Posts for: November, 2020
One in ten Americans has diabetes, a serious condition that may increase the development and severity of other health problems—including gum disease. Because of this latter connection, dental providers join other health professionals during November's National Diabetes Month to call attention to this chronic disease and its effect on health and well-being.
There's another health condition with a diabetes connection that isn't as well known: obstructive sleep apnea (OSA). It's also of keen interest to dental providers, as dentists are often involved in the discovery and treatment of this common sleep disorder.
OSA is the temporary blockage of the airway during sleep by the tongue or other anatomical structures. The subsequent drop in oxygen awakens the body to remove the obstruction. People with OSA may not realize they have the condition, but their bed partner can often attest to their snoring, snorting and gasping for breath during the night. Such episodes can occur several times per night, depriving the person of sufficient sleep.
Chronic OSA can contribute to the development of other health problems, among them Type 2 diabetes. It can do this first by interfering with the metabolization of glucose (blood sugar). It may also increase the body's resistance to insulin, the primary hormone regulating glucose.
Fortunately, properly managing OSA can lower your risk for diabetes, and that's where dentists may be able to help. For one thing, we dentists are often the first to notice early signs of OSA—sometimes even before our patients do.
According to the American Sleep Apnea Association, as many as 80% of the estimated 22 million Americans with OSA may not know they have it. But dentists often identify OSA indicators while examining patients: signs like an enlarged tongue or tonsils, or patients falling asleep in the exam chair. While we can't formally diagnose OSA, we often refer symptomatic patients to a sleep specialist.
Dentists also offer an alternative to the most common OSA therapy, which is continuous positive airway pressure (CPAP). This therapy employs a motorized pump that delivers pressurized air into the throat via face mask to keep the airway open during sleep. Although effective, some people find a CPAP machine noisy and uncomfortable to use.
Alternatively, dentists can provide an oral device that can often help patients with mild to moderate OSA that's worn in the mouth during sleep. Most of the various types of these appliances either reposition the lower jaw with a hinge mechanism to keep the throat open or pull the tongue away from the airway through a suction effect.
Diabetes is one part of a chain reaction that can bring unexpected challenges to your health, including to your teeth and gums. You can slow or even stop its development with proper diet, exercise and good, restful sleep. Dealing with OSA is often part of that equation—and we may be able to help.
If you would like more information about the prevention and treatment of diabetes, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Oral Appliances for Sleep Apnea.”
You can't correct a poor bite with braces or clear aligners overnight: Even the most cut-and-dried case can still require a few years to move teeth where they should be. It's a welcome relief, then, when you're finally done with braces or aligner trays.
That doesn't mean, however, that you're finished with orthodontic treatment. You now move into the next phase—protecting your new smile that took so much to gain. At least for a couple of more years you'll need to regularly wear an orthodontic retainer.
The name of this custom-made device explains its purpose: to keep or “retain” your teeth in their new, modified positions. This is necessary because the same mechanism that allows us to move teeth in the first place can work in reverse.
That mechanism centers around a tough but elastic tissue called the periodontal ligament. Although it primarily holds teeth in place, the ligament also allows for tiny, gradual tooth movement in response to mouth changes. Braces or aligner trays take advantage of this ability by exerting pressure on the teeth in the direction of intended movement. The periodontal ligament and nature do the rest.
But once we relieve the pressure when we remove the braces or aligners, a kind of “muscle memory” in the ligament can come into play, causing the teeth to move back to where they originally were. If we don't inhibit this reaction, all the time and effort put into orthodontic treatment can be lost.
Retainers, either the removable type or one fixed in place behind the teeth, gently “push” or “pull” against the teeth (depending on which type) just enough to halt any reversing movement. Initially, a patient will need to wear their retainer around the clock. After a while, wear time can be reduced to just a few hours a day, usually during sleep-time.
Most younger patients will only need to wear a retainer for a few years. Adults who undergo teeth-straightening later in life, however, may need to wear a retainer indefinitely. Even so, a few hours of wear every day is a small price to pay to protect your beautiful straightened smile.
If you would like more information on orthodontic retainers, 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 Importance of Orthodontic Retainers.”
Although energy drinks are but a blip on the historical timeline compared to coffee or tea, they've displaced these traditional stimulants among nearly half of today's adolescents and young adults. But these sweetened “processed” drinks are also controversial among healthcare experts—particularly the effect they may have on dental health.
Besides the added sugar found in many energy drinks—a prime food source for harmful bacteria—many energy drinks and their cousins sports drinks contain significant amounts of acid. High levels of acid soften and erode tooth enamel, which can lead to tooth decay.
During one experimental study, portions of tooth enamel were subjected to a number of name-brand energy and sports beverages. Over the course of a few days, researchers recorded significant enamel loss, especially involving the energy drink samples.
Abstaining from both energy and sports drinks is a sound way to avoid enamel erosion (the best hydrator, it turns out, is simply water). But if you do wish to continue consuming these beverages, here are a few common sense precautions for reduce the risk of harm to your teeth.
Partake only at mealtimes. Among its many abilities, saliva is able to neutralize oral acid and bring the mouth to a neutral pH level within 30 minutes to an hour. But if you're sipping on high-acid beverages throughout the day, your saliva may not be able to compensate effectively. Drinking energy drinks only during a meal helps saliva do its acid-buffering job better.
Rinse with water afterwards. Rinsing with a little water after eating or drinking something acidic can help reduce the pH levels in the mouth. That's because water is by and large neutral on the acidic/alkaline scale. Because it's not adding more, rinsing with water dilutes any concentrations of acid that may still be lingering in your mouth.
Don't brush immediately. Brushing is essential to overall hygiene, but if you do it right after you eat or drink, you could be doing more harm than good. That's because elevated acid levels that naturally occur after consuming foods and beverages can temporarily soften and demineralize the surface enamel. Brushing could remove microscopic bits of softened enamel. If you wait an hour to brush, you'll be giving saliva time to “re-mineralize” your enamel.
If you would like more information on the role of beverage acid in dental disease, 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 “Think Before Your Drink.”