Over-The-Counter Snore Devices Can Lead to Jaw Joint Problems

April 13, 2010

Filed under: Uncategorized — Tags: , , , , — Dr. Benjamin Hornstein @ 3:44 pm

          We have a patient who treated himself for snoring.  He saw this great ad for a device on the internet.  It was fairly inexpensive and easy to use.  It was made of soft plastic that you boil and then fit to your own teeth.  The device was designed to bring the jaw forward so the tongue would not block the airway and thus stop the snoring.   Most people could probably tolerate such a generic appliance, but for some, this may cause a problem, as in the case of our patient.   (If you visit our website (https://www.cfad.net/tmjbruxism-therapy.html), you can learn more about how muscles, teeth, and nerves all work together for maximum function of chewing, breathing, and positioning the jaw.  This is called neuromuscular dentistry. )

When the teeth are placed in an abnormal position (as with this night-time OTC snore device), it affects not only the teeth, but the muscles that control the position of the jaw.  When this OTC appliance was boiled and fitted by the patient, the lower jaw was not lined up properly with the upper teeth.  This torqued the jaw to the right and put stress on the left jaw joint.  After wearing this devise for three months in this position at night, the left jaw joint developed clicking, popping and pain.   The patient was also unable to bring his back teeth together, which put even more stress on the jaw joints and made chewing difficult.  Had the patient not developed jaw pain and sought intervention, his joints might have become permently remodeled to this new position and surgery may have been required.  Thankfully we were able to release the muscles with electrical stimulation (TENS) and he was able to get his teeth back together.   At the Center For Advanced Dentistry, we are able to treat snoring and sleep apnea with a custom made appliance that is worn at  night.  This design is created using the principles of neuromuscular dentistry to prevent the onset of problems with TMD pain and other jaw problems.  If you snore and want a device designed just for you that is scientifically proven to relieve the problems associated with snoring and sleep apnea, call our office today.   Don’t treat yourself when the best professional help is just a phone call away.

Gum Disease and Your Overall Health

April 8, 2010

Filed under: Uncategorized — Tags: , , , , , , — Dr. Benjamin Hornstein @ 9:56 am

The American Academy of Periodontology (AAP) estimates that approximately three out of four Americans suffer from some form of gum disease — from mild cases of gingivitis, to the more severe form known as periodontitis. However, despite this prevalence, approximately only three percent seek treatment for their gum disease. With increasingly more research indicating that gum disease may be linked to several other diseases, including diabetes, heart disease and certain forms of cancer, maintaining healthy teeth and gums has become more important that ever.

According to Samuel Low, DDS, MS, Associate Dean and professor of periodontology at the University of Florida College of Dentistry, and President of the American Academy of Periodontology, the discrepancy between the prevalence of gum disease and the lack of treatment can likely be blamed on a lack of understanding of the effect periodontal disease can have on overall health. “Patients do not always seek the periodontal care they require because they are not aware of the long-term and potentially dangerous implications of untreated gum disease,” says Dr. Low. “Unfortunately, there are a variety of myths surrounding periodontal disease and its repercussions.”

In order to help distinguish between fact and fallacy regarding periodontal disease, the AAP has identified and addressed below some common misconceptions about oral health.

1. Bleeding gums are not that big of a deal. Red, swollen and bleeding gums are an important sign of periodontal disease. If you notice bleeding while brushing or flossing, or when eating certain foods, you should schedule a visit with your dental professional to be evaluated for periodontal disease. Studies have shown that in addition to tooth loss, gum disease may contribute to the progression of other diseases, including heart disease and diabetes, so it is important that you begin treating periodontal disease as soon as possible.

2. You don’t need to floss every day. Routine oral care, which includes brushing after every meal and before bedtime, and flossing at least once a day, is the best way to prevent gum disease. However, a recent survey estimates that only 13.5 percent of Americans floss each day. It is vital that you keep up with your daily oral care, and see a dental professional for a thorough check-up twice a year. If gum disease is diagnosed, a consultation with a periodontist, a dentist who specializes in treating periodontal disease, may be beneficial.

3. A visit to the periodontist will be scary. Periodontists are gum disease experts. They have received three or more years of specialized training following dental school centered on the diagnosis, treatment and prevention of periodontal disease. Periodontists are equipped with the latest treatments and technologies, using innovative tools such as digital radiography, ultrasound technology, biomarker measurement and laser therapy to help make your visit more comfortable.

