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Posts for: April, 2015

By David A.Susko DDS, PC
April 22, 2015
Category: Oral Health
Tags: snoring   sleep apnea  
SleepApneaandBehavioralProblemsinChildrenHowYourDentistCanHelp

We all know how much better we feel after a good night’s sleep: refreshed, energized and ready to handle — even excel at — our day-to-day responsibilities. Yet millions of people, young and old, are robbed of a good night’s rest by sleep-related breathing disorders such as sleep apnea, in which the soft tissues in the back of the throat block the airway during sleep. This temporarily disrupts airflow, causing numerous “micro-arousals” (sleep interruptions) that we may not even be aware of. A lack of sleep can make us drowsy, irritable and unfocused. In children, these typical symptoms of sleep apnea can lead to mistaken diagnoses of Attention Deficit Hyperactivity Disorder (ADHD).

The relationship between sleep apnea and behavioral problems has been highlighted in several recent scientific journal articles, including a major study published several years ago in Pediatrics, the official journal of the American Academy of Pediatrics. The lead author, Dr. Karen Bonuck, said at the time: “We found that children with sleep-disordered breathing were from 40 to 100 percent more likely to develop neurobehavioral problems by age 7, compared with children without breathing problems. The biggest increase was in hyperactivity, but we saw significant increases across [other] behavioral measures.” Therefore, an accurate diagnosis of a child’s behavioral problems — leading to the right treatment — is crucial. While sleep apnea must be diagnosed by a physician, treatment for the condition is often provided by a dentist.

What can be done for children suffering from sleep apnea? The most common treatment is surgical removal of the tonsils or adenoids. This treatment can sometimes be performed by an oral and maxillofacial surgeon, a dentist who has received several years of post-graduate surgical training. There are several other procedures oral surgeons can perform to open the airway, depending on what anatomical structures are blocking it.

Sometimes a child with sleep apnea can benefit from a procedure to expand the palate (roof of the mouth) to enlarge the airway. This is not a surgical treatment but rather an orthodontic one. An orthodontist (a dentist who specializes in moving teeth) will fit the child with a palatal expander, a butterfly-shaped device that gradually separates the two bones that form the upper jaw and roof of the mouth. This is often done to prevent crowding of teeth and other bite problems, but has been shown in some cases to improve airflow.

There is another dental approach used to treat adults and older children, whose jaw growth is complete. It’s called oral appliance therapy, and it involves wearing a custom-made device during sleep that resembles a sports mouthguard or orthodontic retainer. An oral appliance can maintain an opened, unobstructed, upper airway during sleep in various ways, including: repositioning the lower jaw, tongue, soft palate and uvula; stabilizing the lower jaw and tongue; increasing the muscle tone of the tongue.

If your child has been diagnosed with sleep apnea, we can help you find the best treatment approach. For more information, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders & Dentistry” and “Snoring & Sleep Apnea.”


By David A.Susko DDS, PC
April 14, 2015
Category: Dental Procedures
Tags: partial denture  
TemporaryToothReplacementwithFlexiblePartialDentures

Modern dentistry offers several great ways to permanently replace missing teeth, including high-tech dental implants and traditional fixed bridgework. But sometimes, for one reason or another, it isn’t possible to have these treatments done right away. If you need an aesthetic way to temporarily replace missing teeth, a flexible partial denture could be the answer you’re looking for.

Certain kinds of removable partial dentures (RPDs) can be used as permanent tooth replacement systems, especially for people who aren’t candidates for dental implants or fixed bridges. But in the past, if you needed a temporary tooth replacement, one of the few alternatives was the type of rigid RPD often called a “flipper.” This consists of a firm, relatively thick acrylic base that supports one or more lifelike replacement teeth. It attaches to the “necks” of existing natural teeth via metal clasps, which gives it stability and strength.

However, the same rigidity and thickness that gives these rigid RPDs their durability can make them uncomfortable to wear, while the acrylic material they are made of is capable of staining or breaking. Over time, the RPDs are prone to coming loose — and they are also easy to flip in and out with the tongue, which gives them their nickname.

Flexible partial dentures, by contrast, are made of pliable polyamides (nylon-like plastics) that are thin, light and resistant to breakage. Instead of using metal wires to attach to the teeth, flexible RPDs are held securely in place by thin projections of their gum-colored bases, which fit tightly into the natural contours of the gumline. Their elasticity and light weight can make them more comfortable to wear. Plus, besides offering aesthetic replacements for missing teeth, their natural-looking bases can cover areas where gums have receded — making existing teeth look better as well.

All RPDs must be removed regularly for thorough cleaning — but it’s especially important for flexible RPD wearers to practice excellent oral hygiene. That’s because the projections that hold them in place can also trap food particles and bacteria, which can cause decay. And, like most dentures, RPDs should never be worn overnight. Yet with proper care, flexible RPDs offer an inexpensive and aesthetic way to temporarily replace missing teeth.

