, helps to maintain an open airway in the throat and to reduce breathing problems. With a success rate of around 80%, in many cases it's comparable to the more complex CPAP (continuous positive air pressure) machines, but people often find it easier to wear. Plus, it's a non-invasive treatment that can be explored before deciding on a more involved treatment, such as surgery.
If you would like more information about dentistry and sleep problems, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Sleep Apnea FAQs.”
FAQs About This New and Miraculous Procedure
How can sinus surgery contribute to the replacement of missing back teeth with dental implants?
Dental implants must be anchored the in bone to be successful. Maxillary sinus surgery can help regenerate bone that has been lost and is critically needed to anchor dental implants.
What are the maxillary air sinuses?
Inside the upper jaw, or “maxilla,” are structures known as the maxillary air sinuses, one on either side of the upper jaw. Each sinus is an air-filled space lined by a membrane. Upper back teeth are normally encased in the bone of the maxilla, below the sinuses.
Why is it important to replace missing back teeth?
Replacing back teeth restores the ability to eat, chew, and talk properly. The back teeth also provide facial and cheek support.
Why use dental implants?
Dental implants are the state-of-the-art method for replacing missing teeth.
Why does bone loss occur?
Unless special precautions are taken to prevent it, when teeth are lost, the bone supporting them is also lost.
If there is insufficient bone to anchor dental implants, what are the alternatives?
If all the back teeth are lost and dental implants cannot be placed, removable upper dentures may be the only alternative.
How do you determine whether a sinus surgical procedure is necessary?
The size, shape, and remaining bone of the maxillary sinuses influence whether you can have dental implants with or without a sinus surgical procedure.
How does surgery grow bone?
A small window is created in the sinus wall above where implants need to be placed. The sinus membrane is lifted and the space thus created filled with bone grafting and biologically active bone generating materials. The window is then closed and simply heals.
How is the surgery done?
The surgical procedures are performed from inside the mouth in the area just above the missing back teeth. They are generally carried out under local anesthesia (small shots, just like for a filling), sometimes with the addition of sedation or anti-anxiety medication.
How do bone grafts work?
Bone grafts act as scaffolds that the body replaces with its own bone. The most well researched bone substitute grafting material is currently bovine (cow) bone. All grafting materials are approved by the Food and Drug Administration. They are specially treated to render them completely sterile, non-contagious, and free of rejection factors.
What can I expect after surgery?
Moderate swelling and discomfort after surgery generally lasts for a few days to a week, about the same as having an upper impacted wisdom tooth removed. Supportive treatment usually includes a course of antibiotics to prevent infection and prescription strength medication of the aspirin or ibuprofen type. A decongestant may also be prescribed, if necessary. Healing is generally uneventful.
Who performs this surgery?
Maxillary sinus augmentations are usually carried out by oral surgeons, periodontists, or appropriately trained general dentists. Proper assessment of your situation and diagnosis are critical pre-requisites to the right procedure.
If you are missing upper back teeth, contact us today to schedule an appointment and discuss maxillary sinus augmentation. You can also learn more about this procedure by reading the Dear Doctor magazine article “Sinus Surgery: Creating Bone for Dental Implants out of Thin Air.”
Chronic pain and reduced function of the jaw joints, muscles and other surrounding tissues is generally known as a temporo-mandibular joint disorder (TMJD or TMD). It’s also possible that sufferers of TMD may also experience chronic pain in other parts of the body.
TMD affects from 10 million to 36 million American adults, mostly women of childbearing age. Although the exact causes are still elusive, most researchers believe this family of conditions arises from a combination of gender, genetic, environmental and behavioral factors. This may also hold the key to its connection with other painful conditions in the body.
About two-thirds of patients with some form of chronic jaw pain or disability also suffer from three or more similar medical conditions, including fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis, headaches or sleep disturbances. Investigating the connections between these conditions is a fertile area for developing treatment strategies that would benefit all of these associated conditions.
In the meantime, there are both thermal and surgical treatments for alleviating and managing pain associated with TMD. About 90% of TMD patients respond well to thermal treatments, including hot and cold compresses applied to the jaw area and hot baths. Surgical treatment, however, has a mixed result: some studies show only a third of those undergoing surgical procedures experience noticeable pain relief and restored function and nearly half indicate worse symptoms after the surgery.
