Family Dentistry of Ocean City
Robert W. Yaskin, D.M.D. LLC
421 15th Street
Ocean City, NJ 08226
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Do you still feel tired or unfocused even after a full night’s sleep? Do others complain about your snoring? It’s possible these are signs that you may have sleep apnea.
Sleep apnea is a condition in which you stop breathing while you sleep. Your brain will awaken you to breathe, although you may not consciously realize it since the waking period can be less than a second. But it does disrupt your sleep rhythm, especially during the all-important deep sleep period called Rapid Eye Movement (REM). These disruptions don’t allow your body to receive the full benefit of sleep, hence your lack of energy and focus during the day.
One of the most common causes for sleep apnea is the collapse of soft tissues near the throat as they relax during sleep that restrict the airway. Snoring is an indication this may be occurring: air vibrates rapidly (and loudly) as it passes through this restriction when you breathe in.
As your dentist, we’re well-trained in the anatomy and function of the entire oral structure, and qualified to offer solutions for sleep apnea. If you’ve been diagnosed with sleep apnea (after a complete examination, including an observation session at a sleep laboratory), we can then help you decide on a treatment approach. The following are three such options, depending on the severity of your sleep apnea.
Oral Appliance Therapy. An oral appliance you wear while you sleep is a first line treatment for mild or moderate sleep apnea. The appliance, which we custom design for you, helps hold the lower jaw in a forward position: this moves the tongue and other soft structures away from the back of the throat, thereby opening the airway.
Continuous Positive Airway Pressure (CPAP). Intended for more moderate to severe forms of sleep apnea, a CPAP machine produces continuous air pressure to the throat through a mask you wear during sleep. This forces the tongue forward and the airway open.
Surgical Intervention. These procedures remove excess tissue that may be obstructing the airway. Due to its invasiveness and permanent alteration of the throat area, surgery is reserved for patients who haven’t responded to other therapies in a satisfactory manner.
Whether mild or severe, it’s possible to effectively treat sleep apnea. If successful, not only will you benefit from better sleep and greater alertness, you’ll also improve your long-term health.
If you would like more information on treating sleep apnea, 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 “Sleep Disorders & Dentistry.”
Chronic stress can cause any number of physical problems like back pain, insomnia or stomach ulcers. In the mouth, it can also be the cause of teeth grinding or clenching habits that may lead to pain and tooth damage.
Besides toothaches and jaw pain, stress-related teeth grinding may also be causing your teeth to wear at a faster than normal rate. While the teeth can withstand normal forces generated from biting and chewing, a grinding habit could be subjecting the teeth to forces beyond their normal range. Over time, this could produce excessive tooth wear and contribute to future tooth loss.
Here, then, are some of the treatment options we may use to stop the effects of stress-related dental habits and provide you with relief from pain and dysfunction.
Drug Therapy. Chronic teeth grinding can cause pain and muscle spasms. We can reduce pain with a mild anti-inflammatory pain reliever (like ibuprofen), and spasms with a prescribed muscle relaxant drug. If you have sleep issues, you might also benefit from occasional sleep aid medication.
A Night or Occlusal Guard. Also known as a bite guard, this appliance made of wear-resistant acrylic plastic is custom-fitted to the contours of your bite. The guard is worn over your upper teeth while you sleep or when the habit manifests; the lower teeth then glide over the hard, smooth surface of the guard without biting down. This helps rest the jaw muscles and reduce pain.
Orthodontic Treatment. Your clenching habit may be triggered or intensified because of a problem with your bite, known as a malocclusion. We can correct or limit this problem by either moving the teeth into a more proper position or, if the malocclusion is mild, even out the bite by reshaping the teeth in a procedure known as occlusal (bite) equilibration.
Psychological Treatment. While the preceding treatments can help alleviate or correct dental or oral structural problems, they may not address the underlying cause for a grinding habit — your psychological response to stress. If you’re not coping with stress in a healthy way, you may benefit from treatments in behavioral medicine, which include biofeedback or psychological counseling.