4. A tooth lost to gum disease is a tooth lost forever. Gum disease is a major cause of tooth loss in adults. However, in addition to treating gum disease, periodontists are also experts in placing dental implants — a convenient and comfortable way to permanently replace missing teeth. A dental implant is an artificial tooth root that is placed into the jaw to hold a replacement tooth. Studies have shown that dental implants have a 98 percent success rate, and with proper care, allow you to speak, eat and smile with confidence. In fact, a survey conducted by the American Academy of Periodontology found that over 70 percent of respondents reported being “pleased” or “extremely satisfied” with the results of their dental implants.

5. Poor oral hygiene is the only way to develop gum disease. Forgoing good oral hygiene can certainly contribute to the progression of gum disease, but there are a variety of other factors that can also impact your risk. For instance, tobacco use has been shown to greatly increase your chance of developing gum disease. Stress, poor diet, and even genetics, can also play a role in the health of your gums.

About the American Academy of Periodontology

The American Academy of Periodontology (AAP) is the professional organization for periodontists — specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members world-wide.

Source: American Academy of Periodontology

If you snore, you may have occult sleep apnea.

March 4, 2010

Filed under: Uncategorized — Tags: , , , , , — Dr. Benjamin Hornstein @ 6:50 pm

If you snore, your bed partner may not be the only one who doesn’t have the benefit of restful sleep.   You may not be getting enough oxygen to meet your body’s needs.  One of the ways to measure the effectiveness of your sleep if you snore is to do an at-home sleep test.  The process starts with an evaluation in our office.  Dr. Hornstein will check your mouth and airway and all the necessary information will be gathered before the test.  This info will be sent to Sleep Optima, the company that provides the equipment and processes the insurance claims.  (You can get more information at www.mysleeptest.com.)    They will send the equipment right to your house with specific instructions about how to administer the test.  The test equipment consists of a headband that contains sensors that collect the needed information.  This info is interpreted by the microprocessor in the device.  It also has a nasal cannula that you wear in your nose (similar to how oxygen is delivered) that measures airflow and oxygen levels.   In addition to respiratory breathing rhythms, the sensors also detect sleep positions, stages of sleep, blood oxygen saturation, pulse rate, and snoring loudness.  After using the equipment for two nights, you then return the device back to Sleep Optima.  It takes about 7-10 days for the results of the tests to be available. 

Sometimes people who snore may not look like they stop breathing, but will have periods of low oxygen levels.  This is called occult sleep apnea or hidden times of low O2 levels (also know as hypoxia).   Since even occult apnea can lead to an increased risk of high blood pressure, stroke, heart attack and other problems, it is important to rule out sleep apnea in people who snore.  If you or a loved one snores, you should consider doing a home sleep test. 

It just might save a life!

Sign Your Dog Up For a Shot at Stardom

February 22, 2010

Filed under: Uncategorized — Tags: , , , , — Dr. Benjamin Hornstein @ 2:55 pm

Below is the link from Pedigree Dog Food featuring their Dentastix Treats for your dog’s teeth.  It is used to promote dental health in dogs.  You can upload your own dog’s photo and create a funny view of what might happen if you don’t care for his teeth.    Just a little humor to start your Monday.

https://www.pedigree.com/dog-care/health

Gum Disease and Pregnancy

February 15, 2010

Filed under: Uncategorized — Tags: , , , , — Dr. Benjamin Hornstein @ 1:53 pm

Periodontitis and pregnancy

February 8, 2010

Yiping Han, a researcher from the department of periodontics at Case Western Reserve University School of Dental Medicine, reports the first documented link between a mother with pregnancy-associated gum disease to the death of her fetus.

The findings are discussed in the article, “Term Stillbirth Caused by Oral Fusobacterium nucleatum,” in the February issue of Obstetrics & Gynecology.

An internet search in 2008 led a friend of a mother, who had just delivered a stillborn baby, to Han’s research lab — one of the few in the world working on understanding the role variations of the oral bacteria, Fusobacterium nucleatum, have on pre-term labor and stillbirths.

The mother delivered her full-term baby at Saint John’s Health Center in Santa Monica, Calif., at 39 weeks and five days.

