Clear And Present Danger

“A Problem Even More Dangerous Than Texting While Driving” It’s hard to open a newspaper these days without finding a story about texting while driving — and that’s not surprising, considering how dangerous it can be. What is surprising is that another major driving hazard, called obstructive sleep apnea, doesn’t get the same kind of attention. Nighttime Snoring, Daytime Exhaustion People with obstructive sleep apnea literally stop breathing for as long as 30 seconds at a time while they sleep. Then, when their bodies realize they are starved of oxygen, they wake up gasping. And this doesn’t happen once or twice. It can happen as often as 400 times a night. Surprisingly, most people don’t actually wake up each time it happens. In fact, if there’s no one around to hear them snoring and gasping, they may have no idea they have a problem. But they don’t sleep normally — and as a result they end up exhausted the next day. Danger on the Road... That puts them at serious risk of falling asleep while driving, particularly when they’re on monotonous roads like the interstates. In fact, the American Thoracic Society estimates that up to 20% of crashes on these roads are caused by sleepiness.1 And it’s a bigger problem than you might think. The American Sleep Apnea Association estimates that 22 million Americans suffer from sleep apnea — but as many as 80% of them are unaware they have this dangerous condition. ... And Off As serious as the problem of driving while exhausted is, it’s only one of the dangers facing people with untreated sleep apnea. • The fact that sleep apnea causes sudden drops in blood oxygen increases the risk of high blood pressure. (The more severe the sleep apnea, the greater the risk.) • Stroke risk increases as well and, if you have underlying heart disease, sleep apnea can even lead to sudden death. • Obstructive sleep apnea can also cause congestive heart failure, atrial fibrillation and other vascular problems. • In addition, it can increase complications of surgery and some medications, and lead to memory problems, headaches, mood swings and depression. What’s more, while it has long been recognized that being overweight or obese increases the risk of obstructive sleep apnea, sleep experts have recently become aware that this is actually a two way street. Current thinking is that too little restful sleep may be as much of a contributor to obesity as too much food and too little exercise. Relief — at Least for Some In sleep apnea, throat muscles that keep your airway open when you’re awake relax too much when you sleep, causing your airway to become partially or fully blocked. It’s this blocking that causes the loud snoring and gasping other people may have told you about, as well as the dangerous drop in blood oxygen levels. Treatment is aimed at keeping your airway open, most commonly by using a CPAP (continuous positive airway pressure) machine. These machines have a mask that fits over your nose and mouth and forces air into your throat to help keep it open. When CPAP therapy works, it can make a life-changing difference. But, unfortunately, for many people, it can have some uncomfortable side effects, including claustrophobia, dry mouth, runny nose, even stomach bloating. With the result that many people simply can’t tolerate their machines. A More Comfortable Alternative Fortunately, my staff and I can offer you an effective alternative that’s both easier to use and more comfortable. Called a mandibular advancement device, this FDA-approved appliance gently repositions your lower jaw to help keep your throat open so you can breathe comfortably. Similar in shape to a retainer, they work without tubes, masks or noise, so most people find them easy to tolerate. And they love how much better they feel after finally getting a good night’s sleep. Bottom line: if the people you live with are complaining about your snoring — or you find yourself exhausted day after day — it’s time to visit your doctor and find out if sleep apnea could be the problem. Then, if it is, give us a call and let us help you start breathing better, feeling better and enjoying life again.

What Is Teeth Grinding(Bruxism)?

