Do you snore? You can admit it. Most everyone does, from time to time. But if snoring becomes a frequent and disturbing feature of your nighttime routine, it may be more than just an annoyance. Did you know that excessive snoring — when accompanied by irritability and depression, daytime sleepiness and confusion, and/or several other physical and mood problems — is one of the common symptoms of a sleep-related breathing disorder (SRBD)?

SRBDs are potentially serious conditions, with consequences that can range from poor workplace performance to possible cardiovascular and brain damage. One of the most significant of these maladies is called Obstructive Sleep Apnea, or OSA, a condition in which the tongue and surrounding soft tissues fall back into the throat and obstruct air flow. This reduces oxygen levels in the blood, causing the body to wake suddenly — and in severe cases, it can happen up to 50 times an hour, without a person consciously realizing it.

Needless to say, that doesn't make for a good night's sleep. But even if it turns out your snoring problem isn't severe OSA, it can still prevent you (and your partner) from feeling refreshed in the morning. Did you know that we may be able to recommend an oral appliance that has been proven to alleviate problem snoring in many cases? This custom-made device, worn while youâ??re sleeping, helps maintain an open airway in the throat and reduce breathing problems.

If you have this condition, it's critical that you get professional advice. Dentists who have received special training in sleep problems can evaluate you, provide medical referrals when needed, and help determine the type of appliance that may work best for you. Since sleep disorders can be problematic, a thorough evaluation and follow-up monitoring is essential.

Several treatments for SRBDs are available. But oral appliance therapy, when it's recommended, offers some distinct advantages. The small appliances are comfortable, easy to wear, and very portable — unlike more complex medical devices such as CPAP machines. They're a non-invasive and reversible treatment that should be considered before undertaking a more intensive treatment, like surgery. Could an oral appliance benefit you? Why not ask us if we can help you get a good night's sleep.

If you would like more information about oral appliance therapy for sleep problems, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Sleep Apnea FAQs.”

You've probably brushed your teeth every day since early childhood when your parents handed you your first toothbrush. But do you really know if you're doing it effectively and removing disease causing bacterial plaque or biofilm? Let's take a look at the basics of tooth brushing.

What is the goal of brushing and flossing your teeth? While it is true that brushing your teeth freshens your breath and removes stains from the surfaces of your teeth, the principal goal of tooth brushing is to remove dental bacterial plaque. This biofilm grows in the nooks and crannies of your teeth, and especially at the gum line — regardless of what you eat or drink. If left on your teeth, this bacterial film can cause gingivitis (inflammation of your gums). It can progress to periodontal disease, affecting the supporting bone of your teeth and even result in tooth loss. This means that flossing should also be an important part of your daily dental hygiene routine to remove plaque from the protected areas between your teeth.

Can you actually brush too much? More is not always better and can be damaging. We advise you to use a soft brush and to brush gently. It does not take force to remove plaque, and using a toothbrush too vigorously can damage your gums and cause them to recede (shrink away from your teeth), causing sensitivity and tooth wear. It takes between 12 and 24 hours for plaque to form on your teeth, so you don't need to brush more than twice a day and floss once a day.

How do you know when you've done a good job? A good test is that your teeth should feel like you've just had a professional cleaning. Your tongue is a great evaluator — just feel for smoothness at the gum line.

Is a powered toothbrush better than a manual one? An evidence-based study comparing all the research available found little difference between power and manual toothbrushes. The conclusion was that some powered toothbrushes with a rotation-oscillation action achieve a modest reduction in plaque and gingivitis compared to manual toothbrushes. But as we say, “it's not the brush, it's the hand that holds it.”

Come to our office for a demonstration. Any brush, whether electric or hand-powered, requires professional demonstration and training so that you know how to remove plaque correctly. Bring your toothbrush with you on your next visit to our office, so we can see your brushing technique and make sure you are doing it correctly for the most efficient plaque removal. And don't be embarrassed — nobody really knows how to brush effectively until they're shown!

Contact us today to schedule an appointment or to discuss your questions about tooth brushing and oral hygiene. You can also learn more by reading the Dear Doctor magazine article “Manual vs Powered Toothbrushes.”

What do burnt eggshells, crushed bones, brick dust and ox-hoof ashes have in common? Are they things you discovered in your kid's pocket? Ingredients in a witches brew? Funky organic compost materials?

It may be hard to believe — but they're all substances that were once used to make toothpaste, from ancient Egyptian concoctions through 18th century British blends. But don't worry: You won't find any broken crockery or ashes inside a modern tube! Today's toothpastes are scientifically formulated to be effective in removing plaque, which helps prevent tooth decay and gum disease (not to mention bad breath.) So what makes them work so well?

One class of ingredients found in all toothpastes is abrasives — also called cleaning and polishing agents. These slightly grainy substances make the mechanical action of brushing more effective. But unlike crushed bones, or the harsh, gritty particles of yore, today's abrasives are designed to remove stains and bacterial films without damaging tooth structure.

Next come detergents, which account for the foam you see when you brush vigorously. Detergents (sometimes called “surfactants”) help to break up and wash away materials that would otherwise be difficult to dissolve. An ingredient called sodium lauryl sulfate, which is also found in many shampoos, is probably the most common detergent used in toothpastes.

Fluoride, first included in toothpaste in 1914, is another common ingredient. In fact, all toothpastes that carry the seal of the American Dental Association contain it, typically in the form of sodium fluoride, stannous fluoride or sodium monofluorophosphate. It has been proven to make tooth enamel stronger and more resistant to decay.

In addition to these primary components, toothpastes generally contain flavorings to make them more palatable, and binders and preservatives to hold them together and keep them from drying out. Special-purpose toothpastes — like those designed to whiten teeth, prevent tartar, or help reduce sensitivity — have added ingredients.

But regardless of what's in your toothpaste, there's one thing you should remember: It's not the paste (or the brush) that keeps your teeth and gums healthy — it's the hand that holds it! Brushing once or twice a day, using a soft brush with the proper technique (and your favorite toothpaste!) is probably the most important thing you can do at home to enhance your overall oral health.

If you have questions about toothpastes or oral hygiene, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Toothpaste — What's In It?”

Bad breath can have a serious impact on a person's social and business life. Americans are well aware of this fact, and spend nearly $3 billion each year on gums, mints, and mouth rinses in order to make their breath “minty fresh.”

Bad breath or halitosis (from the Latin halitus, meaning exhalation, and the Greek osis, meaning a condition or disease-causing process) can originate from a number of causes; but oral bacteria are the most common source. About 600 types of bacteria grow in the average mouth. If bacteria act on materials that have been trapped in your mouth, many of them produce unpleasant odors.

Most often, bad breath starts on the back of the tongue, the largest place in the mouth for a build-up of bacteria. In this area bacteria can flourish on remnants of food, dead skin cells, and post-nasal drip. As they grow and multiply these bacteria produce chemical products called volatile sulfur compounds or VSCs. These compounds emit smells of decay reminiscent of rotten eggs.

In addition to bacteria on the tongue, halitosis may come from periodontal (gum) disease, tooth decay, or other dental problems. If you have halitosis, it is thus important to have a dental examination and assessment, and to treat any such problems that are found. Treating bacteria on the tongue without treating underlying periodontal disease will only temporarily cure bad breath.

The next step is to take control of tongue bacteria by brushing or scraping your tongue, with possible addition of antiseptic mouth rinses. People who have bad breath have more coating on their tongues than those who don't, and regularly cleaning the surface of the tongue has been demonstrated to reduce bad breath.

