Posts for: August, 2018
If we could go back in time, we all probably have a few things we wish we could change. Recently, Dr. Travis Stork, emergency room physician and host of the syndicated TV show The Doctors, shared one of his do-over dreams with Dear Doctor magazine: “If I [could have] gone back and told myself as a teenager what to do, I would have worn a mouthguard, not only to protect my teeth but also to help potentially reduce risk of concussion.”
What prompted this wish? The fact that as a teenage basketball player, Stork received an elbow to the mouth that caused his two front teeth to be knocked out of place. The teeth were put back in position, but they soon became darker and began to hurt. Eventually, both were successfully restored with dental crowns. Still, it was a painful (and costly) injury — and one that could have been avoided.
You might not realize it, but when it comes to dental injuries, basketball ranks among the riskier sports. Yet it’s far from the only one. In fact, according to the American Dental Association (ADA), there are some two dozen others — including baseball, hockey, surfing and bicycling — that carry a heightened risk of dental injury. Whenever you’re playing those sports, the ADA recommends you wear a high-quality mouth guard.
Mouthguards have come a long way since they were introduced as protective equipment for boxers in the early 1900’s. Today, three different types are widely available: stock “off-the-shelf” types that come in just a few sizes; mouth-formed “boil-and-bite” types that you adapt to the general contours of your mouth; and custom-made high-quality mouthguards that are made just for you at the dental office.
Of all three types, the dentist-made mouthguards are consistently found to be the most comfortable and best-fitting, and the ones that offer your teeth the greatest protection. What’s more, recent studies suggest that custom-fabricated mouthguards can provide an additional defense against concussion — in fact, they are twice as effective as the other types. That’s why you’ll see more and more professional athletes (and plenty of amateurs as well) sporting custom-made mouthguards at games and practices.
“I would have saved myself a lot of dental heartache if I had worn a mouthguard,” noted Dr. Stork. So take his advice: Wear a mouthguard whenever you play sports — unless you’d like to meet him (or one of his medical colleagues) in a professional capacity…
Fatigue, a “foggy” mind, and irritability are all signs you’re not getting enough sleep—and neither might your sleeping partner from your continuous snoring. You might have a common form of sleep-related breathing disorder (SRBD) known as obstructive sleep apnea.
Sleep apnea occurs when the airway becomes obstructed (usually by the tongue), resulting in a lack of oxygen. The body rouses from sleep just enough to correct the obstruction. This can occur and interrupt deep sleep several times a night, causing the aforementioned problems as well as personality changes, high blood pressure or increased stomach acid reflux. If the problem persists, sleep apnea could also become a long-term factor in the development of heart disease, diabetes or other serious conditions.
Fortunately, we can do something about it. While some may require more invasive intervention, most cases of sleep apnea can be alleviated through continuous positive airway pressure (CPAP) therapy. In this therapy, an electrical pump supplies pressurized air into a face mask worn while sleeping. The increased air pressure helps to keep the airway open.
For some patients, however, CPAP can cause discomfort like claustrophobia, nasal congestion and dryness. If that’s a concern for you, you might want to consider an oral appliance provided by your dentist.
Customized to your own individual mouth contours, this appliance is usually a two-part hinged device that draws the lower jaw and the tongue forward to open the airway. Easily adjustable, these appliances are usually more comfortable to wear than a CPAP and don’t require electricity or have the attendant noise of a CPAP pump.
They do, however, have a few drawbacks: they can disrupt saliva flow, causing either too much or too little; they may result in some morning soreness; and they can stimulate unnecessary tooth or jaw movements. For most, though, these side effects are minor compared to a better night’s sleep.
If you suspect you may have some form of SRBD, you’ll need to have it confirmed through a physical examination and possibly sleep lab testing. If it is sleep apnea, your physician and dentist can work together to help you find the right therapy to regain the benefits of a good night’s sleep.
If you would like more information on 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.”
If you want to keep that new smile after orthodontic treatment, you’ll need to wear a retainer for awhile. Teeth have a tendency to “rebound” to their old positions and a retainer prevents that from happening.
Most people are familiar with the standard removable retainer. But there’s another option: a bonded retainer. While performing the same function as a removable one, the bonded retainer differs in one important aspect—it’s fixed in place and can’t be removed except by a dentist. It’s especially useful for certain bite repairs like the closure of the gap between the front teeth.
If you’re thinking this retainer sounds a lot like the braces just removed, it’s not. The main part of a bonded retainer is a thin metal wire that we bond with a dental composite material across the back of the affected teeth. While you can definitely feel it with your tongue it can’t be seen by others, which is an advantage over many removable retainers.
The fixed nature of bonded retainers also creates a couple of advantages, especially for younger patients. There’s no compliance issue as with removable retainers—the patient doesn’t have the option of taking it out. That also means it can’t be lost, a frequent and costly occurrence with the removable variety.
But a bonded retainer does have some drawbacks. For one, the wire and composite material make it more difficult to floss. There’s also a possibility of breakage from high biting forces, which if that should occur must be immediately repaired to avoid the teeth rebounding. But while removable retainers have their downsides, it’s much easier with them to keep the teeth clean of plaque—you simply take the appliance out to brush and floss.
With your dentist’s help you can weigh the pros and cons of both types of retainers and decide which is best for you or your child. Whichever one you choose, wearing a retainer will help protect that hard-earned smile for years to come.
If you would like more information on protecting your bite after orthodontic treatment, 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 “Bonded Retainers: What are the Pros and Cons?”