Bruxism is due to clenching of the teeth other than in chewing and is associated with forceful lateral or protrusive jaw movements. This results in grinding or rubbing the teeth together. The word bruxism comes from the Greek brychein meaning to grind or gnash the opposing rows of upper and lower molar teeth. People can clench and grind without being aware of it during both the day and night, although sleep-related bruxism is often the bigger problem because it is harder to control. It is sometimes done to such an excess that it damages the occlusal surfaces of the teeth, particularly the molar teeth, and may contribute to the temporomandibular joint (TMJ) syndrome. Bruxism is one of the most common sleep disorders. Eventually, bruxism shortens and blunts the teeth being ground and may lead to myofascial muscle pain, temporomandibular joint dysfunction and headaches. In severe, chronic cases, it can lead to arthritis of the temporomandibular joints. The jaw clenching that often accompanies bruxism can also be an unconscious neuromuscular daytime activity, which should be treated as well, usually through physical therapy including recognition and stress response reduction. Some estimates suggest that 15 to 33% of children grind their teeth. This usually happens after they develop their first teeth and again after they develop their permanent teeth. The habit usually stops when their adult teeth are fully formed. What are the symptoms of Bruxism? A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign. Clenching the teeth puts pressure on the muscles, tissues, and other structures around your jaw. Grinding can wear down the teeth. Grinding can also be noisy enough at night to bother sleeping partners. Other key symptoms include anxiety, depression, eating disorders, headache, sensitivity in the teeth and insomnia. Earache due in part because the structures of the temporomandibular joint are very close to the ear canal, and because one can feel pain in a different location than its source is also common. This is called referred pain. What are the causes of Bruxism The cause of bruxism is not completely agreed upon, but daily stress may be the trigger in many people. It has been estimated that nearly 70% of bruxism occurs as a result of stress or anxiety that is affecting people subconsciously during sleep. Some people actually clench their teeth and never feel symptoms. Each person is different. Whether or not bruxism causes pain and other problems may be a complicated mix of factors including posture, ability to relax, diet and sleeping habits. Bruxism can also be related to an abnormal bite. This is when there is a problem with your top and bottom teeth coming together which is called an occlusal discrepancy. Having teeth that are missing or crooked can also prompt you to grind your teeth. Bruxism can occur as a side effect of taking certain medications. These include some psychotropic drugs as antidepressants and antipsychotics. Diagnosing Bruxism Bruxism can sometimes be difficult to diagnose by visual evidence alone, as it is not the only cause of tooth wear. Over-vigorous brushing, abrasives in toothpaste, acidic soft drinks and abrasive foods can also be contributing factors, although each causes characteristic wear patterns that a trained professional can identify. The most reliable way to diagnose bruxism is through EMG (electromyographic) measurements. These measurements pick up electrical signals from the chewing muscles (masseter and temporalis). What are the treatment options for Bruxism? The cause of the condition is something you should consider before deciding how to treat bruxism. Stress is one of the main causes of bruxism. In this case, the problem is not the condition itself; the problem is the stress, and it should be treated as such. To treat bruxism caused by stress, one should start a case-specific stress management program and then re-assess the situation. This could involve something as simple as getting enough sleep at night or making sure one is getting regular exercise. If the condition is brought on by something other than stress, like a misalignment of the jaw or teeth, one should consider a dental solution to treat bruxism. A dentist can fit a mouth guard to wear at night. One should avoid using generic sports mouth guards as they tend to come out of place and cause more discomfort than they solve. Most users will find that mouth guards improve their situations, but they are not without drawbacks. Over time, a mouth guard can become worn down and lose its effectiveness. Further, when sufferers have tried to stop using the mouth guard, they have generally found that the pain and symptoms return, making it more of a patch up remedy than a permanent solution. There are many different types of splints. Some fit over the top teeth, some on the bottom. They may be designed to keep your jaw in a more relaxed position or provide some other function. If one type doesn't work, another may. When bruxism is caused by a misaligned jaw or by crooked and uneven teeth, a dentist or orthodontist may be able to realign the jaw or fit a person for braces to treat the condition. Avoiding foods and drinks that contain high concentrations of caffeine or alcohol is rocommended as these can enhance grinding. Also, one should avoid any unnecessary chewing. Stay away from things like chewing gum as it embeds clenching and grinding into your muscle memory. To treat bruxism, try to relax jaw muscles with a warm washcloth or a heating pad at least once a day to ease their tension. Preventing Bruxism Basically, stress reduction and anxiety management may reduce bruxism in people prone to the condition.