The best approach is to begin with an examination by your primary physician or specialist to be sure you are not suffering from a medical condition mimicking the symptoms of TMD. If this should eventually lead to a diagnosis of TMD, you should first try thermal techniques with over-the-counter pain relievers to ease the symptoms. A diet with softer foods that don’t require strenuous chewing may also prove helpful.
If you receive a recommendation for extensive bite treatment or surgery, you should discuss this thoroughly with your dentist, or even seek a second opinion. Surgical treatments in particular are not reversible and the results may not be favorable.
For more information on TMD and networking opportunities with other patients, be sure to visit the TMJ Association (www.tmj.org) on the Web.
If you would like more information on chronic jaw pain, 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 “Chronic Jaw Pain and Associated Conditions.”
Nearly everyone who has ever played a sport, or had a child participate in one, has had that panic-filled moment when they witness an injury. And when you consider that there are more than 22,000 dental injuries each year in children younger than 18 years of age, you see there is fact to backup this concern. This is just one reason why we strongly encourage all of our patients who are involved in activities such as football, soccer, hockey, wrestling, lacrosse, skateboarding, field hockey and more to wear one of our custom-fitted professional mouthguards. It is especially true for basketball and baseball, which are responsible for the largest number of dental injuries.
The following are some key issues to help you understand the importance and advantages mouthguards offer.
Is there a way to determine who is at the highest risk for sports injuries?
Yes there are several. Age, gender, dental anatomy, and the type of sports being played are the four categories used to measure the risks for dental injuries. Young male teens still top the list of most likely to be injured; however, the gap is closing with more females getting involved in sports. Learn which sports or exercise activities made the American Dental AssociationÃ¢Â€Â™s list of recommendations for using a custom mouthguard, when you continue reading “Athletic Mouthguards.”
What's the difference between a “boil and bite” mouthguard and a professionally made mouthguard?
We are often asked this very important question. While some over-the-counter (OTC) mouthguards provide what is advertised as a “custom-fit” to your teeth, it is nowhere near the fit — and thus protection — you receive from our mouthguards that are crafted from precise molds of your teeth. Additionally, because all aspects of our mouthguards are tailored to each specific mouth, they provide much more protection and comfort. This important fact can enhance performance as the athlete can literally breathe easier while wearing one of our mouthguards.
What can I do if I witness a dental injury?
The first important fact to know is that you do not have to be a dental or healthcare professional to assist. However, before jumping in to help out, consult Dear Doctor's Field-Side Guide to Dental Injuries. This pocket-sized, quick-reference guide details what you should do at the scene of a dental injury based on the type of injury. But best of all, it is available to you free of charge from Dear Doctor.
Want to know more?
Modern dentistry offers several great ways to permanently replace missing teeth, including high-tech dental implants and traditional fixed bridgework. But sometimes, for one reason or another, it isn’t possible to have these treatments done right away. If you need an aesthetic way to temporarily replace missing teeth, a flexible partial denture could be the answer you’re looking for.
Certain kinds of removable partial dentures (RPDs) can be used as permanent tooth replacement systems, especially for people who aren’t candidates for dental implants or fixed bridges. But in the past, if you needed a temporary tooth replacement, one of the few alternatives was the type of rigid RPD often called a “flipper.” This consists of a firm, relatively thick acrylic base that supports one or more lifelike replacement teeth. It attaches to the “necks” of existing natural teeth via metal clasps, which gives it stability and strength.
However, the same rigidity and thickness that gives these rigid RPDs their durability can make them uncomfortable to wear, while the acrylic material they are made of is capable of staining or breaking. Over time, the RPDs are prone to coming loose — and they are also easy to flip in and out with the tongue, which gives them their nickname.
Flexible partial dentures, by contrast, are made of pliable polyamides (nylon-like plastics) that are thin, light and resistant to breakage. Instead of using metal wires to attach to the teeth, flexible RPDs are held securely in place by thin projections of their gum-colored bases, which fit tightly into the natural contours of the gumline. Their elasticity and light weight can make them more comfortable to wear. Plus, besides offering aesthetic replacements for missing teeth, their natural-looking bases can cover areas where gums have receded — making existing teeth look better as well.
All RPDs must be removed regularly for thorough cleaning — but it’s especially important for flexible RPD wearers to practice excellent oral hygiene. That’s because the projections that hold them in place can also trap food particles and bacteria, which can cause decay. And, like most dentures, RPDs should never be worn overnight. Yet with proper care, flexible RPDs offer an inexpensive and aesthetic way to temporarily replace missing teeth.
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