Implements have been designed specifically for the purpose of scraping or brushing the surface of the tongue. Using a toothbrush is not as effective because it is designed to clean the hard tooth surface, rather than the spongy surface of the tongue. To keep your breath fresh, you must regularly remove the coating from your tongue. This means acquiring a tongue scraper or brush and using it every day.

Contact us today to schedule an appointment to discuss your questions about tongue cleaning and bad breath. You can also learn more by reading the Dear Doctor magazine articles “Tongue Scraping” and “Bad Breath.”

If you wake yourself by snoring or have been told by others that you snore, you should share this fact with us during your next visit. Why? Many people are shocked to learn that their dentist is a vital resource for treating snoring and Obstructive Sleep Apnea (OSA), a condition that occurs when the upper airway (back of your throat) is blocked or obstructed causing significant airflow disruption or even no airflow whatsoever for 10 seconds or more.

Self Test For Sleep Apnea

While your responses to the following questions are not a diagnosis for OSA, they can be warning signs that you may have OSA or another condition that is impacting your sleep.

1. Are you a loud habitual snorer?
2. Has anyone ever witnessed you holding your breath, gasping for air or even choking while asleep?
3. Do you regularly feel un-refreshed or tired even after waking from eight or more hours of sleep?
4. Do you find yourself easily falling asleep throughout your day at work or at home?
5. Do you suffer from poor concentration or judgment, memory loss, irritability and/or depression from lack of sleep?
6. Are you 15 pounds over the normal weight range for your height and/or does you neck measure more than 17 inches around if you are male and 16 inches if you are female?

If you answered, “yes” to any of the above questions, you should share your responses to all of these questions with both your physician and us so that you can receive a thorough examination to address your sleep concerns. And if you are diagnosed with OSA, we can help with specific oral treatment options that may work best for you.

Learn More

Learn more about the signs, symptoms, and treatment options when you read “Snoring & Sleep Apnea.” Contact us today to discuss your questions or to schedule a consultation.

Research has revealed that over 12 million Americans suffer from Obstructive Sleep Apnea (OSA), a condition that occurs when the upper airway (tissues at the back of the mouth and throat) collapse causing significant airflow disruption or even no airflow whatsoever for 10 seconds or more. It can leave you feeling tired, depressed, irritable, as well as cause memory loss and poor concentration. But, did you know that we can help treat your sleep apnea?

The primary method dentists who are trained in sleep medicine use to treat OSA is through the use of an oral appliance. Similar in look to an orthodontic retainer or sports mouthguard, oral appliances are designed to maintain an opened, unobstructed, upper airway during sleep. And while there are many different oral appliances available in the marketplace, less than 20 have been approved through the FDA (Food and Drug Administration) for treating sleep apnea. The key to success is to avoid those over-the-counter (OTC), generic mouthguards and instead use a professionally made and custom-fitted oral appliance, made from a precise models of your teeth and mouth. They are best at keeping your airway open and preventing the muscles and soft tissues from sagging down when relaxed during sleep. Other advantages of custom-fit oral appliances are that they can reposition your lower jaw, tongue, soft palate and uvula (the tissue in the back of the throat that dangles like a punching bag); stabilize your lower jaw and tongue; and increase the muscle tone of your tongue.

But Is Treatment Really That Important?

Absolutely! If undiagnosed and/or left untreated, sleep apnea can be life threatening. It can cause heart attacks, strokes, impotence, irregular heartbeat, high blood pressure, and heart disease — many of which can kill you.

Want To Learn More?

To learn more about sleep apnea, read the Dear Doctor article, “Snoring & Sleep Apnea.” Or if you are ready for a thorough examination and to discuss your snoring, contact us today to schedule an appointment.

The CDC (Centers for Disease Control and Prevention) calls fluoridation of drinking water one of the ten most important public health measures of the 20th century, along with such measures as vaccination and motor-vehicle safety.

A fluoride concentration of about one milligram per liter (1 mg/L), or 1 part per million (1ppm), in the water supply is associated with substantially fewer cavities. This concentration of fluoride (equivalent to a grain of salt in a gallon of water) has been found to have no negative health effects.

The connection between fluoride and oral health was confirmed in the first half of the 20th century, and by 1955 the first clinically proven fluoride toothpaste was launched. Fluoride-containing toothpastes are common today, along with other fluoride-containing products.

Protective Effects of Fluoride
Ongoing studies have shown that fluoride has both a systemic (through the body) effect and a local effect at the tooth surfaces. Tooth decay takes place as part of a kind of active war between de-mineralization and re-mineralization, in which acids produced by bacteria in plaque (a biofilm in your mouth) soften and dissolve the minerals (de-mineralization) in the tooth's surface. At the same time, the saliva bathing the tooth acts to re-harden the tooth's surface by adding minerals back (re-mineralization). If fluoride is present in the biofilm and in the saliva, it protects against de-mineralization.

The fluoride you drink in your water is deposited in your bones. Bone is an active living substance that is constantly broken down and rebuilt as a normal body process. As this happens the fluoride is released into the blood, from which it can enter the saliva and act on the tooth surface. The fluoride in toothpastes and products like rinses is delivered directly to the tooth surface. Fluorides can also be eaten in foods with high fluoride content such as teas, dry infant cereals and processed chicken, fish and seafood products.

Problems with Over-use
Eating or swallowing too much fluoride can contribute to a discoloration of teeth called dental fluorosis, which varies in appearance from small white striations to stained pitting and severe brown mottling of the enamel. To avoid this effect, monitor children's tooth brushing to make sure they use only a small amount of fluoride toothpaste and do not swallow it.

Adding fluoride to water has been controversial because some people believe that it may cause other harmful effects. However, most health experts believe that fluoridated water carries no significant health risks and significantly contributes to public health by preventing tooth decay.

Contact us today to schedule an appointment to discuss your questions about fluoride. You can also learn more by reading the Dear Doctor magazine article “Fluoride & Fluoridation in Dentistry.”

The term TMD means “Temporomandibular Disorder.” But if you suffer from this disorder, it means pain. The pain can be mild or severe, acute or chronic, and it can appear to be centered in different locations, making it difficult to diagnose.

People who clench or grind their teeth because of stress often experience the pain of TMD. They might not even know they are engaging in these habits, because they do them subconsciously, for example when driving in traffic or engaging in vigorous exercise. Another cause of TMD might be an injury such as a blow to the jaw.

You can feel your temporomandibular joints working if you place your fingers in front of your ears and move your lower jaw up and down. On each side the joint is composed of an almond shaped structure at the end of the lower jaw, called the condyle, which fits neatly into a depression in the temporal bone (the bone on the side of your skull near your ear). A small disc between the two bones allows the lower jaw to move forward and sideways. The joints are stabilized by ligaments and moved by muscles.

TMD pain is the result of a process that begins when a stimulus such as psychological stress or an injury to the joint causes spasms (involuntary muscle contractions) in the muscles that move the joint. Blood vessels in the muscle begin to accumulate waste products, causing chemical changes and lactic acid buildup in the muscle. Nerves in the muscle then signal the brain to stop the movement of the jaw by registering pain.

TMD pain can appear to originate from various locations in your jaw, head, or neck. This is why it's important to make an appointment with our office for a professional assessment and diagnosis.

