You may get a laugh out of jokes about snoring, but in fact snoring and “Sleep Apnea” (“a” – without; “pnea” – breath) is no laughing matter. Nights of chronically disturbed sleep results in accidents, lost productivity and even depression, as well as problems at work and with relationships. Chronic snoring as a result of sleep apnea, results in sleep deprivation and health problems such as high blood pressure, congestive heart failure, heart attacks, brain damage and strokes.

What causes snoring?
Snoring results when soft tissue structures block the airway (windpipe) in the back of the throat. These structures include tonsils, soft palate, the uvula (the little punch-bag shaped structure at the back of the throat), and fat deposits. As you relax in sleep these tissues collapse onto themselves and the tongue drops back, causing a blockage in the air passage to the lungs. These obstacles to airflow create the familiar sound that we know as snoring.

What is Sleep Apnea?
When the obstruction is severe, it can block airflow completely. Obstructive Sleep Apnea (OSA) occurs when your upper airway is so seriously obstructed that there is significant loss of airflow, or even a complete arrest of breathing for 10 seconds or more. Reduced airflow into the lungs causes low levels of oxygen in the blood reaching the brain. Your brain, saving itself from suffocation, wakes you briefly out of deep sleep, followed by a loud gasp as the flow of air starts again. This can happen more than 50 times an hour. Low oxygen levels and fragmented sleep cause most of the dangers of sleep apnea.

What can be done to combat sleep apnea?
Medical and dental treatment includes:

• Staying physically healthy: Being overweight contributes to OSA, so start by losing weight and exercising.
• Oral Appliance Therapy: Specially designed (retainer-like) appliances are designed to maintain an open, unobstructed, upper airway during sleep.
• Continuous Positive Airway Pressure (CPAP): CPAP bedside machines send pressurized air through a tube connected to a mask (covering the nose and sometimes mouth), keeping your airway open.

How can we help you combat your snoring and sleep apnea?
The first step is assessment and diagnosis. Dentists, specially trained in sleep medicine, are in a unique position to help diagnose and help treat snoring and sleep apnea as part of a medical team. Contact us today to schedule an appointment if you think you have a problem with snoring and OSA — or if your spouse thinks you do. You can learn more by reading the Dear Doctor magazine article “Snoring and Sleep Apnea.”

A consistently dry mouth is not only uncomfortable and unpleasant but also probably more serious than you think. Dry mouth, medically known as xerostomia (“xero” – dry; “stomia” – mouth) affects millions of people, but few understand why it happens or why it is important.

What Causes Dry Mouth?

It is normal to awaken with a dry mouth because saliva flow decreases at night. But if your mouth is persistently dry throughout the day, it may be a result of habits such as smoking, alcohol or too much coffee drinking or even dehydration. It is also a common side effect of some medications. Xerostomia is not a disease in itself, but it could be a symptom of salivary gland or other systemic (general body) disease.

Why is Saliva Important?

A persistently dry mouth can be a problem. Not only does it feel unpleasant and lead to bad breath, it can also significantly increase your risk for tooth decay. Saliva lubricates your mouth for chewing, eating, digestion and even speaking. Saliva also has important antibacterial activities. Most importantly normal healthy salivary flow neutralizes and buffers acids in the mouth to protect the teeth from the acids produced by bacteria on the teeth that cause decay, and by acids in sodas, sports drinks and juices that can erode tooth enamel.

Not only does saliva neutralize acids but with its high mineral content it can actually reverse de-mineralization — the process by which acids attack enamel and remove calcium from the enamel surface. Healthy saliva actually re-mineralizes the outer layers of tooth enamel, but the process can take 30-60 minutes. That's why it's important not to snack on sugars or drink sodas between meals — one an hour and your mouth is acidic all the time.

Individuals without enough saliva are especially at risk for root decay and fungal infections, and they are also more likely to lose tooth substance through abrasion and erosion.

What Can We Do for a Dry Mouth?

If your mouth is usually dry, make an appointment with us to assess the causes of the problem. However it may be more serious with medical implications. The solution may be as simple as drinking more water and using good daily oral hygiene, or it may necessitate prescription medication to promote more saliva flow.

Contact us today to schedule an appointment to discuss your dry mouth and what we can do to help. For more information read the article in Dear Doctor magazine “Tooth Decay – How To Assess Your Risk.”

If a glance in the mirror reveals stained or discolored teeth that are detracting from your self-confidence, it's time to do something about it. The first step is to make an appointment for an office visit to find out how we can help you.

External (extrinsic) stains that form on the surfaces of teeth are usually caused by beverages such as red wine, tea, coffee as well as unhealthy habits like tobacco use. Extrinsic stains generally come in shades of browns, black or grays, but may even be orange or green from color producing bacteria.

Internal (intrinsic) stains are part of the structure of the tooth and cannot be removed by polishing. Among their causes are excessive fluoride levels or tetracycline antibiotics given in childhood and during tooth formation. Teeth do become more yellow and discolored as we age. Discoloration of individual teeth may be indicative of tooth decay, or teeth that have had root canal treatment and have literally lost their vitality tend to darken over time. Internal discoloration comes in a variety of shades and hues from yellows, grays, browns, and even some reds or pink.

