Dentistry has ventured into the new area of sleep medicine by helping snorers — and their exasperated sleeping partners — with custom-made anti-snoring devices. These oral appliances, which resemble orthodontic retainers or sports mouthguards, keep the snorer's airway clear and the bedroom quiet. To see how they work, you have to understand the mechanics of snoring.

Snoring occurs when the upper airway (back of the throat) becomes blocked by the tongue or other soft-tissue structures, such as large tonsils or a long soft palate. The vibrating of these obstacles creates the sound we call snoring.

Snoring is often worse when sleeping on one's back because that position encourages the lower jaw to fall back and the tongue to close off the airway. This is where Oral Appliance Therapy comes in. These custom-fitted devices are designed to keep the upper airway open during sleep by pulling the lower jaw forward, which in turn brings the tongue away from the throat. Dentists, and our office in particular, are the only source for Oral Appliance Therapy.

People who snore should have a thorough examination to rule out Obstructive Sleep Apnea (OSA), a potentially dangerous condition in which airflow can be cut off completely for 10 or more seconds (“a” – without; “pnea” – breath), reducing blood-oxygen levels. Chronic, loud snoring is a common finding with OSA.

Please remember that sleep is an integral part of health and well-being. In fact, we spend about a third of our lives doing it. If you are snoring or have any sleep-related breathing disorders that are waking you or your bed partner, be sure to tell our office. There are plenty of examples of the havoc wreaked by sleep-deprived individuals. Remember the Exxon Valdez?

If you have any questions about Oral Appliance Therapy, please contact us or schedule an appointment for a consultation.

To learn more about the topic of oral appliance therapy, please see the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

Snoring and Obstructive Sleep Apnea (OSA) is a condition that occurs when the upper airway (back of your throat) collapses or is blocked, causing significant airflow disruption. A person with OSA continues snoring at a regular rate but is interrupted by long silent periods during which there is no breathing for atleast 10 seconds or more. Believe it or not, this issue affects millions of people worldwide. It can leave you feeling tired, depressed, irritable, as well as cause memory loss and poor concentration. And if you have OSA that is left undiagnosed and untreated you could fall victim to heart attacks, strokes, irregular heartbeat, high blood pressure, heart disease and even impotence. For these reasons, we feel it is important that you understand the real-world consequences that can occur if you ignore your OSA.

Reality is that most people are unaware that their dentist can be an excellent resource in helping to diagnose and treat OSA. However the first and most important step is to receive a proper, thorough examination and diagnosis with an appropriately trained physician and dentist. If after completing this process you are diagnosed with OSA, we will discuss treatment options. Some of these may include:

• Suggesting that you exercise and lose weight if you are overweight.
• Sleeping with a Continuous Positive Airway Pressure (CPAP) machine that provides pressurized air into your airways through a mask that covers both your nose and mouth while sleeping.
• Sleeping with a professionally made oral appliance or mouthguard that can reposition your lower jaw, tongue, soft palate and uvula (the dangling tissue in the top, back portion of your mouth) into a better position during sleep to relieve blockage.

If you are ready to discuss you questions and concerns about your snoring, or the snoring habits of another family member, contact us today to schedule a consultation. You can also learn more about the signs, symptoms, and treatment options when you read “Snoring & Sleep Apnea.”

If you see blood when you brush or floss your teeth, it generally indicates a problem with your oral health. You may think you are brushing too hard, but this is not usually why gums bleed. The usual culprit is dental plaque.

Plaque is the sticky, whitish film of bacteria that forms on your teeth every day. If you brush regularly, you probably remove most of it — but some may remain behind and accumulate where your teeth meet your gums, particularly between your teeth. As the bacteria build up, along with by-products of their metabolism (the chemical reactions that maintain their lives), they cause inflammation, called gingivitis, in the adjacent gums.

Bleeding gums are an early symptom of gingivitis. Continuing contact with plaque at the gum line can cause your gum tissue to separate from nearby teeth, creating pockets in which the inflammation becomes even worse. The process leads to periodontal disease (“peri” – meaning around, “odont” – tooth). The increasing infection can eat away the bone that anchors the teeth, leading to possible tooth loss. Periodontal disease is not an uncommon problem. About 90% of the population has bleeding gums at some time or another, and approximately 10% go on to develop periodontal disease.

When you lose bone around your teeth, the gums separate from the tooth and “pockets” form between your teeth and gums. The inflammation and infection may continue within the pockets even if your gums have stopped bleeding when you brush. That's why it is important to have regular dental exams — to check up on and stop periodontal disease before it has a chance to cause serious damage.