Treatment aims to relieve the symptoms of pain and discomfort and to prevent them from recurring in the future. Treatment can include heat, mild painkillers, muscle relaxants, soft diet, and simple jaw exercises, as well as education regarding the causes of TMD. To prevent further pain you may be provided with a “bite guard,” or referred to relaxation training with a licensed therapist. A bite guard is designed to prevent the lower teeth from biting hard into the upper teeth. It is commonly worn at night, but can also be worn during the day if clenching and grinding are apparent.

If these simpler treatments do not solve the problem, we may recommend more complex procedures such as bite adjustment or, as a last resort, surgical treatment may be needed.

Contact us today to discuss your questions about TMD. You can also learn more by reading the Dear Doctor magazine article “TMD: Understanding the Great Imposter.”

If you asked a room full of parents about their opinions on thumb sucking and pacifiers, the odds are good that you would get a wide variety of opinions. The truth is that this habit is a perfectly normal behavior in babies and young children; however, it is something that parents and caregivers should monitor. This is why we want to share a few basic myths and facts to set the record straight.

So how early does thumb sucking start?
It is interesting to note that thumb sucking for some babies actually starts before birth. This fact is proven quite often when expectant mothers “see” their unborn child sucking fingers or a thumb during a routine mid to later term sonogram. Sucking for babies is absolutely normal; it provides them with a sense of security. It is also a way they test, make contact and learn about their world.

At what age should a parent be concerned if their child still sucks a pacifier, finger or a thumb?
Recent studies have shown that if a sucking habit continues after the age of two, there may be some long-term changes in the mouth that have can have a negative impact on jaw development and/or with the upper front teeth. (It can cause these upper front teeth to become “bucked” or protrude forward towards the lips.) The American Academy of Pediatric Dentistry recommends that parents and caregivers encourage children to cease this habit by about age three.

Do children ever stop this habit on their own?
Absolutely! If left alone, many children will naturally stop sucking their fingers or thumb between the ages of two and four. The main points to remember are that sucking habits are totally natural and should stop on their own. You should not make it a problem unnecessarily. If, however, your child is getting older and still seems dependant upon this habit, feel free to contact us today to schedule an appointment for your child or to discuss your specific questions about pacifiers and finger or thumb sucking. You can also learn more about this topic by continuing to read the Dear Doctor magazine article “Thumb Sucking in Children.”

We in dentistry, advise parents to have an orthodontic evaluation some time before your child is 7 years of age. At this time, some of your child's adult teeth have come in and some primary (baby) teeth remain. This is a good time to check for developing problems. Treatment that begins while your child's teeth are coming in is called “interceptive orthodontics.” It provides an opportunity to achieve the best results in orthodontic treatment.

Once this evaluation takes place, it may mean that orthodontic treatment may need to take place in two-stages. A first phase of orthodontic treatment may prevent, intercept or minimize future orthodontic treatment. The first stage may be a process of guiding the growth of the jawbones that support the teeth. This is called “growth modification.” Then when the adult teeth have erupted through the gums, it may be time to do the second and final stage.

If a second phase of treatment is necessary it will probably require braces. These are small metal brackets that are bonded to the teeth. Thin flexible wires are threaded through them, and the wires are designed to push or pull on the teeth to provide a small amount of pressure that makes the teeth slowly reposition themselves within the jawbone. A light and controlled force pulling on a tooth causes new bone and ligament (the fibers that hold teeth in place) to be formed. These are living tissues that are constantly changing and remodeling themselves.

If you wait until your child's permanent (adult) teeth have all come in to start this process, it will be too late to correct some types of orthodontic problems, such as some types of malocclusions (“mal” – bad, “occlusion” – bite). It's better to work together with your child's stages of growth and development in order to have an optimum correction, both in looks and function.

You may be wondering whether a two-stage treatment costs twice as much. In fact, it is likely to be less expensive than a late one-stage treatment would be. Sometimes, the first stage may correct an underlying problem and make further treatment unnecessary. If a second phase is needed, it is likely to be easier and less costly.

Contact us today to schedule an appointment to discuss your questions about orthodontia for your child. You can also learn more by reading the Dear Doctor magazine article “Preventative & Cost Saving Orthodontics.”

Nearly everyone who has ever played a sport, or had a child participate in one, has had that panic-filled moment when they witness an injury. And when you consider that there are more than 22,000 dental injuries each year in children younger than 18 years of age, you see there is fact to backup this concern. This is just one reason why we strongly encourage all of our patients who are involved in activities such as football, soccer, hockey, wrestling, lacrosse, skateboarding, field hockey and more to wear one of our custom-fitted professional mouthguards. It is especially true for basketball and baseball, which are responsible for the largest number of dental injuries.

The following are some key issues to help you understand the importance and advantages mouthguards offer.

Is there a way to determine who is at the highest risk for sports injuries?

Yes there are several. Age, gender, dental anatomy, and the type of sports being played are the four categories used to measure the risks for dental injuries. Young male teens still top the list of most likely to be injured; however, the gap is closing with more females getting involved in sports. Learn which sports or exercise activities made the American Dental Association’s list of recommendations for using a custom mouthguard, when you continue reading “Athletic Mouthguards.”

What's the difference between a “boil and bite” mouthguard and a professionally made mouthguard?

We are often asked this very important question. While some over-the-counter (OTC) mouthguards provide what is advertised as a “custom-fit” to your teeth, it is nowhere near the fit — and thus protection — you receive from our mouthguards that are crafted from precise molds of your teeth. Additionally, because all aspects of our mouthguards are tailored to each specific mouth, they provide much more protection and comfort. This important fact can enhance performance as the athlete can literally breathe easier while wearing one of our mouthguards.

What can I do if I witness a dental injury?

The first important fact to know is that you do not have to be a dental or healthcare professional to assist. However, before jumping in to help out, consult Dear Doctor's Field-Side Guide to Dental Injuries. This pocket-sized, quick-reference guide details what you should do at the scene of a dental injury based on the type of injury. But best of all, it is available to you free of charge from Dear Doctor.

Want to know more?

Contact us today to discuss your questions or to schedule an appointment.

If your teeth have a worn appearance, it's possible you have a habit you're not even aware of: clenching or grinding your teeth. Also called “bruxism,” this destructive action causes your top and bottom teeth to come together or scrape past each other with a force that's many times what is normal for biting and chewing.

So what's normal? This can be expressed in terms of pounds. An adult usually exerts a force of 13-23 pounds to bite or chew food. But we have the potential to generate as much as 230 pounds of force, or 10 times what's normal. A “parafunctional” force of this magnitude applied repeatedly is bound to stress your teeth and other areas of your oral system. Besides wearing away the enamel of your teeth — and maybe even some of the softer dentin layer underneath — you may experience muscle spasms or pain in your jaw joints. Serious cases of wear can lead to “bite collapse” in which your face actually changes shape as your cheeks and lips lose support. This can make you look prematurely aged.

What can be done? To prevent further wear, we can fabricate for you a thin, plastic mouthguard that will protect your teeth at night or during times of intense stress. We can also recommend ways to temporarily relieve the discomfort that your grinding/clenching habits can cause. Heat and/or anti-inflammatory medication, for example, can be helpful.

If your tooth wear is minor (raggedness along the biting edge of a tooth or teeth) you may not need any restorative work. However, if tooth wear has already caused changes to your teeth and bite that you find aesthetically or functionally unacceptable, we can restore lost tooth structure in a variety of ways. Veneers and crowns are two examples.

If you have any questions about tooth wear or grinding habits, please contact us today to schedule an appointment for a consultation. You can learn more about this topic by reading the Dear Doctor magazine article “How And Why Teeth Wear.”

