Snoring is common – most people snore occasionally – but is not a welcomed physical phenomenon. Snoring is noisy, disturbing, can affect the quality of your sleep and prevents your bedroom partner from having a peaceful night! So what are the causes and treatments of snoring? Technically speaking, snoring is defined as the vibration of respiratory structures and the resulting sound, due to obstructed air movement during breathing while sleeping. In some cases the sound may be soft, but in most cases, rather unpleasant.
Generally speaking, the structures involved during vibration (creating subsequent noise) are the uvula and soft palate; the irregular airflow can be caused by any part of airway. Blockage of these passages can be due to inflamed, enlarged glands or ‘floppy’ soft tissues, a large or set back tongue, a small or receded lower jaw or an obstruction of the nasal passageway. These physical attributes can be hereditary or from environmental influences like smoking, alcohol, medications, allergy, asthma and upper respiratory infection.
Snoring can also be a symptom of sleep apnea, an unhealthy condition. While snoring is caused by a narrow airway, sleep apnea is a true breathing obstruction, which awakens the sleeper to begin breathing again. It can occur frequently and can lead to sleep deprivation with further health repercussions. Snoring is a common symptom of sleep apnea, but snoring by itself does not involve the cessation of breathing.
Besides diagnosing what causes snoring, non-invasive and self-regulatory approaches to control snoring can be a good start: losing weight (decreasing fatty tissues which restrict the airway), sleeping with one’s head elevated and sleeping on one’s side (preventing the gravitational collapse of the airway), limiting alcohol consumption, smoking and medication intake (to prevent dilated, dehydrated, inflamed or floppy tissues), and clearing of the nasal passage (a stuffy nose can make inhalation difficult, creating a vacuum in your throat drawing movements the soft tissues). Nasal decongestants or nasal strips can also be effective in opening up the nasal passage; when combined with a snore guard under a health professional’s care, this can be very effective in treating mild to moderate snoring.
There are several designs of snore guards to aid in suppressing snoring, from a simple diagnostic bite plate to a fixed or adjustable double jaw device which repositions your lower jaw and/or tongue forward and downward (opening the airway at your throat). Ask your dentist whether he or she can help you with fitting a snore guard.If you suffer from severe snoring combined with sleep apnea, a continuous positive airway pressure (CPAP) machine is often used.
In most severe cases, a surgical approach might be advised. Surgical treatments like UPPP (Uvulopalatopharyngoplaty) and TAP (Thermal Ablation Palatoplasty) can relieve physical blockages to the breathing pathway. A pillar procedure (palatal implantation) can stiffen and cease vibration of the soft palate to stop snoring.
Playing the didgeridoo may help snorers!
One solution that might surprise you? Sing and playing musical instruments that tone up your throat muscle and soft tissues of one’s airway can help. Even playing the didgeridoo may help snorers! A 2005 study in the British Medical Journal found that learning and practicing the didgeridoo helped reduce snoring and sleep apnea (!) as well as daytime sleepiness. This appears to work by strengthening throat muscles , thus reducing their tendency to collapse during sleep.
At last, I wish everyone a quiet, peaceful and healthy night’s sleep every night – be well rested and ready to carry on a productive and happy tomorrow!
Do you suffer from Sleep apnea? Do you snore at night? Sleep apnea, a sleep disorder characterized by pauses in breathing during sleep, lasts long enough so that one or more breaths are missed, and such episodes occur repeatedly throughout sleep. Common signs and symptoms include gasping, choking or silences during sleep, sudden awakening during sleep, loud snoring and daytime sleepiness. Not only can sleep apnea affect your energy levels throughout your day, but chronic sleep apnea carries potentially dangerous health affects. Thankfully, your dental professional can help!
Sleep apnea (a lack of oxygen) carries heightened risk of cardiovascular disease, stroke, high blood pressure, arrhythmias, diabetes, and sleep deprived driving accidents. Stroke is associated with obstructive sleep apnea as well, as sufferers have a 30% higher risk of heart attack or premature death than those unaffected. Risk factors can often be managed easily without major medical intervention. Being overweight or obese, nasal congestion or blockage and relaxed tongue/throat muscles often contribute to sleep apnea. Avoiding intake relaxants like alcohol or sedatives can play an important role in reducing the occurrence of sleep apnea.