If you would like more information on dental issues related to stress, 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 “Stress & Tooth Habits.”
Many people use a mouthrinse as part of their daily oral hygiene. If you’d also like to include a mouthrinse in your regimen, the kind you choose will depend on what you want it to do for you.
If your main desire is fresh breath, then a cosmetic rinse that imparts a minty smell to the mouth should fit the bill. That, however, is all they do — cosmetic mouthrinses don’t contribute to oral health beyond your personal satisfaction that your breath is free of bad odors. But, if you want more — added protection against dental disease, for example — then you’ll need to consider a therapeutic mouthrinse.
Therapeutic mouthrinses are usually described as anti-cariogenic (prevents decay) or anti-bacterial, and include both over-the-counter (OTC) and prescription rinses. Their purpose is to either strengthen teeth or reduce the mouth’s bacterial levels. Of the OTC variety, most contain a small amount of sodium fluoride, which can strengthen tooth enamel. They’ve proven highly effective: a number of studies show using a sodium fluoride mouthrinse in conjunction with brushing and flossing reduces the chances of new cavities forming.
A number of OTC rinses also have an anti-bacterial effect, usually provided by active ingredients such as triclosan, zinc or essential oils like menthol. Even a slight reduction in bacteria can help lessen the chances of gingivitis (gum inflammation), an early form of periodontal (gum) disease. Reducing bacteria levels may also help alleviate bad breath.
Some individuals, though, have higher than normal levels of bacteria, or a systemic weakness in fighting certain bacterial strains. If this is your case, you might benefit from a prescribed mouthrinse intended to lower bacterial levels. Most prescription mouthrinses contain chlorhexidine, which has been amply demonstrated as an effective anti-bacterial control of tooth decay and gum disease. Chlorhexidine prevents bacteria from adhering to the teeth and so disrupts plaque buildup, the main cause of dental disease. Its prolonged use will result in the dark staining of teeth in some people, but this can be removed during dental cleanings and teeth polishing. Long-term use is generally not preferred compared to getting the proper attention from regular cleanings and examinations.
If you would like more advice on adding a mouthrinse to your daily hygiene regimen, especially to help reduce your risk of dental disease, please feel free to discuss this with us at your next checkup. Regardless of which type of mouthrinse you choose, they should always be used as a complement to daily brushing and flossing, along with regular dental cleanings and checkups.
For more information on mouthrinses, 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 “Mouthrinses.”
Some patients who wear dentures face a kind of Catch-22: their denture fit may have loosened and become uncomfortable over time due to continued bone loss, yet the same bone loss prevents them from obtaining dental implants, a superior tooth replacement system to dentures.
But there may be a solution to this dilemma that combines the stability of implants with a removable denture. A set of smaller diameter implants — “mini-implants” — can support a removable denture with less bone than required by a conventional implant.
Like all living tissue, bone has a life cycle: after a period of growth, the older bone dissolves and is absorbed by the body, a process known as resorption. The forces generated when we bite or chew are transmitted by the teeth to the jawbones, which stimulates new bone formation to replace the resorbed bone. When the teeth are lost, however, the stimulation is lost too; without it, resorption will eventually outpace bone growth and repair, causing the bone mass to shrink.
Removable dentures also can’t supply the missing stimulation — bone loss continues as if the dentures weren’t there; and due to the compressive forces of a denture, bone loss accelerates. As the jawbone structure used to originally form the denture’s fit eventually shrinks, the denture becomes loose and difficult to wear. It’s possible to adjust to the new jaw contours by relining the dentures with new material or creating a new set of dentures that match the current bone mass. Without adequate bone, fixed crowns or bridges anchored by conventional implants may also be out of the picture.
On the other hand, mini-implants with their smaller diameter need less bone than the traditional implant. A few strategically placed within the jaw are strong and stable enough to support a removable denture. One other advantage: these mini-implants can be installed in one visit with local anesthesia and usually without the need for incisions or stitches.
If you would like more information on dentures supported by mini-implants, 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 “The ‘Great’ Mini-Implant.”