If you have questions about removable partial dentures, please contact us or schedule an appointment for a consultation.


By David A.Susko DDS, PC
April 06, 2015
Category: Oral Health
GumDiseaseASilentProblemYouShouldntIgnore

Because its symptoms can be easy to overlook, gum disease is sometimes called a “silent” malady. But don't underestimate this problem! Untreated periodontal disease can progress into a serious condition, possibly leading to tooth loss and even systemic (whole-body) health issues. With proper preventive measures and appropriate treatment, however, the disease can be controlled.

The root cause of periodontal disease — actually, a group of related diseases, all of which affect the tissues surrounding the teeth — is the buildup of bacterial plaque (also referred to as biofilm) around the gums. While hundreds of types of bacteria live in the mouth, only a comparatively few are thought to be harmful. But when oral hygiene (namely, brushing and flossing) is inadequate, the environment in the mouth becomes favorable to those harmful types.

The disease often begins with inflammation of the gums called gingivitis. It symptoms include bad breath, bleeding gums, and soreness, redness, or tenderness of the gum tissue. However, in some people these early warning signs are ignored, or masked by the effects of harmful habits like smoking.

Gum disease is chronic; that means, if left alone, it will worsen over time. Periodontitis, as it progresses, causes damage to the ligament that helps hold the tooth in place, as well as bone loss. This may become increasingly severe, and ultimately result in the loss of the tooth. Severe periodontitis is also associated with whole-body (systemic) inflammation, which has been linked to an increased incidence of cardiovascular diseases, like stroke and heart attack.

But there's no reason to allow gum disease to progress to this stage! Prevention — that is, regular daily brushing and flossing as well as regular dental cleanings — is a primary means of keeping this problem at bay. Plus, every time you have a regular dental checkup, your gums are examined for early signs of trouble. Of course, if you notice the symptoms of gum disease, you should come in for a check-up as soon as you can.

There are a number of effective treatments for gum disease. One of the most conservative, routine ways are those regular dental cleanings we referred to earlier, usually called scaling and root planning. Using hand-held and ultrasonic instruments, the buildup of plaque (tartar) is carefully removed, sometimes under local anesthesia. A follow-up evaluation may show that this treatment, carried out on a regular schedule, is all that's needed. Or, it may be time for a more comprehensive therapy.

If you have concerns about gum disease, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Understanding Gum (Periodontal) Disease” and “Warning Signs of Periodontal (Gum) Disease.”


By David A.Susko DDS, PC
April 03, 2015
Category: Oral Health
DentalInjuriesinSportsATrueFalseQuiz

Everyone knows that football players and boxers wear mouthguards to protect their teeth from injury — in fact, it's thought that this essential piece of protective gear was first developed, around a century ago, for the latter sport. But did you know that many other athletic activities carry a high risk of dental injury?

How much do you know about dental injuries in sports? Take this quiz and find out!

True or False: Of all sports, baseball and basketball are associated with the largest number of dental injuries.

True. While these games aren't categorized as “collision” sports, the damage caused by a flying elbow or a foul ball may be quite traumatic. Tooth damage or loss can create not only esthetic problems, but also functional problems, like difficulty with the bite. Missing teeth can also be expensive to fix — running up a lifetime tab of some $10,000 - 20,000 if they canâ??t be properly preserved or replanted.

True or False: In general, oral-facial injuries from sports decline from the teen years onward.

True. Sports-related dental injuries, like other trials of adolescence, seem to peak around the teenage years. It's thought that the increased skill level of participants in the older age groups reduces the overall incidence of injury. But there's a catch: when dental injuries do occur in mature athletes, they tend to be more serious. So, protecting your teeth while playing sports is important at any age.

True or False: Over 80% of all dental injuries involve the upper front teeth.

True. For one thing, the front teeth areâ?¦ in front, where they can easily come in contact with stray objects. An individual's particular anatomy also plays a role: The more the front teeth “stick out” (referred to as “overjet” in dental parlance), the more potential for injury. In any case, theyâ??re the most likely to be damaged, and most in need of protection.

True or False: Your chance of receiving a dental injury in non-contact sports is very slim.

False. Even “non-contact” athletes moving at high rates of speed can be subject to serious accidents. Activities like bicycling, motocross, skateboarding, skiing and snowboarding all carry a risk. The accidents that result can be some of the most complicated and severe.

True or False: An athlete who doesn't wear a mouthguard is 60 times more likely to suffer harm to the teeth.

True. This figure comes straight from the American Dental Association. So if you want to reduce your chance of a sports-related dental injury, you know what to do: Wear a mouthguard!

What's the best kind of mouthguard? Like any piece of sports equipment, it's the one that's custom-fitted just for you. We can fabricate a mouthguard, based on a precise model of your teeth, that's tough, durable and offers the best level of protection. And, as many studies have shown, that's something you just can't get from an off-the-shelf model.

If you have concerns about sports-related dental injuries and their prevention, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”




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