There are three basic types of sleep apnea. Obstructive Sleep Apnea (OSA) is the only type of sleep apnea that can be treated by your dentist. Central Sleep Apnea is when a person’s brain “forgets” to signal the chest muscles to breathe during sleep. This variation of sleep apnea requires medication prescribed by your physician. Mixed Sleep Apnea is a combination of the preceding two types, and is the most difficult type of sleep apnea to diagnose and treat.
What can be done about sleep apnea – and how can your dentist play a role? The first step is diagnosis. Sleep apnea is diagnosed with a “sleep study”. An individual with sleep apnea is rarely aware of having difficulty breathing, even upon awakening, and is recognized as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body. Symptoms may be present for years without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance.
One of Many Snore Guard Designs Pictured Above
Once a breathing problem during sleep has been established, there are two main routes of therapy for mild or moderate sleep apnea. The first is Oral Appliance Therapy, to reposition your lower jaw into a forward and downward position, opening up your throat, typically given by your dental care professional or physician. There are several designs from a simple diagnostic one to more sophisticate double jaw design. Your treating health professional will help to determine which would fit you better.
For more severe cases, the use of a continuous positive airway pressure (CPAP) device can help, which ’splints’ the patient’s airway open during sleep by means of forcing pressurized air into the throat. The CPAP machine assists only inhaling, whereas a BiPAP machine assists with both inhaling and exhaling and is used in more severe cases. Home remedies to treat sleep apnea include loose weight, treating allergy to decrease the volume of inflamed soft tissue of the airway, using a humidifier (in conjunction with the CPAP machine), trying a saline nasal spray before sleep.
If you have been diagnosed with OSA and think your dentist can help, be sure to bring your concerns to his or her attention.
Did you catch the 2010 Winter Olympic Games in Vancouver? The games present an exciting and fiercely competitive time for the globe’s top winter athletes! One thing I noticed while watching the 2010 Vancouver games is how many athletes wore their protective mouth guards during the competition, which was very exciting to me.
It was not uncommon to see athletes removing and replacing their mouth guards before and after events; most wear clear silicon rubber guards while some wear colored ones. I am very pleased to see the awareness of preventing sport injuries on globally broadcast television - all athletes with a chance of injury should be wearing a sport mouth guard to prevent oral facial injury, jaw injuries and even brain concussions.
The dangers of an unprotected oral cavity don’t just apply to olympians – any physical activity can result in an accident without safety precautions! Proper protection in the form of a custom-fitted mouth guard is vital to assure the health and safety of your teeth, jaw and fasciomuscular system. Using your teeth as a tool for anything other than eating food – even opening a plastic bag – can cause a tooth to crack.
Vancouver Canuck champion Kyle Wellwood lost tooth #8 in an ice hockey injury.
Dental trauma usually results from an accidentally cracked or broken tooth. Many times, teeth that have previously been treated with a root canal are prone to breakage due to a weak and/or compromised structure. All root canal teeth should be capped with a crown to protect the tooth structure. Certain hard foods can also trigger tooth breakage, such as corn nuts, popcorn, hard candy, and especially ice! Tooth decay, periodontal disease and even cracked teeth can all be prevented! Most hygienists will inform patients of important daily cleaning habits, but rarely elaborate on dental trauma and how to prevent it.
If you ever find yourself in a situation with missing teeth, try and preserve them in milk. If your tooth becomes cracked, avoid using your mouth and get to your dental professional ASAP! If you have a night guard (or mouth guard), wear it to protect the site. If you can get to your dentist in a timely manner, the teeth may be reattached. Simple chipping can be repaired rather simply (bonding or porcelain veneers can be explored with your dental care professional). Your doctor will be able to evaluate you further and discuss whether more extensive procedures are necessary (like implants or a root canal). Whether you’re jogging in your neighborhood or racing for the gold, being prepared will help you avoid dental trauma.