During the 35-year-old mother’s pregnancy (her first), she told Han she experienced excessive gum bleeding, a symptom of pregnancy-associated gingivitis. Approximately 75 percent of pregnant women experience gum bleeding due to the hormonal changes during pregnancy.

“There is an old wives’ tale that you lose a tooth for each baby, and this is due to the underlying changes during pregnancy,” said Han, “but if there is another underlying condition in the background, then you may lose more than a tooth, but a baby.”

Bleeding associated with the gingivitis allowed the bacteria, normally contained to the mouth because of the body’s defense system, to enter the blood and work its way to the placenta.

Even though the amniotic fluid was not available for testing, Han suspects from work with animal models that the bacteria entered the immune-free amniotic fluid and eventually ingested by the baby.

Han says normally a mother’s immune system takes care of the bacteria in the blood before it reaches the placenta. But in this case, the mother also experienced an upper respiratory infection like a cold and low-grade fever just a few days before the stillbirth.

“The timing is important here because it fits the time frame of hematogenous (through the blood) spreading we observed in animals,” Han said.

Postmortem microbial studies of the baby found the presence of F. nucleatum in the lungs and stomach. The baby had died from a septic infection and inflammation caused by bacteria.

After questioning the mother about her health during the pregnancy, Han arranged for her to visit a periodontist, who collected plaque samples from her teeth.

Using DNA cloning technologies, Han found a match in the bacterium in the mother’s mouth with the bacterium in the baby’s infected lungs and stomach.

Han also ruled out by testing bacteria from the vaginal and rectal areas, which did not show the presence of F. nucleatum.

“The testing strongly suggested the bacteria were delivered through the blood,” Han said.

With preventative periodontal treatment and oral health care, the mother has since given birth to a healthy baby.

Han, who has spent the past decade taking her oral bacteria research from the lab to the bedside, says this points again to the growing importance of good oral health care.

In addition to this direct link from the mother to her baby, oral bacteria have been associated with heart disease, diabetes and arthritis.

The researcher suggests women, who are considering a pregnancy, seek dental care to take care of any oral health problems before getting pregnant. If pregnant, she encourages expectant moms to practice good oral health and alert the doctor to any gum bleeding.

Collaborating with Han on the case study were Yann Fardini, Casey Chen, Karla G. Iacampo, Victoria A. Peraino, Jaime Shamonki and Raymond W. Redline. The study had support from the National Institute of Dental and Craniofacial Research.

For more on the research, click here.

Taken from RDH emagazine

How to Handle a Dental Emergency When Out of Town

February 3, 2010

Filed under: Uncategorized — Tags: , , , , — Dr. Benjamin Hornstein @ 5:38 pm

We just had a patient who had a dental emergency and was out of town.  What do you do?  How do you find a dental practice like ours?  The first step would be to call our office to see if your problem is something that can wait until you return home.  However, if you are on an extended visit and won’t be coming home for awhile, you don’t want to let an infection or broken tooth go untreated. 

You could use a local friend’s recommendation or if you don’t know anyone, you could use the Internet.  We like Google for a search engine.  If you type in “dentist” and the city and state where you are located, you will get a variety of dentists and their locations.  You can see reviews and click on the links to the various dental websites.  A dentist should have the latest technology, use bonded or porcelain restorations, have digital x-rays, and can see you in the same day.  When you call their office, you should talk to a real person and not a machine.  Excellent dentists have excellent customer service for their patients and the team members should be friendly and knowledgeable.   If you have an infection and need a root canal, then you should be referred to a specialist who does only root canals (called an endodontist).  If the tooth is not savable and you need an extraction, you would want to see an oral surgeon who can also evaluate the site for the possibility of a future implant.   If you find yourself this predicament, then you can call our office for guidance and we will help you make the best decision for your oral health.  Hopefully, by maintaining your dental health with regular cleanings and check-ups, you will avoid this situation.  We are here to help you.

CFAD is now on Twitter. Follow us.

February 1, 2010

Filed under: Uncategorized — Tags: , , , , , — Dr. Benjamin Hornstein @ 8:23 pm

The Center For Advanced Dentistry is now on Twitter.  Tune in to our tips and musings.  Tell your friends or family about our Tweets.  You never know when they may save a life.   They cover everything dental and sometimes Doctor Hornstein’s humor.  You won’t want to miss a one. 

