Millions of people have obstructive sleep apnea—and some don’t even realize it. That’s because even though these airway-blocking episodes can occur several times a night, they may only last a few seconds. The brain rouses the body just long enough to open the airway but not long enough to awaken the person to consciousness.
Even though a person with sleep apnea might not remember what happened to them, they can still experience the effects of sleep disturbance: drowsiness, irritability or an inability to focus. Over time, the accumulation of “bad sleep” could increase their risk for heart disease or other life-threatening conditions.
But there are effective ways to alleviate or lessen obstructive sleep apnea. The main “go-to” treatment is a method called continuous positive airway pressure (CPAP). CPAP utilizes an electric pump that supplies a constant flow of pressurized air through a mask worn by the patient while sleeping. The increased air pressure around the throat helps keep the airway open.
But although it’s effective, CPAP is unpopular with many people who have tried it. Many find the hose and other equipment cumbersome, or the mask too uncomfortable or restrictive to wear. As a result, quite a number simply avoid using it.
If you’ve had a similar experience with CPAP or would rather explore other options, we may have an alternative: an oral appliance you wear while you sleep. It can help prevent or lessen symptoms in cases of mild to moderate airway obstruction caused by the tongue or other forms of tissue.
Sleep apnea appliances come in two basic forms. One uses metal hinges to help move the lower jaw and tongue forward. The other form has a compartment that fits around the tongue and applies suction to help keep the tongue moved forward.
These appliances may not be suitable for patients with severe sleep apnea or whose cause is something other than a physical obstruction like abnormal neurological signaling patterns. But where they are appropriate, they can be an effective alternative to CPAP and the key to a better night’s sleep.
If you would like more information on this dental solution for 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 “Oral Appliances for Sleep Apnea.”
Like the rest of healthcare, antibiotics have transformed dentistry. Advanced oral infections that once eluded successful treatment are routinely stopped with the use of these “wonder drugs.” But their overuse over the years has given rise to dangerous “superbugs” resistant to many antibiotics.
Antibiotics are one of the 20th Century's most significant healthcare achievements. Drugs like penicillin played a major role ending the global threat of tuberculosis, cholera and bacterial meningitis. Over the last few decades, more antibiotics have been developed to defend against an even wider array of bacterial dangers.
But along the way doctors and dentists began prescribing antibiotics for all manner of illnesses including viral infections like colds or flu for which they're less effective. They've also been increasingly used as a preventive measure, including inclusion in animal feed to fight disease.
But our tiny biological nemeses are adaptable. As bacterial strains come in contact with greater amounts of antibiotics, individual bacterium that survive transmit their resistance to subsequent generations. This can produce new strains like Staphylococcus aureus (MRSA) that are resistant to methicillin and other common antibiotics that once contained them.
There's deep concern that these new resistant strains, often recent incarnations of old diseases once thought defeated, will lead to higher rates of sickness and death. Increasing resistance could also make common procedures like those performed by dentists and oral surgeons, much riskier to undertake.
To combat this, pharmaceutical companies are racing to create new drugs to compensate. Recently, they've received an encouraging sign of hope in this battle from an unlikely source: viruses. Researchers in Tel Aviv, Israel have discovered an antagonistic protein to bacteria among a group of viruses called bacteriophages. The protein, injected into a bacterium, commandeers the cell's DNA function to aid virus reproduction, which kills the host.
In the words of one researcher, this makes these particular “enemy of our enemy” viruses our “friend.” Although the discovery is still a long way from practical use in antibiotics, harnessing it in future drug versions could help pack a greater punch against resistant bacteria.
In the meantime, providers and patients alike must practice and advocate for stricter protocols regarding the use of antibiotics. The viability of tomorrow's healthcare is on the line.
Eating is like breathing: We often do it without much thought. But if you suffer from chronic jaw pain, every bite can get your attention—and not in a good way. What's worse, in an effort to avoid the pain associated with a temporomandibular joint disorder (TMD) you might make less than nutritious food choices.
But there are ways to eat healthy without aggravating the symptoms of TMD—not just your choices of food, but also how you prepare and actually eat the food. Here are 4 tips that can help you manage eating with TMD.
Choose moist foods in sauces or gravy. A lot of chewing action is intended to mix saliva with tough or dry foods to make them easier to digest. But this extra jaw action can irritate the jaw joints and muscles and increase your discomfort. To help reduce your jaws' work load, choose foods with a high moisture content, or cook them in a sauce or gravy.