Wow – 2009 really flew by! As this year draws to a close and another prepares to bloom, take time to reflect on your life and plan for a better future. Did you do well taking care of yourself this year? Could you do better? What is your new year’s resolution? Being happy with our dental health should be one of our top priorities for 2010. It’s up to us to control our future! Have fun and be safe this new year!
Holidays are a joyful time for friends and family, filled with good food and great memories. During this happy time you must remember to take care of your oral health, not only during the feast but beforehand as well! Since most dental offices close for the winter holidays (some for up to two weeks!), it is a good idea to get a checkup before the holiday – especially if you have any pain or sensitivity.
With regards to holiday staining of your teeth, as I have previously mentioned in a wine blog, white wine has an acid content that tends to increase the risk of stain or darkening of your teeth, if combined with other habits of drinking tea, or similar dark beverages. Do not be fooled by the crystal clear appearance of a white wine – they are certainly capable of dulling your teeth. Both whites and reds are equally capable of staining teeth. Certain acidic properties present in wine (white, red or rose) create micro-porosity etching which rough the surface of your teeth, making your teeth much more susceptible to stains from other foods.
If you were to drink a glass of white wine with a red meat sauce, the acidic properties in the white wine could make your teeth more prone to staining from the red sauce in your meal, or the cup of tea after the dinner! Red wine is still more “dangerous” to the pearly opalescence of your teeth than white, however, as it contains pigment molecules known as chromagen, which will stain your teeth. All wines contain tannins, which act as a binding protein, aiding chromogen to saturate upon the surface of the tooth. Just remember to brush and floss after every meal, especially during the holidays!
When you do drink acidic liquids or eat sugary foods, be sure to rinse your mouth with water. Brush and floss twice daily, and after meals – oral hygiene should be routine to avoid problems. Prevention is the most powerful form of self defense from oral health problems!
Apart from keeping your teeth beautiful and pearly-white, remember not to over-do the quantity of the foods you eat during over the holidays. Lean proteins (like turkey and chicken), veggies (like green beans and yams), fruits (like pumpkin and cranberries) are all delicious in moderation – the Christmas ham could be a bit much (taste everything)! Don’t forget the pumpkin or pecan pie for desert! Holiday meals don’t have to be boring and bland to be healthy; sample everything in moderation. Have a happy and safe new year!
Sure, us Humans may only have two sets of natural teeth that are produced over the course of our entire life, but dinosaurs, particularly the Tyrannosaurus Rex, had many. A fascinating fact: the T-Rex actually produced a new set of teeth every year! 60 Minutes recently featured a headline story entitled “B-Rex” which contained information about the teeth of dinosaurs, specifically the T-Rex.
The new teeth in the dino would grow directly beneath the existing teeth, similar to how our permanent teeth develop beneath our baby teeth. Wouldn’t it be nice to have a replacement tooth grow automatically whenever we have a problem?!
Earlier this year, researcher and long-famed paleontologist Jack Horner had uncovered “B. Rex,” a 68-million year old T-Rex that is giving the academic community a lot to think about, both relating to dinosaurs and to the use of tooth material (and other mineral matter) in fossils. Through a special process of acid dissolution of ancient dino bones, organic material – blood vessels – were extracted and found in near-fresh condition!
“[We] dissolved away pieces of an even older dinosaur – a well-preserved 80-million-year-old duckbill – in acid, and again, found what appear to be blood vessels.” With this matter, new creatures could be genetically grown that had fallen extinct millions of years ago – a dino zoo even! What is interesting about dinosaur teeth however is that they illustrate how versatile teeth are in Earth’s many different life forms.
Humans obviously use their teeth for tearing, chewing and start the process of digesting food; speech and aesthetic purposes are also served by our teeth. Although we only have two sets of natural teeth, we can artificially create new teeth with implant dentistry. Other creatures have no teeth, like ducks and geese, which simply use their bill to seek out food and begin the digestion process.
The systematic replacement of old or broken teeth in dinosaurs is what’s driving research that will hopefully, in the future, result in human teeth being grown for human tooth replacement. Imagine being able to have a real, natural and healthy tooth installed in your mouth!
A new tooth is ready to replace the existing T-Rex tooth!
