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.”

Tongue and lip piercing is a growing popular trend for some young people and adults; however, did you know that they could wreak havoc on oral health? In fact, some people soon discover that before they can even enjoy their new piercing they are faced with issues ranging from bleeding and infection to nerve damage. Tongues and lips are highly vascular — that means they have lots of blood vessels that can bleed easily and are not always easy to stop once they start bleeding. Many tongue and lip bolts can initiate problems such as tooth sensitivity, gum disease and recession, chipped teeth and more. In addition, not all tattoo parlors and tattooists are properly licensed to do piercings. Therefore, sterile techniques are not always guaranteed if they do not come under the scrutiny government agencies. Unfortunately, these potential concerns are rarely discussed prior to receiving a piercing.

So what can be done if you already have a tongue or lip piercing?

If you already have piercings, it is critical that they are closely monitored by your health professionals to make sure they are not doing damage. It is also important that you have routine dental exams to ensure that you do not have any silent problems causing issues that you haven't noticed. However, your best option is to consider removing these oral piercings. The good news is that most often the hole in your tongue or lip may heal itself; otherwise, a minor corrective surgery may be required.

A note of warning: Before you contemplate a piercing, get as much information as you can about them and the person who will do them. This includes asking about their risks, benefits and better alternatives. And then think twice to make sure they will not become permanent and negative reminders of temporary emotions!

Oral sedation can be an ideal and safe solution for someone who suffers from fear and anxiety regarding dental appointments — the very reason we offer it to our patients. However, there are some things you need to do prior to and following your treatment for optimal oral sedation benefits and treatment results.

• Being completely honest about your health history and any medication you are taking is a critical aspect, as it lets us know that oral sedation medication is safe and will work for you. We also ask you to let us know about any over-the-counter (OTC) medications, remedies, or vitamins and/or supplements you are taking. The reason this is so vital is that some can negatively impact your treatment, recovery, and the effectiveness of the oral sedation medications.
• You should not eat or drink anything six hours prior to your appointment unless we instruct you otherwise.
• You should make arrangements to have someone drive you to and from your appointment, as it may not be safe for you to drive or operate any heavy machinery until the effects of oral sedation have worn off. It is important to note that this will vary depending on what medication is used, so do not assume your reaction/response will always be the same.
• Drink plenty of fluids (especially water) to stay hydrated after your appointment.

To learn more ways you can prepare, read the article “Oral Sedation Dentistry.” Or you can contact us today to discuss your questions or to schedule an appointment.

Signature Smiles Dental Care is joining Toys for Tots to bring smiles to children in our community in need. Bring in your new, unwrapped toy now until December 22nd and help us create bright smiles this holiday!

!

Dental implants are replacements for missing teeth. They are very stable and can be made to look as good as or better than the teeth they replace. How do we do it? Here are seven frequently asked questions.

What are the parts of a dental implant?
The implant consists of a root, usually made of a titanium alloy, which extends below the gum tissue into the bone; and a crown, which emerges from the gum and resembles the crown of the original tooth.

Why is a dental implant so stable?
Titanium has a property of fusing with the bone of the jaw, so that it actually becomes part of the bony structure. The new implant's stability depends on having the needed volume of bone and gum tissue in the right position to anchor the implant.

How can you make sure I have enough bone?
When a tooth is lost, the bone in which it was anchored will resorb or melt away if care is not taken. It is important to minimize trauma during tooth removal to preserve bone tissue. If tissue has been lost it can be built up by bone grafting techniques.

What factors make a crown on an implant look real?
How real the crown looks depends on its shape, particularly as it emerges through the gum tissues, its color and its position relative to the teeth around it.

What is the emergence profile?
This term refers to the way the crown emerges through the gum tissue. It involves both the shape of the implant and how far it is placed into the gum and bone tissues.

How do you match the color of the crown?
We analyze your tooth color using shade guides and/or photography to provide the dental lab with as much information as possible to create the best color match. This is part of the artistry of reconstructive dentistry.

How will my gums look with my dental implant in place?
When people use the word “gums” they are often referring to the small pink triangles of tissue that fill in the spaces between teeth, called “papillae.” An implant must be placed at the correct distance from adjacent teeth and at the correct depth below the gum tissue for natural looking papillae to form.

You can see that success in matching of color, shape, and location of an implant is not simple and depends on the skill, artistry, and experience of your dental team.

Contact us today to schedule an appointment to discuss your questions about dental implants. You can also learn more by reading the Dear Doctor magazine article “Matching Teeth & Dental Implants.”