There may also be other reasons for bleeding gums that have to do with your general state of health. Women who have elevated levels of hormones caused by birth control pills or pregnancy may experience an increased response to plaque that makes their gums bleed more easily. Increased bleeding in your gums can also be caused by some diseases or as a side effect of some medications.

The most important way to prevent bleeding gums is to learn proper brushing and flossing techniques so that you effectively remove plaque from your teeth on a daily basis. If you are not sure you are using the right techniques, make an appointment and have us demonstrate at your next dental visit.

With all the best intentions, some plaque may remain. Plaque that is allowed to stay on your teeth hardens into a substance called tartar or calculus. This must be removed periodically with a professional cleaning by me or by our hygienist.

With not too much effort, you can ensure that your teeth are clean and plaque free, and your healthy gums no longer bleed.

Contact us today to schedule an appointment to discuss your questions about bleeding gums. You can also learn more by reading the Dear Doctor magazine article “Bleeding Gums.”

Your teeth were designed to last you a lifetime, so you should do everything you can to protect them. This includes guarding them against dental erosion. However, many people may not know for sure what dental erosion is, much less how or why they need to guard against it.

Dental or tooth erosion is the irreversible loss of tooth enamel from chemical attack by acids. Eating or sucking acidic foods such as lemons is a good example. But most people are shocked to discover that it can also be caused by their favorite sodas (carbonated beverages), natural fruit juices, energy and sports drinks — especially with excessive consumption. It takes the saliva, nature's protection, at least 30 to 60 minutes to neutralize the effects of acid, so only one acidic drink an hour causes your teeth to be continually bathed in acid. And this is an important fact to know, because if your mouth is acidic all the time, this will promote tooth decay.

Will brushing help out with prevention?

When it comes to dental erosion, brushing immediately after acid consumption can actually make it worse by accelerating the erosion process. This is because the acids in these drinks (and some foods) actually dissolves tooth enamel and softens the tooth surface. These newly softened surfaces can literally be brushed away if you brush before your saliva has a chance to try to reverse the process. If done often, you could even brush away your enamel! For this reason, you should wait at least 30 to 60 minutes before you brush your teeth after consuming any of these products.

So what can you do to prevent dental erosion?

One important step that you (and your family) can do to help prevent dental erosion is to limit the amount of these beverages you drink. Instead, try drinking calcium-rich milk or water and saving your favorite acidic beverage for a special treat that you consume preferably with a meal. Try reducing the number of these drinks you consume over a period of time. If you must drink an acidic beverage avoid swishing it in the mouth and use a straw to reduce the contact between the acid and your teeth.

Just remember that once your dental enamel has eroded, it is gone forever. So you should follow these simple tips now to protect your smile and future.

Perhaps you've seen Nate Berkus on The Oprah Winfrey Show or watched his television program, The Nate Berkus Show. You may even have read his best-selling book, Home Rules: Transform the Place You Live Into a Place You'll Love. Regardless of where or how you discovered Berkus, you will surely have noticed his dazzling smile.

Berkus recently opened up about the facts behind his trademark smile during an interview with Dear Doctor magazine. First off, his smile is totally natural, as he never wore braces or had any cosmetic work, including porcelain veneers. However, Berkus does give credit to his childhood dentist for the preventative healthcare he received as a young boy. “I'm grateful for having been given fluoride treatments and sealants as a child,” he said. Nate also shared the important flossing advice he learned from his dentist that he still follows today: “Floss the ones you want to keep.” Berkus went on to say that he feels, “healthy habits should start at a young age.”

And we totally agree! For this reason we have put together the following list of facts and oral hygiene tips:

• Over 50% of plaque accumulation occurs in the protected areas between teeth — a place that may be difficult or even impossible to reach with a toothbrush.
• A thorough brushing may take up to two minutes at first, and it may feel awkward as you reach some places in your mouth.
• Remember, more is NOT always better! Brushing or flossing too hard can be damaging to your teeth and gums. And never saw back and forth with your floss.

To learn more about oral hygiene, including brushing and flossing techniques, you can continue reading the Dear Doctor article “Oral Hygiene Behavior - Dental Health For Life.” Or you can contact us today to schedule an appointment so that we can conduct a thorough examination, review your brushing and flossing techniques, and discuss any questions you have as well as treatment options. As needed, we will work with you to teach you the proper brushing and flossing techniques so that you feel confident before you leave our office. And to read the entire interview with Nate Berkus, please see the Dear Doctor article “Nate Berkus.”