Millions of people suffer from mouth dryness, but most people just never talk about it. As your dental care providers, we don't want you to keep it a secret anymore and mouth dryness really can be a problem.

Why? Saliva is a very important fluid that moisturizes, lubricates, and aids in the first stages of chewing and digestion. A normal flow of saliva provides antibacterial benefits that even protect against cavities by buffering the effects of acids. It can also make the surfaces of your teeth more vulnerable to abrasion and erosion. Without enough saliva, you may be especially at risk for not only tooth decay, but even yeast infections.

Causes of dryness include dehydration and even morning breath, both of which are normal. Smoking, alcohol and coffee drinking also cause dryness. It is also a side effect of many medications. Although mouth dryness is not a disease in itself, it could be a symptom of salivary gland or other systemic (general body) disease.

As a first step in the treatment, we will assess your situation by taking a detailed habit, diet, medical, and drug history to properly assess the cause and establish whether this is a local condition affecting only your mouth or an indication of a generalized bodily problem.

It's always helpful to keep yourself well hydrated by simply drinking a sufficient amount of water every day and by using good daily oral hygiene to remove dental bacterial plaque. Chewing gum, especially containing Xylitol, will also help promote saliva flow and keep your mouth moist. Be careful not to suck on candy or mints, because they are likely to cause decay. There are also prescription medications that can be used to promote more saliva flow.

Contact us today to schedule an appointment or to discuss your dry mouth and what we can do to help. For more information read the article on Dry Mouth in Dear Doctor magazine.

Did you know that the bacteria that cause tooth decay are usually transmitted to children from their parents, through sharing the same spoon or kissing? Once inside the child's mouth, the bacteria live on the teeth in what is called a biofilm. When the child consumes sugary foods or drinks, the bacteria act upon the sugar to produce acids that eat away at the child's teeth, producing tooth decay.

These bacteria thrive on carbohydrates such as bread, sweets, and sodas. Even fruit juices, which offer more vitamins than soda, are filled with sugars that lead to decay. The child's saliva works hard to neutralize the acidity produced from these foods, but if the child often snacks between meals this neutralization process doesn’t have a chance to occur.

The first sign of decay may be white spots on the teeth, an indication that minerals in the surface enamel have been dissolved in certain locations. Before it goes any farther, this process can be reversed by reducing the exposure to acids and using fluorides to strengthen the tooth surface.

Make sure your child sees a dentist by his first birthday, to provide preventive care and treat any beginning decay.

You can also help your child develop the habit of brushing his teeth with fluoridated toothpaste. It is important to use only a smear of toothpaste on the brush for very young children, and a pea-sized amount on the brush for children over the age of 2. Sometimes small children swallow their toothpaste, and excessive amounts of fluoride can cause staining on the teeth. When your children are very young, you must brush their teeth. As they get older, they can do it themselves, with your supervision. We can also apply fluoride varnish to strengthen the tooth surface and make it resistant to acids.

Brushing twice a day is a good start. But it can't prevent tooth decay when a child is eating carbohydrates all day. One way to reduce the use of sugar is to use xylitol, a naturally occurring sweetener that looks and tastes like table sugar and improves oral health. Studies have shown that use of this sweetener reduces tooth decay in children.

Another good idea is to wean children from bottles and training cups as early as possible. Sometimes children are given bottles filled with milk or sugary beverages at bedtime to help them relax. A better idea for their teeth is to teach them to drink from a regular cup filled with milk — or preferably, with water.

Contact us today to schedule an appointment to discuss your questions about tooth decay in children. You can also learn more by reading the Dear Doctor magazine article “Managing Tooth Decay In Children With Chronic Diseases.” While this article focuses on children with health challenges, it contains excellent advice to help all children prevent tooth decay.

Tooth decay is not trivial. It's a worldwide epidemic, one of the most common of all diseases — second only to the common cold. It affects more than one fourth of U.S. children of ages 2 to 5 and half of those 12 to 15. Among adults, tooth decay affects more than ninety percent of those over age 40.

Prevention of cavities starts with a healthy diet and effective brushing and flossing, but it is much more complex than that. Three strategies for reducing dental caries (tooth decay) include:

Protect with Fluoride and Sealants
This works best when fluoride is applied to the crystalline coating of your child's teeth just after they push through the gums (erupt). The fluoride becomes incorporated into the tooth's surface and acts as a barrier to decay. Studies have shown that low doses of fluoride are safe and effective.

Dental sealants are used as a companion to fluoride because they seal tiny pits and fissures in the tooth's structure, creating an even stronger barrier.

Modify Oral Bacteria
Every mouth contains bacteria, no matter how well you clean your teeth. Not all bacteria cause tooth decay. The problem bacteria are those that produce acid as a byproduct of their life processes. We can identify acid-producing bacteria in your mouth, you can reduce their concentrations using antibacterial mouthrinses such as chlorhexidine, and pH neutralizing agents (substances that reduce the amount of acid).

Reduce Sugars in Your Diet
Bacteria in your mouth ferment sugars and other carbohydrates, producing acids that eat into the mineralized outside structure of your teeth, the enamel. So eating fewer sugars — particularly added sugars such as those in juices, sodas, candy and other sweets — will help prevent decay. Your total sugar intake should be less than fifty grams, or about ten teaspoons, per day. If you begin to read labels showing sugar content of common foods, you may be surprised at the amount you consume without knowing it.

If you must snack between meals, non-sugary snacks like raw vegetables and fresh fruits create a better environment for your teeth.

Xylitol, an “alcohol sugar” used in some chewing gums and dental products, has been shown to reduce decay-producing bacteria.

Try these easy strategies to keep your teeth healthy and functional throughout your lifetime.

Contact us today to schedule an appointment to discuss your questions about tooth decay. You can learn more by reading the Dear Doctor magazine article “Tooth Decay.”

We tend to think of aspirin as a harmless medication. It is dispensed over the counter and is the most widely used OTC medication in the U.S. We take it without thinking we may be exposing ourselves to risks. But in certain situations aspirin can cause dangerous side effects.

What is aspirin, and how does it work?
The chemical name for aspirin is acetylsalicylic acid. It is used to reduce mild pain, inflammation and fever. When you take an aspirin, it blocks the formation of prostaglandins, substances your body creates that are associated with inflammation. Prostaglandins cause inflamed tissues to become red and swollen, but they also serve protective purposes, such as forming a barrier that protects the stomach from the acid it produces to digest your food. That's why long-term aspirin use can sometimes cause stomach bleeding and ulceration or other health problems.

Why do cardiac patients take aspirin?
Another effect of aspirin is to prevent blood platelets from clumping together. Blood platelets are structures in the blood, smaller than white or red blood cells, that aid clotting by sticking together at the site of an injury. This effect of aspirin can cause prolonged bleeding, but it may be beneficial to people who have cardiovascular (from cardio, meaning heart; and vascular, meaning vessel) disease with narrowed blood vessels.

Aspirin can keep blood flowing in the obstructed vessels and thus prevent heart attacks and strokes; but it can also increase the risk for strokes that are caused by bleeding in the brain. Most physicians attempt to lower such risks by asking their patients to keep their daily aspirin consumption to a low dose 81 mg “baby” aspirin.

How does aspirin affect your teeth and gums?
Be sure to let your medical and dental professionals know you are taking aspirin, and how much you take. Also tell us about other OTC medications you take, including herbal medications and supplements, because they may interact with aspirin to cause side effects.