As the Baby Boomer generation moves into its 60s, more and more of us are concerned with looking younger. We do it with vitamins, diet, exercise, makeup, cosmetic surgery, and yes, even with cosmetic dentistry.

In recent years we have learned a lot about how aging affects the soft tissues and bones of your face. This has led to an approach to orthodontics that considers not only the teeth and jaws, but also the continuing growth of the bones and soft tissues of the face.

We used to think that growth stopped when people reached their late teens or early 20s. However, recent studies have shown that some kinds of growth continue throughout a person's lifetime. Your bones and facial structures change as much between the ages of 25 and 42 as they do between 18 and 25.

As you age your facial profile flattens, your nose becomes more prominent, the lower part of your face becomes shorter, and your lips become thinner. By studying these changes we have learned to consider them when planning orthodontic treatment. Modern orthodontics treats the entire face, not just the teeth.

The science of orthodontics is dedicated to slowly moving the teeth within the jaws to better functional and aesthetic positions, using standard braces or clear aligners. Sometimes the upper and lower jaws are so far out of alignment that more extreme treatment is needed. In such cases orthognathic (from ortho, meaning straight and gnathos, meaning jaw) surgery may be required to achieve the best results. Orthognathic surgery was once considered a drastic procedure, but it has become easier to manage during and following surgery and is now considered a more normal treatment option, like a facelift. Since the nose becomes more prominent as part of the aging process, the surgery is sometimes combined with rhinoplasty, or reshaping of the nose.

This new approach to orthodontics and cosmetic dentistry — taking into consideration the normal changes that occur as a person's face ages throughout life — requires teamwork among a general dentist, an orthodontist, and an oral surgeon. The results are a long-lasting change that holds back the clock on aging.

Contact us today to schedule an appointment to discuss your questions about cosmetic dentistry. You can also learn more by reading the Dear Doctor magazine article “Understanding Aging Makes Beauty Timeless.”

Christie Brinkley's world-famous smile has graced the covers of countless magazines for over 30 years. In fact, in her own words from an interview with Dear Doctor magazine, the supermodel said, “I think my smile was really my passport to success in the modeling industry.” And while most of her smile's appeal comes naturally, Christie does give it a boost with good oral hygiene, regular dental checkups and tooth whitening. As Christie says, “When it comes to teeth, keep it as natural as possible. Do not go overboard on whitening. You want your teeth to compliment your face…your friends should not be required to wear sunglasses when you smile!”

Aside from some potential minor side effects such as tooth sensitivity, whitening teeth through bleaching is a relatively inexpensive way to brighten your smile conservatively and successfully. There are three common methods, as described below:

• An external or vital approach where “vital” (living) teeth are bleached through direct contact to the tooth's surface.
• An internal or non-vital approach where the tooth is whitened from the inside during a root canal treatment.
• A combination approach in which both internal and external bleaching techniques are used.

But what causes teeth to become discolored?

Tooth discoloration can be caused by a traumatic blow to your teeth resulting in nerve tissue (pulp) death. However, there can be many other causes: consuming or using products that stain the teeth such as coffee, tea, cola, tobacco products and red wine, to name just a few. Aging is another factor, as it results in changes in the mineral structure of the tooth as the enamel, the outermost layer, loses its beautiful and youthful translucency. Other causes include exposure to high levels of fluoride; tetracycline, an antibiotic, administered during childhood; inherited developmental disorders and jaundice in childhood; and tooth decay.

The good news is that we routinely brighten smiles through tooth whitening. To learn more about brightening your smile, continue reading the Dear Doctor magazine article “Teeth Whitening.” Or if you are ready to have your teeth professionally whitened, contact us today to schedule an appointment so that we can conduct a thorough examination and discuss your whitening treatment options. And if you want to read the entire feature article on Christie Brinkley, continue reading “The Secret Behind Christie Brinkley's Supermodel Smile.”

Florence Henderson has inspired generations of people through her portrayal of America's most beloved TV mother, Carol Brady, on one of the longest running situational comedies, The Brady Brunch. Today Florence is still a role model but for a much different audience: senior citizens.

Henderson created the FloH Club as an organization to assist senior citizens with understanding and embracing technology, as she described in an interview with Dear Doctor magazine. “I was inspired to create the FloH Club because of my own fear of technology and because I didn't want to keep asking my children for help,” she said.

And while Henderson was blessed with naturally straight teeth and has had no cosmetic work done, she is not opposed to it. “I wouldn't care how old I was, if I had misaligned teeth or felt I needed cosmetic dentistry I would certainly do it!”