Current technology, like existing biocompatible metals (such as titanium) are used to replace human parts like hip bones. Biocompatible titanium is used for dental implant fixture, replacing a tooth’s root being implanted in the jaw bone. Porcelain restorations are then attached to the artificial titanium root after proper healing of the jaw bone.
It is also important to remember that not all dental implant restorations are made due to improper oral care or an irresponsible lifestyle! More and more people are being born with congenitally missing teeth, which can cause surrounding teeth to become misaligned, a possible evolutionary trend. Early diagnosis always makes the restoration process easier.
Though technology is constantly evolving, and may at one point completely replace the need for artificial dental restorations, it is of the utmost importance to try and take care of what you have! A person’s original, natural teeth are always the healthiest and most desirable option.
” Doc – My tongue hurts! It hurts to eat, drink , even talking hurts!” These are unfortunate symptoms of glossitis.
It’s not a canker sore or a new piercing – a tender feeling tongue with a burning sensation and a red color, swollen with a smooth appearance indicates glossitis – inflammation of the tongue. The causes of an inflamed tongue may stem from local factors like contact with irritants – tobacco, alcohol, spices, hot food and liquids. Dental conditions can also contribute to an inflamed tongue, such as chipped or rough tooth surfaces. Viral infections like herpes simplex, canker sores and even allergic reactions – food, toothpaste, mouthwash – can all contribute to glossitis as well!
An inflammation of the tongue (glossitis) typically leads to a change in the appearance of the tongue surface. Protrusion projections on the tongue’s surface layer (called papillae) may be lost, losing the classic bumped appearance, making the tongue appear completely smooth. Red or irregular patches of pale skin is called geographic tongue, and usually has no symptom but is a chronic condition that does not go away. An overly sensitive tongue might lead to difficulty speaking or swallowing. In some cases, glossitis may result in severe tongue swelling which can impede the throat, making it very difficult to breathe, a medical emergency that would require immediate attention.
Though not widely known, the tongue is a great indicator of our body’s general health. Experienced practitioners in alternative medicine can often diagnose an individual’s physical condition by just looking at a patient’s tongue! An inflamed tongue can be associated with a disease, disorder or condition like anxiety, depression, hypothyroidism, hormonal changes, immune system alterations, drugs reactions, leukemia,a vitamin deficiency in folic acid, B12 and iron, or even cancer.
So what are the treatments of glossitis? We do need to differentiate the cause of the inflammation of the tongue first.As previously mentioned, a vitamin deficiency such as iron deficiency anemia, pernicious anemia and other B-vitamin deficiencies are the most common reasons for a painful tongue. Oral lichen planus, erythema multiforme, aphthous ulcer, pemphigus vulgaris, syphilis, and others can also be culprits of causing glossitis. Irritants such as alcohol, tobacco and spicy foods and even certain medication may also cause temporary glossitis.
The important thing to remember with an inflamed or burning tongue is that reversing the inflammation is the primary treatment goal – if the inflammation is treated, other side effects (like burning sensations, redness etc) will almost always dissipate. Take both vitamin C and vitamin B complex every day, as these are the most common vitamin deficiencies associated with a painful tongue.
Cutting back on bad daily habits (like drinking and smoking),watching your diet for possible allergic reactions and better managing your daily stress will also aid in healing your tongue back to a healthy and normally functioning condition. If the symptoms of a painful tongue persist after two to three weeks of home self management, visit your health care professional to rule out any other possible medical conditions.
Dental CSI – it may sound funny, but it’s a very real science! Teeth are not only for eating, speaking and looking beautiful, but can be used in crime scene investigations with bite marks and extracted DNA. Dental ID, similar to fingerprint ID, is the most common form of dental forensics, a definitive meansof identification of unknown human remains in forensic investigations.It is routinely acceptable as evidence in court. Because of the resistant nature of dental tissues to environmental assaults, such as incineration, immersion, trauma, mutilation and decomposition, teeth represent an excellent source of DNA material as scientific identification!
Dental DNA can be used in anthropology as well! Earlier this month, doctors from the Massachusetts General Hospital threaded a scope up the neck and into the skull of a disembodied, 4,000-year-old mummified skull, in an effort to extract a molar. The tooth DNA was collected from the pulp of a well-preserved tooth and used to solve an “ancient art mystery,” which could identify his or her gender and age from material lying deep within the pulp of the tooth.