If you have been told to take aspirin because of a cardiac condition or procedure, be sure to follow your recommended treatment. Do not suddenly discontinue aspirin therapy; doing so can increase your risk for heart attack and stroke. Ask us if you should stop taking aspirin before a major dental or oral surgery, but do not stop taking it on your own. We will consult with your physician about your medical condition and let you know our recommendation. In most cases you can continue your aspirin therapy without causing excessive bleeding during the dental procedure.

Contact us today to schedule an appointment. You can also learn more by reading the Dear Doctor magazine article “Aspirin: Friend or Foe?”

If you engage in frequent air travel, you have probably experienced pain in your ears and sinuses related to pressure changes. The pain is caused by “barotraumas” (from baro meaning pressure — also the root of the word “barometer” — and trauma meaning injury) and is also called a “squeeze.” Divers also sometimes experience this discomfort or pain.

The cause of barotraumas is air pressure (or water pressure, in the case of divers) on the outside of your body that is not equal to the pressure inside your body. Normally when pressure outside your body changes, your organs such as your blood, bones, and muscles transmit the changes equally from outside to inside. Some structures in your body, such as your middle ear spaces and your sinus cavities (spaces in the facial bones of the skull), don't transmit the pressure as well because they are filled with air and have rigid walls. The maxillary (upper jaw) sinuses are pyramid-shaped spaces in the bone located below your eyes, on either side of your nose.

You have probably tried to stop such pain in your ears by yawning, chewing, or moving your jaw back and forth. These maneuvers, called “clearing,” allow air to move from the back of your throat into your ear canals so that the pressure can equalize. Similarly, your sinuses have small openings near their lower borders, so that you can clear pressure changes within them. If you have a head cold or flu and the membranes lining your sinuses are swollen and inflamed, they may close off the openings and make it difficult to clear these spaces. This can sometimes lead to intense pain.

Because the lower walls of these sinuses are adjacent to your upper back teeth, these teeth share the same nerves as the maxillary sinuses. This sharing sometimes causes pain felt in your back teeth to be perceived as pain in the sinuses, or vice versa. Pain felt a distance from its actual stimulus because of shared nerves is called “referred pain.”

Be sure to make an appointment with us if you experience pain in any of your teeth. Any defect in a filling or tooth can allow air to enter the tooth. It could be referred pain from your sinuses, or the result of pressure changes on trapped air within a filling or a tooth. Such pain, called barodontalgia (from baro meaning pressure, don't meaning tooth, and algia meaning pain) is an early sign of injury in a tooth.

Contact us today to schedule an appointment to discuss your questions about tooth and sinus pain. You can also learn more by reading the Dear Doctor magazine article “Pressure Changes Can Cause Tooth & Sinus Pain.”

The medical term for dry mouth is xerostomia (“xero” – dry; “stomia” – mouth), something that many of us have experienced at some point in life. However, for some people it can be a chronic condition that is ideal for promoting tooth decay. It can also be a warning sign of a more serious health condition.

Dry mouth occurs when there is an insufficient flow of saliva, the fluid secreted by the salivary glands. Your major salivary glands are located in two places: inside the checks by the back top molars and in the floor of the mouth, with about six hundred tiny glands scattered throughout your mouth. And many people are surprised to learn that when they are functioning normally, saliva glands secret between two and four pints of saliva per day! While this may sound like a lot (and it is), saliva is key for buffering or neutralizing acids in the mouth. Without this powerful protection, tooth decay can increase quickly. This is especially true for older individuals who have exposed tooth root surfaces.

It is also important to note that there are times when mouth dryness is perfectly normal. For example, when you wake, you will probably have a slightly dry mouth because saliva flow slows at night. Another example is if you are dehydrated when it is simply a warning sign that you need to drink more fluids (especially water). Other causes for temporary dry mouth include stress as well as what you consume: coffee, alcohol, onions, and certain spices.

You can also have a dry mouth due to a side effect from an over-the-counter (OTC) or prescription medication. If it turns out that this is the cause in your case, you need to talk to the prescribing physician to see if there is something else you can take to avoid this side effect. If there are no substitutes, one tip you can try is to take several sips of water before taking the medication followed by a full glass of water, or chew gum containing xylitol, which moistens your mouth and decreases the risk of tooth decay.

Another cause of dry mouth is radiation treatment for cancer in the head and neck region. Yes, these treatments are crucial for fighting cancer; however, they can inflame, damage or destroy salivary glands. You can also have dry mouth from certain systemic (general body) or autoimmune (“auto” – self; “immune” – resistance system) diseases, diabetes, Parkinson's disease, cystic fibrosis and AIDS (Acquired Immune Deficiency Syndrome).

To learn more, continue reading the Dear Doctor magazine article “Dry Mouth.” Or, you can contact us today to ask your questions, discuss your circumstances or schedule an appointment.

Some of the most important lessons parents and caregivers can give their children involve teaching and demonstrating good oral health habits. The following tips from the Centers for Disease Control and Prevention (CDC) are some ideas for helping you keep your children's teeth healthy.

1. Start cleaning teeth early.
   As soon as a child's first tooth erupts (appears), you should clean it daily by using a clean, damp cloth. Once several teeth are in, you should switch to a small, soft-bristled toothbrush. As for using toothpaste containing fluoride, you typically should start using it to brush your child's teeth at around 2 years old. However, there are some situations in which we recommend using toothpaste earlier than age 2. It just depends on your child’s mouth and development.


2. Use the right amount of fluoride toothpaste.
   Many people are aware that using toothpaste containing fluoride is an important tool for fighting tooth decay. But, many are shocked to discover how much should be used and what could happen if too much is used and swallowed. Because children under the age of 6 may tend to swallow all or some portion of toothpaste, you should only use (and teach them to use) a small amount—about the size of a pea. Otherwise, they could be at risk for getting white spots on their permanent teeth years later from having swallowed too much fluoride. This is also a key reason for teaching children how to rinse and spit properly after brushing their teeth.


3. Supervise brushing.
   Because children's abilities and maturity can vary greatly from child to child, you should brush your children's teeth until they have demonstrated the ability to handle the task alone. However, even when you give them the power to self-brush, you need to monitor them closely to ensure they are doing a thorough job, using the correct amount of toothpaste, and not brushing in a way that could damage teeth or gums. Brushing for too long and too hard are bad habits that can be detrimental to teeth and gums.


4. Talk to your child's doctor and with our office.
   Did you know that your first appointment should be at age one? The age one dental visit can be critical in establishing great communication and trust, and preventing early childhood decay. And having a positive rapport with your dentist and physician is important at any age; however, it is vital for parents and caregivers to develop great communication with their healthcare professionals on behalf of their children from the start of life. Not only does it model good habits for them to observe, but it also helps you stay abreast of the oral and general health needs.

Want to learn more?

Contact us today to discuss your questions or to schedule a consultation. You can also learn more by reading the Dear Doctor article, “Oral Hygiene Behavior.”

Getting enough sleep is necessary for good health. We all know how energetic we feel when we are sleeping well at night. Yet, many of us do not feel rested, even after seven or eight hours of sleep. Let's answer some common questions about snoring and sleep apnea, problems that are often called sleep related breathing disorders (SRBD).

What is the purpose of sleep?
Scientists know we need sleep, at a particularly deep level, to be rested, but they are not sure why we need sleep. Sleep may have evolved as a way to conserve energy in the body, to conserve food supplies, or to reduce our risk during darkness. Sleep appears to give the brain a chance to store and organize its information and the body a chance to recuperate. Sleep studies have shown that in order to get the full benefits of sleep we need to sleep long and deeply enough to enter into a series of sleep cycles including Rapid Eye Movement (REM) and Non-Rapid Eye Movement (NREM) sleep.

