I Can't Breathe, And My Teeth Are Shrinking!

Years ago, I could swear people were coming to me with signs of freshly ground tooth enamel or broken teeth and crowns. I could literally watch the teeth being carved down over the course of hygiene visits. So I would ask them if they were aware of a habit that would make that happen. "No," they would shrug. "I don't." The only thing I and my patients could agree on was that they didn't grind their teeth during the day.

I know tooth wear is not typical. In fact, our brains do not allow our teeth to touch, even when we eat. If they do touch, it's called parafunction, or an abnormal function. So I was puzzled for a long time. It's frustrating when you know there's a reason for an occurrence, but you can't identify it.

What I started to recognize around 2005 was that patients informed me more often about obstructed breathing in their medical histories. Then I started to make a tally of which of these patients had tooth damage  and which didn't. And then I compared them to the patients who were not claiming obstructed breathing disorders. I noticed that all patients I saw who had a sleep breathing disorder were manifesting tooth wear.  The literature showed that this was occurring in a cause-and-effect fashion: When your airway closes, your brain instructs your jaw to move to open your airway. Your teeth can be in the way, and over time, will suffer damage in attempts to remedy obstructed airflow.

We work closely with specialists to determine if you have a breathing disorder, and we treat sleep breathing disorders with oral appliance therapy. We just so happen to treat teeth as well. Call us to schedule an appointment today.

Treat Blood Pressure By Treating Apnea

A patient walked in to see me last week, middle aged gentleman, energetic, talkative, friendly. Not the least bit stressed-out from all outward appearances. But his blood pressure was 210/130!  His readings came down modestly as we sat and talked.  But I booked him a visit at his primar care doctor's office before he left. Upon examination, I recognized he had lots of risky physical characteristics and a positive history for sleep breathing obstruction. I told him he could manage his blood pressure by managing his breathing.  His eyebrows went up.

It's true--blood pressures are reduced in patients treat their obstructive sleep apnea. The atricle I attached goes on to describe the study was performed with patients using oral appliance therapy.

I am a member of the AADSM--The American Academy of Dental Sleep Medicine.  Call today to begin your treatment.

Please Get Educated about the 2010 Healthcare Act

A decent summary of the Affordable Healthcare Act (ACA) as it impacts dental patient care was released recently.

The ACA has inadvertently developed many complicated twists and turns for patients and providers on the long road to a successful, comprehensive care horizon.

My thoughts:

1) Dentistry isn't about to get cheaper or easier to access with the advent of the ACA activity.

2) Maintain great communication with your employers and human resources representatives. Do your best to communicate the continued need for dental insurance policies.

3) Consider a health savings account or a flexible spending account and talk with your employer or HR about matching or funding those accounts for dental care. These types of accounts allow flexibility in how and where you get care. They can also help you and your family break through dental insurance limitations for where, when, and how you get care.

4) Educate yourself on how you can keep your children healthy under the ACA provisions. Odds are there is a state-funded program for kids in need, wherever you may live.

5) The ACA will create better access to medical insurance for our country's patients. Keep in mind surgical care in a dental office (tooth extractions, periodontal surgery, grafting, dental implants) and treatment for sleep apnea in a dental office can be submitted to medical insurance.

Sleep Apnea--A Pictorial

Let Us Help You Understand Your Risk For Sleep Disordered Breathing

Sleep apnea is more common today than ever. Just look at how national news covers this disease. But a better way of defining this problem is sleep-disordered breathing (SDB). SDB is connected to a higher risk of depression, loss of concentration, hyperactivity, heart disease, heart attack, stroke, dementia, as well as a number of dental problems.Children and adults are candidates for this problem. In previous posts, I have shared what signs you or your partner should look for when you suspect a sleep breathing disorder for you or your family.

If you are worried about you, your partner, or your family having SDB, we can help. We can screen you for signs and symptoms of the disease in our office.

Some people question a dental office as the best place for a screening. But Dentists may likely be the best providers to screen patients for SDB based on their understanding of the head, and neck, the many anatomic signs they can diagnose in SDB patients. Dentists also have the luxury of seeing patients more often over time than their physician counterparts, and that is a helpful element when being able to track changes in patients' health as it relates to SDB.

Based on your initial consultation, we can offer an at-home overnight oximetry and motion sensor test to monitor your breathing and motion while sleeping. We will analyze the data from your at-home test and determine if you are at high risk for sleep disordered breathing.Call us today for a free consultation to discuss your sleep breathing concerns.

Managing Apnea On The Road

A CPAP device is the standard for treating obstructive sleep apnea. The numbers of apneic patients is increasing annually. So there is a greater need to address their lifestyles and management of the disease at home an on the road. I thought it important to offer some tips and advice for managing apnea while traveling.

There are many CPAP and related devices on the market, but not all of them are travel-friendly. Recently, I got to try a System One device from Respironics, a Philips company. I was keen on the essential lack of noise from the machine, which has historically been the brunt of Darth Vader jokes. Being in a hotel room with this device wouldn't seem very distracting. Not only was it much quieter than models from even 5 years ago, it is also reasonably sized. Both the positive-pressure CPU and the mask fit into a laptop-sized carrying case.

Even though it's easy to put in your carry-on, I wouldn't recommend if you're hoping for a hassle-free airport screening. Stowing it in your luggage is probably your best choice. But if you're hell-bent on making your travels free of baggage, check this link from the TSA. It might be best to slip a copy of your treating physician's letter of medical necessity in the carrying case, in case the TSA decide you don't have a compliant appliance for travel. You can get one from your doctor upon request.

If you suffer from simple snoring all the way up up to moderate obstructive sleep apnea, and you and your spouse rely on a CPAP device for your health and sanity, you might want to consider an oral appliance. Most of them are acrylic with few metal parts, most are FDA approved, and usually don't require a letter from your doctor. The most popular device in recent years is the Thornton Adjustable Positioner, also known as the TAP appliance. It's the most compact way to manage your breathing obstruction.

We are experts at oral appliance therapy. Dr Rafoth is a member of the American Academy of Dental Sleep Medicine, and works intimately with sleep physicians in Snohomish County.
For more information, contact us today.