Peel foods with skin. Fresh fruits and vegetables are an excellent source of vitamins and minerals, but their tough outer skin or peel is often hard to chew. Although these parts may also contain nutrients, removing them allows you to gain most of the nutritional benefit of the food while making it easier to chew it.
Cut foods into bite-size pieces. A lot of discomfort with TMD occurs with having to open the jaws wide to accommodate large pieces of food. To minimize the amount of jaw opening, take time to cut all your food portions down into smaller pieces. Doing so can help you avoid unnecessary discomfort.
Practice deliberate eating. All of us can benefit from slower, more methodical eating, but it's especially helpful for someone with TMD. By chewing deliberately and slowly and doing your best to limit jaw opening, you can enhance your comfort level.
Eating often becomes an arduous task for someone with TMD that increases pain and stress. But practicing these tips can make your dining experience easier—and more enjoyable.
If you would like more information on managing TMD in everyday life, 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 “What to Eat When TMJ Pain Flares Up.”
You've been treating a persistent rash around your mouth with medicated ointments, but it's not going away. The problem may be the ointment — it could actually be sustaining the particular rash you have.
Peri-oral dermatitis is a scaly rash with small bumps (some filled with pus) around the mouth, eyes or nose. It's especially common among women ages 20-45, possibly due to hormonal factors or cosmetic use. Other than its unattractiveness you might not otherwise notice it, although it can cause stinging, itching or burning. There are ways to treat it effectively, though not necessarily the way you might think.
Many skin conditions respond well to topical steroids, like ointments or lotions containing hydrocortisone. But prolonged use of a steroid for skin irritations might actually increase risks for peri-oral dermatitis. Applying it to an existing rash may also deceive you — the steroid constricts some of the skin's tinier blood vessels, which will make the rash appear as if it's fading. The effect, though, usually doesn't last more than an hour. If you continue to use the steroid, the rash won't get better.
The key to alleviating peri-oral dermatitis requires treatment from a physician, dermatologist or dentist, who will also be able to accurately diagnose the specific skin condition you have. If it is peri-oral dermatitis, the first step is to stop using any topical steroids and only wash with mild soap or similar substitute. You'll have to be patient because the rash may at first appear to flare up and worsen before getting better.
Instead of steroids, we may prescribe antibiotics to help clear the rash, typically tetracycline. It may take several weeks of use before the rash begins to clear; as it does clear, you would either stop the antibiotic treatment or taper off over a four-to-five week period.
While some cases of peri-oral dermatitis will clear up and remain that way, some people may experience chronic reoccurrences. Even so, by using the same treatment approach we can still effectively manage the condition for the long-term.
You already know the basics for healthy and attractive teeth and gums: brush and floss every day; and have your teeth cleaned and checked by a dentist every six months. But there are also some lesser known things you can do to improve what you're already doing—and some of them may go against popular wisdom.
Here then are 3 counter-intuitive tips for turbo-boosting your teeth and gum health.
Avoid brushing too hard and too often. While it may not seem like it, “The more, the better” isn't necessarily a good thing when it comes to brushing your teeth. Vigorous brushing several times a day could actually damage both your teeth enamel and your gums, eventually leading to problems like sensitive teeth. So, easy does it on the brushing pressure—let the mild abrasives in your toothpaste do the work removing disease-causing dental plaque. Likewise, avoid brushing more than twice a day.
Wait on brushing right after eating. If your first instinct right after a meal is to head to the sink to brush your teeth, curb your enthusiasm. Your enamel is actually in a slightly softened state right after eating and drinking because of an increase in mouth acid (especially if you've consumed sodas, sports drinks or juices). Saliva restores the mouth's pH balance and helps remineralize enamel in about an hour. If you brush before then, you could be sloughing off microscopic bits of enamel—an eventual problem if this is a regular habit.
Stop snack “grazing.” If you're one of those that likes to munch on food throughout the day, you could be thwarting your overall efforts to maintain good dental health. Remember saliva? As mentioned, it effectively neutralizes acid in a few minutes. But continuous snacking maintains a constant high level of acid in the mouth—saliva has little chance to catch up. As a result, your mouth stays acidic, which can lead to higher risk of dental disease. If possible, limit your snacking to mealtimes.
These tips might be surprising, but they're based on sound science and research. Incorporating them into your regular, ongoing dental care, could increase your chances of healthy teeth and gums.
If you would like more information on how best to clean and care for your teeth, 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 “10 Tips for Daily Oral Care at Home.”
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