Brewster MA Dentist Has Another Happy Dental Implant Patient

Summer Time Prevention

Bursting the Bubble The popularity of soft drinks during the summer increases year after year, due in part to their sweet taste, and in part to the aggressive advertising campaigns run by soda companies. The amount of soda consumed by the average American every year is staggering – over 50 gallons per person. Soft drinks are a danger to oral health due to the high amounts of sugar and acids. Because of their liquid nature, gulping down soft drinks is equivalent to bathing teeth in a solution of acids and sugar. Over time, even the relatively mild acids in soft drinks can eat away and weaken tooth enamel, making teeth more susceptible to decay and damage. Another indirect effect of soda consumption is the reduced consumption of other, healthier drinks. The reduced consumption of milk has led to a deficiency in the intake of important vitamins and minerals. Calcium, in particular, is important to the maintenance of strong teeth and bones. Without a sufficient supply of calcium, the body cannot properly maintain the integrity of teeth – combined with the damaging effects of the sugar and acid in popular soft drinks, and it is easy to see why dentists are concerned. Lowering or eliminating soft drink consumption entirely is not a very likely solution. Sodas are so prevalent in the American diet that elimination is simply unrealistic. Therefore, if you are concerned about the effect of soft drinks on your oral health, consider the following steps. First, take a good look at your brushing and flossing habits. These are vital if you are to counteract the negative effects of soft drinks. Second, try to reduce your soft drink consumption as much as possible, and replace it with beneficial liquids such as milk or fluoridated water. Third, if you must drink sodas, use a straw when possible, to minimize contact with your teeth. A timely visit to the dentist is always a key factor in maintaining good oral and dental health.