My experience with forensic dentistry was sad and shockingly personal – I had to send dental x-ray records to police department officials for identification of a friend killed in a plane crash.
Even criminals are aware of dental identification. Just this past summer, reality show star Ryan Jenkins had been suspected of killing his ex-wife Fiore; the perpetrator removed her teeth and fingers to destroy her forensic ID. What he didn’t realize was that the breast implants in Fiore’s chest carried a serial number that was later used to identify the body, and subsequently issue a warrant for Jenkins’ arrest. He committed suicide.
Dental identifications have always played a key role in natural and manmade disaster situations, in particular the mass casualties normally associated with aviation disasters. In the attacks on the World Trade Canter on September 11, 2001, only an estimated half of the 2,749 victims were identified – through a mixture of DNA, jewelry, and dental records. The deceased individual’s teeth are photographed and charted with impression materials that can be compared to the dentist’s patient chart, to make a positive identification.
Forensic dentistry has also been used to identify several infamous figures from the Nazi era, including Adolf Hitler, Martin Bormann, Eva Braun, and Joseph Mengele. The assassin responsible for the murder of John F. Kennedy, Lee Harvey Oswald, was also confirmed through dental records. Even the remains of Czar Nicholas II and his family, who were shot during the 1917 Russian Revolution, were initially identified through dental identification.
Forensic evidence in dentistry is a widely-applicable science in the identification of those individuals who cannot be identified visually or by other means or used as evidence utilized in law enforcement, but in scientific discovery as well! Teeth speak the truth!
On Halloween (October 31st) weekend, Autism Awareness Walks took place from San Francisco to New York and everywhere in between. Michelle Parris, a walker in Washington, D.C. came out to the Washington Mall ready to walk 2.5 miles for her son Miles. “I just want other people to not have to deal with the same difficulties that my son has dealt with,” she said. “If there’s a way that we can end it that would be great.” The annual Autism Awareness Walk is to raise funds and awareness to help fight autism, a disorder of neural development that hampers certain skills associated with social interaction and communication. Idiosyncratic use of language is also consistent. People suffering from autism also often suffer from restricted and repetitive behavior. The condition begins to show itself in children as young as two years old. Because much of the condition is still fairly mysterious, raising awareness and funds to fight autism is vital.
Often times, children suffering from autism are very difficult to treat by a physician – especially in dentistry. Autistic children often have a very hard time trusting physicians (especially if he or she is unfamiliar with said physician). In regards to dentistry, autistic children can have difficulty sitting still. This can make orthodontic treatment very difficult, especially if the child does not like braces or feels they are causing him or her pain. An autistic child can be treated just as successfully as any child if he or she is treated with patience and care.
Regarding dental home care, brushing and flossing will require a family member’s daily help and guidance. Nutritional needs for Autistic children are extremely important, not just for dental hygiene, but for the brain. There are researches showing how certain foods seem to affect the developing brain of certain children, causing autistic behavior. This is not because of allergies, but because many of these children are unable to properly break down certain proteins. Researchers in England, Norway, and at the University of Florida had previously found peptides (a breakdown product of proteins) with opiate activity in the urine of a high percentage of autistic children. Opiates are drugs, like morphine, which affect brain function. These findings have recently been confirmed by researchers at Johnson & Johnson’s Ortho Clinical Diagnostics. Gluten-free diets (a protein fraction found in wheat, rye, barley and most oat products) and Casein-free diets (a protein in dairy) are suggested. A professional nutrition consultation is really a must.
I was luckily blessed to have the opportunity to treat some special people who needed special care. Of course, every patient is special in my dictionary, but when dealing with someone who cannot communicate (or resists treatment), the challenge is greater to make that person better. You can also feel the love in between the family members – the special person actually plays the “glue” role to get the family together! When you see them together, it is such a beautiful scene.
Treating Autistic or any other special people can be an extremely rewarding experience. Everything is possible if we determine how to make things better; with patience, love and knowledge, we can experience miracles!
