Month: November 2018
How Sleep Apnea Impacts Your Oral Health
Sleep disorders are common, with over 70 million Americans suffering from one of the 80+ varieties, according to the Cleveland Clinic. Sleep disturbances are not just an annoyance that cause daytime sleepiness, but serious health concerns that are associated with heart disease and a shortened life span.
One of the most common kinds of sleep disorders is sleep apnea, which affects approximately 20 million Americans. Sleep apnea has been linked to diabetes, stroke, systemic inflammation, rheumatoid arthritis, and more. It can also affect oral health in a number of ways.
Sleep Apnea Basics
Before we look at how sleep apnea can affect your oral health, let’s first look at what it is.
Sleep apnea describes a condition in which the breath is stopped multiple times during sleep. There are two main kinds, central and obstructive. (A third kind, mixed, is a combination of the two.) Central sleep apnea is less common than obstructive sleep apnea and is caused by problems with the signals coming from the brain to the muscles that control breathing.
Obstructive sleep apnea (OSA) is more common and is typically caused by obstruction of the upper airway, such as swollen nasal passages or soft tissue in the throat that collapses during sleep. This type of sleep apnea can often be successfully addressed with orthodontic intervention, while central sleep apnea cannot.
How Sleep Apnea Can Affect Your Oral Health
Tooth grinding
Grinding your teeth – also called bruxism – is a common symptom of sleep apnea. This is the main source of problems for oral health connected with sleep apnea. Many people who grind their teeth aren’t even aware of it, as it happens during sleep. Dentists look for telltale signs of grinding like worn-down tooth surfaces. Bruxism can lead to pain in the face, head, ear, and jaw joint (TMJ).
(Note that there are many other causes of tooth grinding, including stress and consumption of alcohol, cigarettes, and caffeine. No matter the cause, tooth grinding can do damage, so talk to your dentist if you suspect that you grind your teeth.)
Problems with the teeth
Due to intense forces it causes, tooth grinding can lead to broken teeth and dislodged fillings. Plus, as the hard enamel layer wears down over time, teeth become more susceptible to decay, leading to cavities and potential infection.
Gum inflammation and gum disease
Tooth grinding can also cause the gums to recede over time, leading to inflammation of the gums (gingivitis) or gum disease (periodontitis). Gingivitis can be reversed fairly easily with good attention to brushing and flossing, but if not caught in time can progress to periodontitis, which itself can lead to bleeding gums, tooth loss, and infection. It’s a serious condition that needs to be addressed by a professional.
Orthodontic Treatments Available
If you are diagnosed with OSA, you have many options for treatment, including the use of a continuous positive airway pressure (CPAP) machine, which is typically the first line of treatment. While it’s highly effective, the downside of the CPAP machine is that many people find it uncomfortable and difficult, if not impossible, to use night after night.
Fortunately, there are orthodontic alternatives to the CPAP machine worth exploring that can address sleep disorders in both children and adults, including expanders and nighttime appliances. These treatments work because they improve airflow through the airway so the breath is not interrupted during sleep, and compliance is typically much higher than with CPAP machines.
Don’t Ignore Sleep Disorders, Treat Them
Sleep is a crucial part of health. If your sleep is routinely disturbed, speak to your doctor about undergoing a sleep study so you can get a diagnosis and start seeking treatment. Depending on your diagnosis, you may also want to speak to your dentist or orthodontist about treatment. At our practice, we evaluate patients who come to us with sleep disorders and offer customized solutions. The results can be life-changing.
Sources:
https://my.clevelandclinic.org/health/articles/11429-common-sleep-disorders
https://www.sleepapnea.org/learn/sleep-apnea-information-clinicians/
The Hazards of “Do-It-Yourself” Dental Treatments
Some things are perfectly fine for “do-it-yourself” if you have the skill, like replacing kitchen countertops, fixing a clogged sink, or changing your car’s oil. Other things, like dentistry, are not meant for DIY. Unfortunately, more people are choosing the DIY route when it comes to straightening their teeth.
The internet is responsible for this. Now people can find instructional videos and blogs promising quick fixes to common orthodontic problems. Several companies sell clear aligners to straighten teeth directly to consumers. What’s missing from all of these treatment options is the oversight of a knowledgeable and experienced professional.
For many people, this can add up to unintended consequences of DIY dentistry. When it goes wrong – and it often does – the results are bad. Here’s what can happen if you decide to play dentist with your own smile.
Unintended Consequences of DIY Dentistry
One common DIY treatment for crooked teeth is aligners that you can buy on the internet. First, you need to take an accurate impression of your teeth, which is challenging. Then you receive a series of clear aligners in the mail intended to take your teeth from where they are now to where you want them to be.