If you aren’t familiar with Twitter, it is one of the most expanding ways of staying in touch.  We are www.twitter.com/CFADBeachwood.  Check us out and join in the fun.

Sleep Apnea Now Treated At CFAD

January 27, 2010

Filed under: Uncategorized — Tags: , , , , , — Dr. Benjamin Hornstein @ 7:51 pm

You may think of snoring as a mild nuisance, but it can actually be indicative of a sleep-breathing disorder known as sleep apnea. Snoring occurs when soft tissues block air passages. Air forces entry, causing the muffled vibrations we know simply as snoring. A variety of factors can contribute to airway blockage, including tongue and jaw position, throat size, and tonsil or adenoid size. Snoring does not necessarily indicate sleep apnea, and many patients who snore do not have sleep apnea.

Sleep apnea occurs when the airways are blocked to the extent that the person stops breathing at intervals of ten seconds or longer. The continual oxygen deprivation prevents the person from receiving a restful night’s sleep, because he or she must awaken enough to breathe. If left untreated, sleep apnea can lead to:

  • Heart attack
  • Stroke
  • High blood pressure
  • Acid Reflux
  • Heartburn
  • Depression
  • Memory loss

Symptoms of Sleep Apnea
If you snore, gasp for breath at night, or sleep restlessly, you may have sleep apnea. Other signs include dry mouth, dizziness, inability to concentrate, morning headaches, irritability, and falling asleep when driving, reading, or sitting quietly. A sleep study will help Dr. Hornstein determine if you suffer from sleep apnea. You can also take an online risk assessment at www.mysleeptest.com, which is a brief questionnaire that assesses your risk level.

You may think of snoring as a mild nuisance, but it can actually be indicative of a sleep-breathing disorder known as sleep apnea. Snoring occurs when soft tissues block air passages. Air forces entry, causing the muffled vibrations we know simply as snoring. A variety of factors can contribute to airway blockage, including tongue and jaw position, throat size, and tonsil or adenoid size. Snoring does not necessarily indicate sleep apnea, and many patients who snore do not have sleep apnea.

Sleep apnea occurs when the airways are blocked to the extent that the person stops breathing at intervals of ten seconds or longer. The continual oxygen deprivation prevents the person from receiving a restful night’s sleep, because he or she must awaken enough to breathe. If left untreated, sleep apnea can lead to:

  • Heart attack
  • Stroke
  • High blood pressure
  • Acid Reflux
  • Heartburn
  • Depression
  • Memory loss

Symptoms of Sleep Apnea
If you snore, gasp for breath at night, or sleep restlessly, you may have sleep apnea. Other signs include dry mouth, dizziness, inability to concentrate, morning headaches, irritability, and falling asleep when driving, reading, or sitting quietly. A sleep study will help Dr. Hornstein determine if you suffer from sleep apnea. You can also take an online risk assessment at www.mysleeptest.com, which is a brief questionnaire that assesses your risk level.

Treatment
Three methods of treatment include surgery, using a CPAP (Continuous Positive Airway Pressure), and wearing a custom fit oral appliance at night. 

One option is surgery for those patients who have a blocked airway. With obstructive sleep apnea (OSA), blockages somewhere in the airway occur repeatedly and cause breathing to stop for at least ten seconds and maybe for a minute or longer. The intention of surgery is to open the airway sufficiently to eliminate or to reduce obstructions to a clinically insignificant level. In order to do so, surgical therapy in adults often must reconstruct the soft tissues (such as the uvula and the palate) or the bony tissues (the jaw) of the throat. This method has about a 50% success rate.

The most common method of treatment for sleep apnea involves a CPAP machine, which delivers a continuous stream of oxygen via nose and/or facial mask. While effective, the CPAP often proves cumbersome, and many patients find CPAP therapy intolerable and discontinue use. 

In many cases, Dr. Hornstein can provide CPAP intolerant patients with an alternative. Oral appliance therapy involves a custom-made orthotic worn at night. Depending on your needs, the orthotic can reposition the tongue, hold the jaw forward, and prevent the soft palate from blocking the airways. An oral appliance also alleviates snoring. Dr. Hornstein will consult with you to determine which kind of oral appliance is right for you.

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