Which Is It--Your Teeth, Your Jaw, Or Your Muscles?

Had a patient come in, complaining of some intense pain in her lower left back tooth that not even medication could help.  My instincts screamed "ROOT CANAL" for the hurting tooth, but I let my doctor brain put the brakes on that line of thinking and I thoughtfully worked through the examination.  In the end, there was no treatment recommended. WHAT?!?!? A dentist doesn't want to carve up a patient?

That scenario is more common than you think. I have treated head and neck pain for years, and I have learned about how pain can be referred from non-tooth sources. Problems with blood vessels, facial nerves, skin, and muscles can elicit tooth pain, and vice versa. These relationships are called bi-directional trigger points. 

Take the example of the primary muscles of chewing.  Not only do we use them to chew, we also use them to clench our teeth in times of stress. Wherever and whatever the nature of the stress (bruxism, apnea to name a couple), our muscles can become inflamed, and pass pain onto the nerve pathways of the teeth. The pictures below will show how upper teeth and lower teeth can be affected.

Conversely, I have anecdotal cases of patients with jaw or muscular or facial pain that is not felt in the teeth, but comes from abscessing, decayed, or inflamed teeth.

I have successfully used bite guards, night guards, Botox in the muscles, and sleep breathing appliances to deal with these aches and pains. 

Pushing A Wheelchair With Our Feet

Heard a funny observation this morning on the way into work: you ever wonder why there are people who are bound to a wheelchair, yet they somehow find a way to push themselves across the street with their feet, all the while remaining seated in the chair?

Then I picked through the morning's literature review, and the disabled wheelchair riders may be similar to patients suffering a sleep breathing epidemic. The increase in middle-age and elderly population's use of medication "sleep aids," and the rising prevalence in sleep disordered breathing that goes undiagnosed. It is a silent epidemic on the rise, and those who suffer it may be able to navigate through their lives with no clear understanding of their breathing disability.

In recent studies, it was observed that over 90% of women and over 80% of men with moderate to severe obstructed breathing disorders were living undiagnosed prior to survey.

Middle age and elderly individuals have a greater prevalence of sleep breathing disorders, most of them being obstructive sleep breathing type. Many sufferers have other associated conditions that make their condition worse, like the rising prevalence of chronic allergic rhinitis and sinus congestion, and the rising incidence of obesity.

With that being said, I have witnessed a great number of patients in my practice that are candidates for a sleep breathing evaluation. And a majority of those patients I refer are confirmed with sleep breathing disorders by our specialists.

We routinely screen our patients for a risk of airway obstruction. Call us today for an appointment.

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.

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.

Have You Checked Your Breathing Lately?

Poor breathing during sleep is a concern for 1 out of 4 adults. It is clled sleep-disordered breathing, and it can be responsible for sleep apnea. Kids are becoming increasingly more common patients with the disease.

The most popular emerging issues I am seeing in my practice are obstructive breathing disorders. A blocked airway can occur because of obesity, or anatomic differences in the head, jaws, neck, and/or throat. When breathing is not optimal, it creates a cascade of medical problems.

Obstructive airway disease is life-threatening. It can lead to high blood pressure and congestive heart disease. It increases a person's risk for stroke and heart attack. And sleep breathing disorders can complicate other diseases and their management.

As I continue my education and membership in the American Academy of Dental Sleep Medicine, I have learned there are only 2 ways for patients to address this disease: You treat it and live longer, or you don't treat it, and you live a shorter life with complications.

I have started to attend grand rounds with the local sleep medicine specialists at North Sound Sleep Center in Everett, I see the impact breathing disorders have on various patients; these patients who suffer have common characteristics. I compiled a self-test anyone can take to identify their risk for sleep breathing diseases. Here it is:

I have been told that I snore.
I have been told that I stop breathing when I sleep, or I have challenges with breathing efforts.
I am sleepy during the day even if I slept throughout the night.
I have high blood pressure.
I have been told that I sleep restlessly, I am always "tossing" and "turning" while asleep.
I tend to sweat excessively during my sleep.
I frequently awaken with headaches or jaw pain in the morning.
I have been known to fall asleep/nod off behind the wheel or other inappropriate times.
Others and/or I have noticed a recent change in my mood or personality.
I am consistently fatigued during waking hours.

I am overweight.

If any of these items apply to you, you need to see your primary physician or call our dental office for a more complete evaluation. Working together, we can get you the right care.

Cascadia's weekly prescription

Over the years, I have become increasingly aware of which patients have higher risks for obstructive airway disorders (OAD), also known as sleep apnea. What was at first a suspicion has now turned into an important screening procedure at every patient examination for my patients. I routinely examine the airway and offer a brief medical survey to patients who appear to be at greater risk for the disease. In collaboration with their specialists, we have treated patients with OAD to improve their quality of life.

I have been reviewing literature and websites for several years, and feel that the Academy for Dental Sleep Medicine is a decent resource for learning more about diagnosis and treatment for the disease. This site also offers you a self-test to determine if you should visit a doctor to determine if you can be treated for this debilitating disease. You can also visit our site to take the self-test.