Five Ways to lighten, whiten and brighten stained or discolored teeth

1. Change your habits. Reduce or stop consuming or using foods, drinks or tobacco if they are staining your teeth.
2. Improve your daily oral hygiene. Make sure to brush your teeth well, twice a day. Change to a toothpaste that contains a mild abrasive. Some toothpastes also contain tooth whiteners.
3. Visit our office for a professional cleaning and polish. Routine scaling and polishing will remove most superficial external stain and discoloration. Sometimes ultrasonic cleaning (by high frequency vibration) and polishing with slightly abrasive pastes may just do the trick.
4. Treatment for internal stain and discoloration. Brown colored decaying teeth need to have the decay removed and the teeth restored. Stained old and leaking fillings may also need to be replaced.
5. Tooth whitening by bleaching. Bleaching or tooth whitening is a safe and effective way to brighten stained teeth. Internal tooth bleaching can whiten even discolored root canal treated teeth. Ask us for more information about this technique.

If your mirror tells you that your smile needs attention, there's no time like the present to get started. Get back your bright, white smile and your self-confidence as well.

Contact us today to schedule an appointment to discuss your questions about tooth staining and its treatments. You can also learn more by reading the Dear Doctor magazine article “Tooth Staining.”

Bad breath, or halitosis, is bad news in any social situation — whether you're having an intimate conversation with a date or simply saying hello as you shake someone's hand. Halitosis, from the Latin halitus (exhalation) and the Greek osis (a condition or disease causing process), can also be a warning that something's amiss healthwise — usually in your mouth (85% to 90% of the time) but sometimes elsewhere in your body.

Most Common Causes of a Malodorous Mouth
Most unpleasant odors emanating from the mouth result from the processing of food remnants by certain strains of bacteria that typically populate the oral environment. As they feed on food particles, these microbes produce nasty-smelling byproducts — mostly volatile sulfur compounds, which have a distinctive “rotten egg” odor. That's why diligent dental care is front and center when it comes to banishing bad breath. Brushing, flossing and routine professional cleanings will help ensure that traces of last night's dinner or your midday candy bar don't stick around for bacteria to dine on.

Especially important, but often overlooked, during routine home oral care is the back of the tongue. This is actually the most common location for mouth-related bad breath to develop. Unlike the front of your tongue, which is bathed in saliva, the back of the tongue is relatively dry and poorly cleansed — an ideal setting in which microbe-laden plaque can form and flourish.

Even if you're industrious when it comes to brushing and flossing, food debris can get trapped and plaque can build up in hard-to-reach places such as between teeth (interdental), under the gums (subgingival) and around faulty dental work (e.g., ill-fitting crowns or veneers) contributing to overall oral odor. Other culprits include unclean dentures and oral disease such as tooth decay, gum disease, and abscesses.

Halitosis may accompany dry mouth, or xerostomia (xero – dry, stomia – mouth), a condition in which the normal flow of saliva, which cleanses the oral environment and keeps odor-producing bacteria in check, is interrupted. Most of us wake up with a temporary case of halitosis or “morning breath” because our salivary glands are less active while we sleep, but it usually disappears after a good brushing. If dry mouth is persistent, other possible triggers include: breathing through your mouth, a medication side effect, fasting or dehydration, or even stress.

Clearly, maintaining or restoring a healthy oral environment is your greatest defense against halitosis. Take care of your teeth and there's no reason your breath should be any less attractive than your smile!

If you would like more information about halitosis and ways to prevent or treat it, 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 “Bad Breath.”

If you are at all uncomfortable at the thought of getting a dental implant, you might be pleasantly surprised to learn the truth about these marvelous state-of-the-art tooth-replacement systems — and the special role of a relatively new device, the mini-implant. So, first, let's go over some basic facts.

What's a dental implant? Basically, it's just a replacement for the root part of the tooth, the part that lies beneath the gum line. It attaches to a crown, which is a replacement for the visible portion of the tooth. But instead of ceramics or metals, implants are made of titanium, which becomes fused to the surrounding bone. When complete, implants are much stronger and longer-lasting than other methods of tooth replacement, like bridgework and dentures.

Implants are presently regarded as the best way to replace missing teeth, with a success rate of over 95%. They also help prevent bone loss in the jaw, a major goal of modern dentistry. Having one put in is an office procedure that's generally accomplished with local anesthesia, and most patients experience only minor discomfort. Standard dental implants can be used to replace a single tooth, or multiple teeth. The mini-implant, which is just a miniature version of the same technology, is now playing an increasing role in many other phases of dentistry.

Why mini-implants? Because in several situations, this smaller and less expensive alternative offers a solution that's just as good — or better — than any other dental treatment. One area where mini-implants excel is in supporting lower jaw overdentures.

Many people find that lower dentures are far more troublesome than upper dentures. The movement of the tongue muscle, and the smaller area of surface contact (compared to the upper denture, which is supported by the palate) often results in a poor, loose fit, which leads to problems when eating or speaking. These problems can be solved by affixing a lower overdenture (an implant-retained denture) with just two mini-implants.

Not only do mini-implants help prevent bone loss, they also give the denture wearer increased stability, comfort, and confidence. And they do so at a price that's more economical than you might think. In some cases, the mini-implants can be placed in a single one-hour office visit, and your own denture can be modified to fit them — so you can go home and eat a steak that night!

Another area where mini-implants are finding increasing use is in orthodontics. Orthodontic appliances (commonly called braces) move teeth by exerting a light force on them, using a wire which is fixed to a solid anchor point. Traditionally, other teeth are used as anchors — but sometimes these teeth move as well! By using immovable mini-implants as the anchor points, the process is greatly simplified. Strategically placed mini-implants called TADS (temporary anchorage devices) can be used to correct both skeletal (jaw) position and dental (tooth) position problems.

Mini-implants may also be used in upper dentures and temporary bridgework.

If you would like more information about 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 articles “Implant Overdentures for the Lower Jaw,” “The Great Mini-Implant,” and “What are TADS?”