But moving teeth is complicated. (If it weren’t, orthodontists wouldn’t spend years of their professional life studying it!) Problems can arise even in the best of circumstances, and they’re much more common with DIY. For instance, if there’s not enough room in the mouth, teeth will shift to make room for other teeth that are moving, which can lead to crooked teeth. It’s even possible to move teeth right out of the bone. You don’t need to be a dental professional to know that’s a bad thing.
In some cases, DIY dental treatment can lead to the permanent loss of teeth. There’s a video online that shows you how to close a gap in between the front teeth with a little rubber band. What the video doesn’t explain is how that small rubber band can ride up and up and up along the tooth, under the gums, and eventually up the roots of the teeth. This can put pressure on the bone holding the teeth, leading to tooth loss.
These are just a few examples of what can happen when you choose to treat your own orthodontic issues. The takeaway is that by trying to fix one problem, you can end up with many more.
Understanding “Cost” Versus “Value”
With all the risks to DIY dentistry, why do so many people do it? The answer is simple: money. These “solutions” are appealing because they’re free or inexpensive compared with traditional orthodontics costs.
However, it’s important to understand the difference between cost and value. Cost is how much you pay. Value is what you get. You may pay $0 but end up with terrible results, meaning the cost is great but the value is terrible. Conversely, you may pay more for something but get exactly what you want. Here, the value is high because the quality is high compared to the cost. Orthodontic treatment that leaves you with a beautiful, healthy smile to last a lifetime can be the best value you ever find.
If you’ve considered DIY dental treatments, please simply talk to an orthodontist first. Don’t avoid the orthodontist because you assume you can’t afford treatment; you may be surprised to find out what your options are. Many orthodontists, including me, make it a priority to offer their patients affordable treatment. At my practice, we work with families to set up flexible payment arrangements that make it possible for them to get the treatment they need.
Having orthodontic treatment under the supervision of a specialist is a must. If you value your smile, don’t trust it in the hands of anyone other than an experienced professional – including yourself.
Wisdom Teeth Woes
Why are they called “wisdom teeth”? Because they appear so much later than other teeth, usually coming in between 17-25 – when one is (supposedly) wiser.
This third set of molars, which appear in the very back of the mouth beyond the other two sets of molars, are considered vestigial, a holdover from a time when our ancestors needed to grind down plant tissue for food. Since our diet has changed, we don’t really need wisdom teeth anymore, but most of us still have them. (Though up to 35% of people are missing at least one wisdom tooth, and some people have none at all.)
These days, wisdom teeth may be nothing more than a pain to people who do have them, as up to 85% of people with wisdom teeth will eventually need them removed. Dentists recommend they be extracted because if left alone, they can cause some big problems, including the following.
When They Don’t Come In: Impacted Wisdom Teeth
Impacted teeth are fully or partially stuck under the gum line, unable to emerge into the mouth on their own. Partially impacted wisdom teeth can lead to significant infections as food and germs become trapped under the gums. The most common teeth to be impacted are the wisdom teeth, due to their position in the back of the mouth. An impacted tooth is a problem because it can lead to significant pain, swelling, and even infection if left untreated.
A dentist or orthodontist can see where your wisdom teeth are by taking X-rays, which show how impacted they are and give an idea of how difficult an extraction will be. Depending on positioning, some are easier to extract than others.
When They Come in Wrong: Angled Wisdom Teeth
Not all wisdom teeth are impacted. The problem is that for many people, even if the wisdom teeth do come in on their own, there’s simply not enough room in the jaw to accommodate them. That can lead to problems.
Wisdom teeth that are not impacted may break through the gum line and start to come in but at an angle, pointing in or out of the mouth, towards the second molar or away from it, even completely horizontal. This misalignment means the bite will be off and the wisdom teeth won’t be functional for biting and chewing. It can also lead to damage of the jawbone, nerves, and neighboring teeth.
When They Push Other Teeth Forward: Relapse
Another issue is “relapse,” where teeth that have already been straightened are pushed out of place by wisdom teeth erupting and putting forward pressure on the rest of the teeth. Remember that wisdom teeth are the last to come in, and they may not come in until years after braces and other orthodontic treatment have been completed.
Some dentists and orthodontists believe this is a problem, while others say that it isn’t, since teeth tend to move towards the front of the mouth anyway.
Wisdom Teeth: To Keep or Remove?
If your wisdom teeth are not impacted, are coming in fine on their own, and there’s space in your mouth to accommodate them, then your dentist or orthodontist may not recommend they be removed. If they are recommended for extraction, now you understand why. Although extraction might be uncomfortable at the time, it can save a lot of pain and problems later. Talk to your dentist or orthodontist if you have any concerns about your wisdom teeth and make a plan that’s best for you.