What kinds of problems get in the way of the type of sleep we need?
There are eight main categories of sleep disorders, but the ones affecting the largest numbers of people are insomnia, SRBD, and Circadian Rhythm Sleep Disorders. SRBDs include snoring and Obstructive Sleep Apnea (OSA), which is a serious health problem.

How do I know if I have OSA or another SRBD?
Often, your bed-partner will tell you that you snore. Chronic loud snoring is an indicator of OSA. To make a diagnosis your physician must take a thorough sleep and medical history. The diagnosis may then be confirmed by a study in a sleep lab.

What causes sleep apnea or OSA?
Snoring and OSA happen when your tongue and other soft tissues in the back of your throat collapse backwards and block airflow through your upper airway or windpipe. You may briefly awaken as many as 50 times per night because of these breathing lapses. These brief awakenings, called micro-arousals, keep you from reaching the deep stage of sleep your body needs.

What are the treatments for sleep apnea?
Treatments include CPAP therapy, in which patients wear a mask while sleeping. The mask pushes air through the airway, keeping it open. In Oral Appliance Therapy (OAT) patients wear a device that moves the lower jaw forward, allowing more room for air to move down the airway. Oral surgical procedures and orthodontic approaches also have the goal of moving the tongue away from the throat. These are all treatments that can be carried out by a dentist who has training and experience in treatment of sleep disorders.

Contact us today to schedule an appointment to discuss your questions about sleep disorders and their treatments. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Sleep Apnea Frequently Asked Questions.”

Dental professionals agree that effective removal of plaque, the film of bacteria (also called a biofilm) that gathers on everyone's teeth, is the key to good dental health. Daily brushing and flossing are the usual recommendation for plaque removal. It is important to ask us about effective brushing and flossing. At your next appointment, ask us for a demonstration.

Effective brushing removes plaque from the easily accessed surfaces of the teeth. To remove plaque from between the teeth, you must floss.

Some people find it awkward to hold the floss with their fingers as they move it around their teeth. One technique for flossing, suggested by a dentist in Dear Doctor magazine, may make it easier than more traditional methods, although it does take a little practice.

Preparation
This method requires tearing off a 10 to 12 inch length of floss and tying it to form a circle big enough for your fingers, but not your thumbs, to fit within it. The circle should be knotted with a double knot.

To Clean Teeth and Gums
Keep the floss taut at all times, with about and inch or less between your thumb and index fingers for your upper teeth, or index fingers only for your lower teeth. Curve the floss around each tooth and gently move it up and down until you hear a squeaky clean sound. Extend the downward movement of the floss to just below the surface of the gum, without being too harsh and causing injury. As you move from tooth to tooth, move around the floss circle so that each tooth gets a clean section of floss.

Upper Teeth
Place all your fingers in the ring, with the floss over your left thumb and right index finger to floss your upper left teeth, and over your right thumb and left index finger to do the other side.

Lower Teeth
Use both index fingers to floss all your lower teeth.

You may only need to floss once a day before or after brushing to keep your gums health and ward off periodontal (gum) disease. Your dentist will guide you as to how often you may need to floss your teeth. Try this technique and see how it works for you.

Contact us today to schedule an appointment to discuss your questions about flossing techniques. You can also learn more by reading the Dear Doctor magazine article “Flossing — A Different Approach.”

If you suffer from snoring or think you may have Obstructive Sleep Apnea (OSA), did you know that your dentist could play an important role in treating your condition? For most people this is surprising; however, we can provide both education and some treatment options. And as needed, we will work with your other healthcare professionals to get an accurate diagnosis so that you can improve both your sleep and your health.

Oral Appliance Therapy: These devices may look like orthodontic retainers or sports mouthguards, but they are designed to maintain an open, unobstructed, upper airway (tissues at the back of your throat) during sleep. There are many different oral appliances available but less than 20 have been approved through the FDA (Food and Drug Administration) for treating sleep apnea. Depending on your specific condition, we may use it alone or in combination with other means of treating your OSA. Here’s how they work. They reposition the lower jaw, tongue, soft palate and uvula (the tissue in the back of the throat that dangles like a punching bag); stabilize the lower jaw and tongue; and increase the muscle tone of the tongue — unblocking the airway.

Continuous Positive Airway Pressure (CPAP): CPAP bedside machines generate pressurized air delivered through a tube connected to a mask covering the nose and sometimes mouth. Pressurized air opens the airway (windpipe) in the same manner as blowing into a balloon; when air is blown in, the balloon opens and gets wider. This treatment option is generally not used for snoring, but rather for the more serious condition, OSA.

Surgery: Specially trained oral and maxillofacial surgeons may include more complex jaw advancement surgeries. Additionally, an Ear, Nose & Throat (ENT) specialist (otolaryngologist) may consider surgery to remove excess tissues in the throat. It also may be necessary to remove the tonsils and adenoids (especially in children), the uvula, or even parts of the soft palate.

The first step towards getting a great night's sleep if you are a snorer that has never been diagnosed or treated for your condition is to obtain a thorough examination by a physician specifically trained in diagnosing and treating sleep disorders. And depending on the seriousness of your condition, he or she may strongly encourage you to participate in a sleep study. The results from this “study” can provide your dentist and other healthcare professionals with precise data about your snoring, breathing and sleeping habits. This information is key to treating OSA, if you are in fact diagnosed with this condition. Learn more when you read, “Snoring & Sleep Apnea.” Or if you are ready for a thorough examination and to discuss your snoring, contact us today to schedule an appointment.

Do you constantly feel like you are running on empty? Do you snore, feel like napping every day, or even drink multiple cups of coffee just for the caffeine boost? You may have a sleep related breathing disorder (SRBD) or Sleep Apnea (“a” – without; “pnea” – breath) in which your airways become obstructed causing chronic loud snoring. The good news is that we can help both diagnose and treat this disorder, which means you will be able to finally get the rest that you (and your sleeping partner) so desperately need.

The reason that sleep apnea is so disruptive to daily living is that it causes awakening for a few seconds up to 50 times per night, significantly decreasing the amount of deep sleep that is necessary for full rejuvenation. Airway blockage during sleep commonly results from obesity, an enlarged tongue or tonsils, and other factors that can cause your airway to close off when you lie down, all increasing the likelihood that you will suffer from sleep apnea. These conditions are dangerous and impair the brain and heart from receiving adequate oxygen, increasing your risk for both stroke and heart attack.

The study of sleep and its disorders is relatively new. One successful way to treat sleep apnea is with a “CPAP” machine which uses a Continuous Positive Airway Pressure mask overnight to keep air passages open while sleeping. Another more comfortable, less noisy, and unobtrusive method is to use Oral Appliance Therapy, which features an appliance like a retainer that can be custom fitted to your mouth made by a dentist trained in sleep medicine.

And yes, dentists are increasingly being recruited to help study and treat sleep disorders. There are actually several ways in which we can help. Because we see our patients on a regular basis, we are uniquely qualified to diagnose early signs of SRBDs. For example, if you start to snore almost immediately after falling asleep in the dental chair, we will be able to discuss this important warning sign with you. We can also examine the back of your mouth to see if you possess any of the traits that point to SRBDs, including large tonsils and/or an elongated uvula — the tissue in the back of your throat that looks like a little punching bag.