Dental Hygiene Is Not Just For Cavities

Most of us are aware that poor dental hygiene can lead to tooth decay, gum disease and bad breath - but not brushing your teeth could also have consequences for more serious illnesses. In this spotlight feature, to coincide with National Dental Hygiene Month, we peer beneath the plaque to investigate what other - perhaps unexpected - health conditions are affected by poor dental health. Alzheimer's disease In 2010, researchers from New York University (NYU) concluded that there is a link between gum inflammation and Alzheimer's disease, after reviewing 20 years of data on the association. However, the number of participants in the NYU study was fairly small. The researchers analyzed data from 152 subjects enrolled in the Glostrop Aging Study - a study looking at psychological, medical and oral health in Danish men and women. The study spanned a 20-year period and ended in 1984, when the subjects were all over the age of 70. Comparing cognitive function at ages 50 and 70, the NYU team found that gum disease at the age of 70 was strongly associated with low scores for cognitive function. Study participants were nine times more likely to have a score in the lower range of the cognitive test - the "digit symbol test" (DST) - if they had inflammation of the gums. Although this study took into account potentially confounding factors like obesity, cigarette smoking and tooth loss unrelated to gum inflammation, there was still a strong association between low DST score and gum inflammation. In 2013, UK-based researchers from the University of Central Lancashire (UCLan) built on the findings of this study, by comparing brain samples from 10 living patients with Alzheimer's with 10 brain samples from people who did not have the disease. Analysis showed that a bacterium - Porphyromonas gingivalis - was present in the Alzheimer's brain samples but not in the samples from the brains of people who did not have Alzheimer's. What was interesting was that P. gingivalis is usually associated with chronic gum disease. The team followed up this research in 2014 with a new mouse study, the results of which were published in the Journal of Alzheimer's Disease. Medical News Today spoke to co-author Dr. Sim K. Singhrao regarding the findings. Dr. Singhrao says that there is sufficient scientific evidence to show that two of the three gum disease-causing bacteria are capable of motion (or "motile") and have been consistently found in brain tissue. "These motile bacteria can leave the mouth and enter the brain via two main routes," he explains. "They can use their movement capability to directly enter the brain. One of the paths taken is to crawl up the nerves that connect the brain and the roots of teeth. The other path is indirect entry into the brain via the blood circulation system." In a patient who has bleeding gums, says Dr. Singharo, the gum disease-causing bacteria will enter the blood stream every time they clean their mouth and even when they eat food. He continues: "P. gingivalis is particularly interesting as it has found ways to hitch a lift from red blood cells when in the blood stream and instead of getting 'off the red blood cell bus' in the spleen, they choose to get off in the brain at an area where there are no immune checkpoints. From there, they spread to the brain at their will. In addition, in older individuals, the blood vessels tend to enlarge and become leaky." "The published work confirmed P. gingivalis placed in the mouths of mice finds its way to the brain once gum disease becomes established first," Dr. Singhrao concludes. "Furthermore, our hypothesis is strengthened by the recent results demonstrating that the chemicals released by the brain's immune system in response to P. gingivalis reaching the brain 'inadvertently' damage functional neurons in the area of the brain related to memory." Pancreatic cancer A research team from Harvard School of Public Health in Boston, MA, were the first to report strong evidence on a link between gum disease and pancreatic cancer, back in 2007. The type of gum inflammation associated with pancreatic cancer in the study was periodontitis, which affects the tissue that support the teeth and can cause loss of bone around the base of the teeth. The other main kind of gum disease - gingivitis; where the tissue around the teeth becomes inflamed - was not linked to increased cancer risk. However, gingivitis can lead to periodontitis if persistent. Gingivitis happens when bacteria in the plaque around the base of the teeth build up due to bad dental hygiene. Examining data on gum disease from the Health Professionals Follow-Up Study, which involved a cohort of more than 51,000 men and began collecting data in 1986, the Harvard researchers found that men with a history of gum disease had a 64% increased risk of pancreatic cancer compared with men who had never had gum disease. The greatest risk for pancreatic cancer among this group was in men with recent tooth loss. However, the study was unable to find links between other types of oral health problems - such as tooth decay - and pancreatic cancer. The researchers suggest that there may be a link between high levels of carcinogenic compounds found in the mouths of people with gum disease and pancreatic cancer risk. They argue that these compounds - called nitrosamines - may react to the digestive chemicals in the gut in a way that creates an environment favorable to the development of pancreatic cancer. However, a follow-up study from the team in 2012 was unable to prove whether the periodontitis bacteria are a cause or result of pancreatic cancer - the study could only prove that the two were linked. "This is not an established risk factor," admitted author Dominique Michaud. "But I feel more confident that something is going on. It's something we need to understand better." Heart disease Perhaps more well established is the association between dental hygiene and heart disease. "The mouth is probably the dirtiest place in the human body," said Dr. Steve Kerrigan. In 2008, MNT reported on research from joint teams at the University of Bristol in the UK and the Royal College of Surgeons in Dublin, Ireland, who found that people with bleeding gums from poor dental hygiene could be increasing their risk of heart disease. The researchers found that heart disease risk increased because - in people who have bleeding gums - bacteria from the mouth is able to enter the bloodstream and stick to platelets, which can then form blood clots, interrupting the flow of blood to the heart and triggering a heart attack. "The mouth is probably the dirtiest place in the human body," said Dr. Steve Kerrigan from the Royal College of Surgeons, explaining that there are up to 700 different types of bacteria co-existing in our mouths. Prof. Howard Jenkinson, from the University of Bristol, added: "Cardiovascular disease is currently the biggest killer in the western world. Oral bacteria such as Streptococcus gordonii and Streptococcus sanguinis are common infecting agents, and we now recognise that bacterial infections are an independent risk factor for heart diseases." The Bristol University researchers investigated how the bacteria interact with platelets by mimicking the pressure inside the blood vessels and the heart. Prof. Jenkinson's team found that the bacteria use the platelets as a defense mechanism. By clumping the platelets together, the bacteria are able to completely surround themselves. This platelet armor shields the bacteria from attack by immune cells and makes them less detectable to antibiotics. Although some of the associations we have looked at in this spotlight feature are still under investigation, good dental hygiene remains important for lowering risk of a variety of conditions. The American Dental Hygienists' Association (ADHA) recommend that we should brush for 2 minutes, twice daily. The ADHA guidelines also stress the importance of flossing daily and rinsing with mouthwash.