Trick or treat! The sweetest and most scary time of the year! Saturday eve, your street will likely be filled with ghouls, vampires and princesses all vying for your sugar-laden loot. Be it chocolate, sweet tarts or candy corn, be careful! It is important to remind the little ones that sweets will not be so sweet if we do not carefully clean it afterward!
We all know that we should brush and floss after every meal, especially after eating sweets, as within minutes, the sugar turns to acid and bacteria strives, the erosion and decay process initiates, and your candy isn’t so sweet any longer. Dental decay and gum disease are the consequences of poor oral hygiene conditions. For baby teeth, enamel is thin and not hard, and is very vulnerable to decay. Bad oral health is not isolated to the mouth, but can cause systemic problems including (but not limited to) heart disease, digestive problems and even dementia. It has been theorized that inflammation from periodontal disease, a hard-to-cure condition in which the bacteria get into your blood stream increases inflammation throughout your body, which challenges the body’s immune system, making it more susceptible to sickness.
A few examples of systemic health problems stemming from periodontitis include increased blood sugar levels in diabetics and a doubled likelihood of developing coronary artery disease. Expectant mothers with gum disease may also be several times more likely to give birth to a premature, underweight and sick child.
We all need to get into the habit of carrying our oral health tools – a toothbrush and floss. This is a particularly good habit to develop if you have children, encouraging them to brush after meals even in school, restaurants and when traveling. The minimum is that at least morning and night, twice a day, a mandatory oral hygiene routine is carried out. If your child has a sweet tooth or is prone to cavities, additional fluoride treatments might be necessary to strengthen the enamel, preventing a cavity. Ask your dental professional to be a part of the game plan to better equip your child in life for a healthy and happy mouth. If we can develop our child’s hygiene habits early on, that is a precious gift!
Halloween is scary season, and not just for costumes – it’s cavity season as well. Instilling good habits in your kids will ensure a healthy, bright and white future for your child’s teeth, and for their overall health as well.
In a recent study released by the Oral Health Journal, a systematic evaluation of patient oral hygiene for orthodontic patients has revealed stunning information that links poor patient oral hygiene with impacted orthodontic treatment quality and treatment times.
When a person seeks out orthodontic treatment to fix a problem (crooked teeth, a misaligned bite, etc…), he or she must realize that the bone is actually being remodeled. Orthodontic treatment rearrange teeth into a proper alignment, which pressure transfer to the roots of the teeth within the jawbone. Bone is actually lost and added during this process as the teeth are repositioned to their proper places as reaching the treatment goal.
Poor oral hygiene will influence your tooth and gum structures negatively. The progress of orthodontic treatment consist of inflammatory and regenerative responses. A mouth with plaque and tartar build-up will trigger the body’s inflammatory response, amplifying the already inflamed structures associated with orthodontic treatment and can lead to a prolonged inflammatory stage and a delayed regenerative phase within orthodontic treatment. Poor oral hygiene during orthodontic treatment can and will have a damaging affect on your treatment goals as well. Reports have shown that “poor oral hygiene can increase treatment times from 1.2 to 2.2 months – other consequences of poor oral hygiene during orthodontic treatment affect the quality of the end result of treatment.” Whereas standard orthodontic treatment (in a clean mouth) leads to the balanced loss and gain of bone, poor oral hygiene restricts the ability of new bone to grow, affecting the treatment results.
Orthodontic treatment seeks to improve a patient’s oral health, but what every patient must remember is that a treatment plan can only be fully realized if both the doctor and the patient are making concerted efforts to correct a problem and stick with a course of action. A patient’s oral health cannot improve without patient compliance. If a patient sees his or her orthodontic specialist (or physician or dentist) on a regular basis but does not fulfill his or her duties to maintain a clean and healthy oral environment, no improvement will ever be seen. A doctor and a patient must work together to obtain a successful result.
Remember that your dental professional may be a miracle worker, but that does not retract your obligation to maintain proper oral hygiene (or any other instructed daily routines)! Any orthodontic treatment plan is a dual-sided plan that requires dedication from both the physician and the patient. Without proper compliance from the patient, prolonged treatment time and reduced oral improvement will result.
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