So, if you want to stop snoring and start sleeping well or you think you may have a SRBD, call our office to schedule a basic oral exam and consultation. If you would like to learn more about the link between dentistry and the treatment of sleep disorders, read the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

Nearly everyone has snored at some point in life. However, if your sleeping partner routinely tells you that you suffer from this problem, you really should take action to confirm or deny your suspicions. You may be like one of the 50 to 70 million people in the US alone that suffer from Obstructive Sleep Apnea (OSA), a medical condition in which the upper airway (the back of your throat) collapses during sleep thus limiting your intake of oxygen. And this condition is serious. If left untreated, OSA can lead to a stroke, impotence, an irregular heartbeat, heart attacks, high blood pressure, and other forms of heart disease.

The first and most important step you should take if you snore is to obtain a thorough examination by both your primary-care physician and our office. We have completed specialized training in sleep medicine so that we can not only diagnose but also thoroughly treat your sleep disorders.

If you are diagnosed with this problem, relax. We have many ways we can treat your condition. One of the most common methods is to provide you with oral appliance therapy. This first line of treatment involves our making a customized oral appliance (mouthpiece) that will hold your lower jaw forward. By doing this, we can move your tongue away from the back of your throat so that your airway is less likely to get blocked while you sleep. (It is this blockage that causes the infamous snoring sound.)

Another option we may consider using to treat your sleep apnea if it is moderate to advanced is a Continuous Positive Airway Pressure (CPAP) machine. These machines require you to sleep with a mask over your nose and/or mouth and produce continuous pressure in your windpipe so that your tongue is forced forward away from your airway. Not only can these machines potentially eliminate your snoring, but they can also give you the restful night's sleep that you have been missing.

The last and most permanent solution for treating certain non-responsive cases of sleep apnea is surgery. This option is typically reserved for the most advanced cases to eliminate or reduce an obstruction to the airway.

Contact us today to discuss your questions about sleep apnea or to schedule an appointment. You can also learn more about sleep apnea when you continue reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

Ensuring that your children have good oral health is (or should be) the goal of every parent or caregiver. But how confident are you about this topic? The following true/false quiz will help you evaluate your expertise while learning more about keeping your child's teeth healthy.

Questions

1. All children older than 6 months should receive a fluoride supplement every day.
2. Parents should start cleaning their child's teeth as soon as the first tooth appears.
3. Parents should start brushing their child's teeth with toothpaste that contains fluoride at age 3.
4. Children younger than 6 years should use enough toothpaste with fluoride to cover the toothbrush.
5. Parents should brush their child's teeth twice a day until the child can handle the toothbrush alone.
6. Young children should always use fluoride mouthrinses after brushing.

Answers

1. False. Check with your child's physician or dentist about your children's specific fluoride needs. If your drinking water does not have enough fluoride to help prevent cavities, parents of a child older than 6 months should discuss the need for a fluoride supplement with a physician or our office.
2. True. Start cleaning as soon as the first tooth appears by wiping the tooth every day with a clean, damp cloth. Once more teeth erupt, switch to a small, soft-bristled toothbrush.
3. False. Parents should start using toothpaste with fluoride to brush their children’s teeth at age 2. Only use toothpaste with fluoride earlier than age 2 if the child's doctor or our office recommends it.
4. False. Young children should use only a pea-sized amount of fluoride toothpaste. Fluoride is important for fighting cavities, but if children younger than 6 years swallow too much fluoride, their permanent teeth may develop white spots. Using no more than a pea-sized amount of toothpaste with fluoride can help prevent this from happening.
5. True. Because children usually do not have the skill to brush their teeth well until around age 4 or 5, parents should brush their young children's teeth thoroughly twice a day. You should continue doing this until the child can demonstrate a proper brushing technique.
6. False. Fluoride mouthrinses have a higher concentration of fluoride than toothpaste containing fluoride. Children younger than 6 years of age should not use fluoride mouthrinses unless your child's doctor or our office recommends it. Young children tend to swallow rather than spit it out, and swallowing too much fluoride before age 6 may cause the permanent teeth to have white spots.

Learn More

If you feel you missed too many of the above questions, read the Dear Doctor article, “Oral Hygiene Behavior.”

A good night's sleep...have you been getting them lately? While everyone knows that sleep is important, did you know that we all spend about one-third of our lives asleep? And did you know that when deprived of sleep, the negative impact is detrimental on both an individual as well as at the societal level? These important facts are just some of the reasons why there has been an increased interest in studying sleep, sleep loss and sleep disorders.

If you have issues with sleep, you might have a sleep disorder — an epidemic problem that impacts approximately 50 to 70 million people in the US alone. Obstructive Sleep Apnea (“a” – without; “pnea” – breath) (OSA) is a medical condition that occurs when your tongue collapses against the back of your throat causing a significant reduction in your intake of air or even total temporary blockage. If left untreated, OSA can lead to an irregular heartbeat, heart attacks, high blood pressure, and other forms of heart disease plus strokes and even impotence.

Please note that while your responses to the questions below do not equate to a diagnosis, sharing them with our office can be extremely beneficial in helping us properly evaluate and treat issues related to poor sleeping habits.

• Do you weigh 15 pounds or more than the normal weight range for your height, sex and age?
• If you are male, is your neck measurement 17 inches or more? Or if you are female, is it 16 inches or more?
• Do sleep partners routinely tell you that you are a loud snorer and/or that during your sleep you choke, gasp for air or briefly stop breathing?
• Do you often wake up still feeling tired after 8 or more hours of sleep?
• Do you often find yourself falling asleep at work or home during periods when you should be awake?
• Do you suffer from irritability, depression, loss of memory, poor judgment and/or concentration?

The first and most important step in treating sleep apnea is to obtain a proper diagnosis. Contact us today to schedule an appointment to discuss your questions about sleep apnea. We can assist in the diagnosis and treatment of sleeping disorder along with a physician trained in this area. And rest assured that we have many treatment options we can use to help you get a great night's sleep. To learn more about sleep apnea, continue reading the Dear Doctor magazine article “If You Snore, You Must Read More!”

Perhaps you've seen Nate Berkus on The Oprah Winfrey Show or watched his television program, The Nate Berkus Show. You may even have read his best-selling book, Home Rules: Transform the Place You Live Into a Place You'll Love. Regardless of where or how you discovered Berkus, you will surely have noticed his dazzling smile.

Berkus recently opened up about the facts behind his trademark smile during an interview with Dear Doctor magazine. First off, his smile is totally natural, as he never wore braces or had any cosmetic work, including porcelain veneers. However, Berkus does give credit to his childhood dentist for the preventative healthcare he received as a young boy. “I'm grateful for having been given fluoride treatments and sealants as a child,” he said. Nate also shared the important flossing advice he learned from his dentist that he still follows today: “Floss the ones you want to keep.” Berkus went on to say that he feels, “healthy habits should start at a young age.”

And we totally agree! For this reason we have put together the following list of facts and oral hygiene tips:

• Over 50% of plaque accumulation occurs in the protected areas between teeth — a place that may be difficult or even impossible to reach with a toothbrush.
• A thorough brushing may take up to two minutes at first, and it may feel awkward as you reach some places in your mouth.
• Remember, more is NOT always better! Brushing or flossing too hard can be damaging to your teeth and gums. And never saw back and forth with your floss.

To learn more about oral hygiene, including brushing and flossing techniques, you can continue reading the Dear Doctor article “Oral Hygiene Behavior - Dental Health For Life.” Or you can contact us today to schedule an appointment so that we can conduct a thorough examination, review your brushing and flossing techniques, and discuss any questions you have as well as treatment options. As needed, we will work with you to teach you the proper brushing and flossing techniques so that you feel confident before you leave our office. And to read the entire interview with Nate Berkus, please see the Dear Doctor article “Nate Berkus.”