Type 2 Diabetes And Your Gum's Health

Going to the dentist isn't fun for anyone, but for those with periodontal disease related to type 2 diabetes, a new research discovery may have them smiling. In a report appearing in the August 2014 issue of the Journal of Leukocyte Biology, one of the most important blood cells involved in the human immune response, B cells, are shown to promote inflammation and bone loss in type 2 diabetes-associated periodontal disease. These findings support the idea that treatments that manipulate the responses of B cells may treat or prevent this complication. "Our study identified common inflammatory mechanisms shared by type 2 diabetes and periodontal disease. It paves the way for the development of novel therapeutics which aim to simultaneously treat both type 2 diabetes and its complications," said Min Zhu, Ph.D., a researcher involved in the work from the department of microbiology at Boston University School of Medicine in Boston, Massachusetts. To make this discovery, scientists used an experimental model (mouse model) of periodontal disease and applied it to two groups. The first group had a genetic alteration that knocked out all B cells. The second group had normal B cell levels. When fed a low-fat diet, without development of obesity and type 2 diabetes, both groups demonstrated a similar extent of oral bone loss and inflammation. However, when they were fed a high-fat diet, became obese and developed type 2 diabetes, oral bone loss and inflammation occurred in the normal group with B cells, but did not develop in the group with the altered gene to knock out the B cells. This suggests that the B cell-response might be a viable target for pharmacological intervention in both type 2 diabetes and periodontal disease, as well as potentially in other type 2 diabetes complications. "This is an exciting study that helps us better understand why some complications related to type 2 diabetes occur," said John Wherry, Ph.D., Deputy Editor of the Journal of Leukocyte Biology. "For those who are dealing with periodontal disease related to type 2 diabetes, this is especially exciting. B cell targeting drugs are available for B cell cancers and these new findings could open the door for applying new B cell-based treatment strategies for periodontal diseases and perhaps other inflammatory conditions."

Sports Drinks And Teeth

Dental researchers at the University of Adelaide are warning parents of the dangers of soft drinks, fruit juice, sports drinks and other drinks high in acidity, which form part of a "triple-threat" of permanent damage to young people's teeth. For the first time, researchers have been able to demonstrate that lifelong damage is caused by acidity to the teeth within the first 30 seconds of acid attack. The researchers say drinks high in acidity combined with night-time tooth grinding and reflux can cause major, irreversible damage to young people's teeth. "Dental erosion is an issue of growing concern in developed countries, and it is often only detected clinically after extensive tooth wear has occurred," says Dr Sarbin Ranjitkar, corresponding author of a paper on tooth enamel erosion published in the Journal of Dentistry. Dr Ranjitkar is a member of the University's Craniofacial Biology Research Group, which is part of the Centre for Orofacial Research and Learning. The research was conducted by School of Dentistry Honors student Chelsea Mann. "Such erosion can lead to a lifetime of compromised dental health that may require complex and extensive rehabilitation - but it is also preventable with minimal intervention," Dr Ranjitkar says. Dr Ranjitkar says the number of cases of tooth erosion from the consumption of acidic beverages is on the rise in children and young adults. "Often, children and adolescents grind their teeth at night, and they can have undiagnosed regurgitation or reflux, which brings with it acidity from the stomach. Combined with drinks high in acidity, this creates a triple threat to young people's teeth which can cause long-term damage," he says. Dr Ranjitkar says parents should minimize consumption of any kind of soft drinks, sports drink, fruit juice or acidic foods to their children. "Our research has shown that permanent damage to the tooth enamel will occur within the first 30 seconds of high acidity coming into contact with the teeth. This is an important finding and it suggests that such drinks are best avoided. "If high acidity drinks are consumed, it is not simply a matter of having a child clean their teeth an hour or 30 minutes later and hoping they'll be okay - the damage is already done," he says. Dr Ranjitkar suggests children consume fresh fruit instead of drinking fruit juice. "Although fresh fruit is naturally acidic, it is a healthier option to fruit juice, which can have additional food acids in it. "The important thing to appreciate is that there is a balance between acids and host protection in a healthy mouth. Once that balance is shifted in favor of the acids, regardless of the type of acid, teeth become damaged," he says.