Athletic activity can boost your health, but many sports also carry some risk — especially to the teeth. This is something NFL wide receiver Jerry Rice well knows.

“Football can be brutal — injuries, including those to the face and mouth, are a common risk for any player,” Rice noted in an interview with Dear Doctor magazine. In fact, Rice himself chipped a couple of teeth, which were repaired with crowns. “There wasn't a lot of focus on protecting your teeth in high school,” Rice recalled.

You don't have to be a legend of the NFL to benefit from the type of high-quality mouthguard a dentist can make for you or your child. Consider that:

• An athlete is 60 times more likely to suffer harm to the teeth when not wearing a mouthguard.
• Mouthguards prevent an estimated 200,000 or more injuries each year.
• Sports-related dental injuries account for more than 600,000 emergency room visits annually.
• Each knocked-out tooth that is not properly preserved or replanted can cause lifetime dental costs of $10,000 to $20,000.

You and/or your child should wear a mouthguard if you participate in sports involving a ball, stick, puck, or physical contact with another player. Mouthguards should be used for practice as well as actual games.

It's also important to be aware that all mouthguards are not created equal. To get the highest level of protection and comfort, you'll want to have one custom-fitted and professionally made. This will involve a visit to our office so that we can make a precise model of your teeth that is used to create a custom guard. A properly fitted mouthguard is protective, comfortable, resilient, tear-resistant, odorless, tasteless and not bulky. It has excellent retention, fit, and sufficient thickness in critical areas.

If you are concerned about dental injuries or interested in learning more about mouthguards, please contact us today to schedule an appointment for a consultation. If you would like to read Dear Doctor's entire interview with Jerry Rice, please see “Jerry Rice.” Dear Doctor also has more on “Athletic Mouthguards.” and “An Introduction to Sports Injuries & Dentistry.”

It is not uncommon to have one or more teeth that are particularly sensitive to heat, cold, or pressure. If you have such a tooth, you probably want to know what caused it and what you can do about it. Here are some frequently asked questions, and their answers.

What causes teeth to become sensitive?
The most common cause of sensitivity is exposure of the tooth's dentin, a layer of the tooth's structure that is just below the outer protective layer (the enamel).

The dentin is sensitive but the enamel layer is not. Why?
The enamel is composed of minerals that are hard and protective. It is not living tissue and has no nerve supply. The dentin layer underneath is bone-like living tissue that does contain nerve fibers. It is protected by enamel above the gum line and by gum tissue in the area of the tooth's root, below the gum line. If the tooth's protective covering is reduced, the nerve fibers in that section of the dentin are exposed to changes in temperature and pressure, which they conduct to the inner pulp layer (nerve) of the tooth. The sensations that reach the tooth's interior pulp layer cause pain.

What causes exposure of the dentin layer in teeth?
Often the dentin is exposed by receding gums, causing areas of the tooth that are normally below the gum surface to be uncovered.

What makes gums recede?
One cause of receding gums is excessive, rough brushing techniques. This is particularly common in individuals who have a family history of thin gum tissues. Removing the film of bacteria called plaque requires only gentle action with a soft brush. This is one reason that we stress the value of learning proper and effective brushing techniques. Gum recession becomes worse after the uncovered dentin of the tooth's root is exposed to erosion from sweet and acidic foods and beverages, such as fruit juices.

Doesn't tooth sensitivity indicate decay?
Decay can also cause tooth sensitivity. As decay destroys a tooth's structure, it eventually invades the inner pulp of the tooth, causing greater and greater pain.

How can you prevent or reduce tooth sensitivity?
As we mentioned above, learn proper brushing techniques; we would be happy to demonstrate them. Use a toothpaste that contains fluoride, which increases the strength of the tooth's protective coating. In more serious cases, we can apply a fluoride varnish or a filling material as a barrier to cover sensitive areas. If you experience long-term tooth sensitivity, make an appointment for an assessment and diagnosis so that we can determine the cause and proper treatment.

Contact us today to schedule an appointment to discuss your questions about sensitive teeth. You can also read the Dear Doctor magazine article “Sensitive Teeth.”

Design expert and television celebrity Nate Berkus has definite ideas about how to live. In a recent interview, he explained his ideas on design. He also talked about health, and how he keeps his teeth and mouth healthy.

From an initial design makeover that he did eight years ago on the Oprah Winfrey Show, Berkus has gone on to do 127 such makeovers. He was such a success that he now hosts his own daily talk show. He has also developed a line of home products for the Home Shopping Network and has his own design firm, Nate Berkus Associates. His clients include well-known restaurants and hotels as well as private homes. He has written articles for O Magazine and authored a book on the subject of transforming your home into a place you love.

“I realized many years ago that I wasn't going on Oprah to pick sofa colors and paint chips. I was there to lift people up through the way they live,” he says. His secret to design success is to “go with what you love.” He says, “Don't worry about mixing metals, eras or styles. If you love each item, you'll find a way to make it work.”

His common sense practical attitude continues when it comes to dental health. Berkus is blessed with a healthy mouth and teeth. He doesn't feel anxious when visiting the dentist because he usually has a good report. He has not needed orthodontics or cosmetic dentistry. He thanks his childhood dentist for giving him fluoride treatments and sealants, and for teaching him healthy dental hygiene habits.

Berkus brushes his teeth twice or even three times a day, with a manual or electric toothbrush — depending on whether he is at home or traveling. He also follows his dentist's advice about flossing: “Floss the ones you want to keep!” He says that he tried tooth whitening once, but he felt that the whiteness was “too white.” Now he simply works to maintain his natural tooth color and smile.

Contact us today to schedule an appointment to discuss your questions about maintaining healthy teeth. You can also learn more by reading the Dear Doctor magazine article “Nate Berkus, Helping Others Love the Way They Live.”

Periodontal or gum disease is an often silent disease that can cause significant damage to the health of your teeth and body. The reason it is so often classified as a silent disease is because it is chronic or longstanding and often without any symptoms or pain that most people associate with a disease until it may be too late.

If you think you may have gum disease, here is what to look for:

• Bleeding gums — probably one of the most common and overlooked early warning signs that most people ignore is thinking that the bleeding is being caused by brushing their teeth too hard. The truth is that you would have to brush extremely hard to cause healthy gum tissues to bleed.
• Bad breath — something everyone has experienced; however, it can also be a warning sign of periodontal disease. This is especially true for people who hate or refuse to floss their teeth, thereby trapping literally billions of bacteria where they love to collect in the protected areas between the teeth.
• Redness, swelling, and/or receding gums — all signs of gum disease often accompanied by sensitivity of the gum tissues around the teeth.
• Chronic inflammation — long-standing gum inflammation is a sign that your gum tissues are not healing properly. Periodontal disease exhibits periods with bursts of activity followed by periods where the body tries to recover.
• Loose and/or moving teeth — that seem to be drifting into a new position, are visible signs that you are highly likely to have periodontal disease.
• Abscess formation — late stage gum disease is characterized by painful, swollen, red pockets of pus, which denotes an acute localized periodontal infection.

If you have any of these signs, you need to make an appointment for a thorough evaluation. Otherwise, you could end up losing your teeth to the second most common disease known to man after tooth decay. To learn more about gum disease, continue reading, “Warning Signs of Periodontal (Gum) Disease.” Or, contact us today to schedule an appointment.