One teeth-straightening option many adults consider is clear orthodontic aligners. They are an excellent way for self-conscious adults to align their teeth without feeling that they will appear as an awkward “brace-faced” youth — a look that is commonplace for the teenage years.

But what are clear aligners? They are an alternative system to traditional braces that use a sequence of individual, custom-fitted trays that are clear and removable to gradually straighten teeth. They are usually recommended for correcting mild to moderate spacing problems or crowding of the teeth, and for cases in which there are no major issues with your bite (i.e., your back teeth fit together properly and biting forces are distributed evenly on all of your teeth).

To learn more about this method of aligning teeth, you can continue reading the Dear Doctor magazine article “Clear Orthodontic Aligners.” Or you can contact us today to schedule an appointment so that we can conduct a thorough examination and discuss what treatment options will be best for you. And to read the entire interview with Florence Henderson, please see the Dear Doctor article “Florence Henderson.”

Maria Menounos, an independent filmmaker, actress, and co-host of daily entertainment news program Extra, learned at an early age about the importance of maintaining good general and dental health when her father, Constantinos, a Greek immigrant, was diagnosed with type 1 diabetes. As a result, her parents made sure the family consumed a diet filled with fresh fruits and vegetables, many of which they produced themselves. Maria and her family also consumed little-to-no junk food.

Menounos is still committed to helping those with diabetes. In fact, because she saw first hand the power of communication in the lives of diabetes patients and their families, Menounos is an avid ambassador for the American Diabetes Association.

Maria's experience with diabetes is one that she shares with millions of people worldwide. And if you or someone you care about is suffering from this disease, it's important to be aware of the connection between diabetes and oral health. Recent research has shown a link between two chronic inflammatory conditions: periodontal (gum) disease and diabetes. Evidence consistently reveals that diabetes is a risk factor for increased severity of periodontal disease and conversely, periodontitis is a risk factor for worsening blood glucose control in patients with diabetes and may also increase the risk of diabetic complications. Periodontal inflammation is also associated with an elevated systemic (general body) inflammatory state and an increased risk of major cardiovascular (“cardio” – heart; “vascular” – blood vessel) events such as heart attack, stroke, adverse pregnancy outcomes (e.g., low birth weight and preterm births) and altered blood sugar control in people with diabetes.

If you are interested in learning more about periodontal disease, you can continue reading the Dear Doctor magazine article “Diabetes & Periodontal Disease.” Or, if you are diabetic and fear you may have periodontal disease, you can contact us today to schedule an appointment so that we can conduct a thorough examination. During this private consultation, we will also discuss any questions you have as well as what treatment options will be best for you. And to read the entire interview with Maria, please see the Dear Doctor magazine article “Maria Menounos.”

When asked about her dazzling white smile, Cat Cora, the first female iron chef on the hit television series Iron Chef America, freely admits to maintaining the brightness of her smile with professional whitening sessions.

“With what I do, whitening your teeth is like getting your hair done, your nails done and everything else you have to do to be on television,” Cat recently told Dear Doctor magazine. However, she does have her limits. “I want my teeth to be white and healthy looking — but not stark white or looking like they could glow in the dark,” she said with a laugh.

Cat's perceptions and experiences with tooth whitening may accurately describe Hollywood, but through the power of media, celebrities and their respective fan bases, having attractive white teeth has become a goal for most people. This is because white teeth are subconsciously associated with youth and virility.

Here in the dental office, we can use professional-strength “power bleaching” to whiten teeth several shades in a single visit. To prevent irritation to the area surrounding the teeth being treated, we isolate the gums and skin of the mouth with a protective gel or a rubber barrier known as a dental dam. After the whitening solution is placed on the teeth, the process may be supplemented by heat or a light source to activate or enhance peroxide release.

For bleaching teeth at home, our office can make custom-fitted bleaching trays that you fill with a gel form of carbamide peroxide. Sometimes this whitening gel can cause a temporary tooth sensitivity to hot and cold, but this normally lasts for no more than four days after you stop bleaching your teeth.

To learn more about tooth whitening, you can continue reading the Dear Doctor magazine article “Teeth Whitening.” Or you can contact us today to schedule an appointment so that we can conduct a thorough examination and discuss what treatment options will be best for you. And to read the entire interview with Cat Cora, please see the article “Cat Cora.”

You didn't have your teeth straightened as a child. Is it too late, or should you have orthodontic treatment now as an adult?

Orthodontics is a sub-specialty of dentistry devoted to the study and treatment of improper bites, or malocclusions. Orthodontic treatment has the goal of slowly applying pressure to teeth in a way that moves them into proper alignment in your mouth.

Recommendations are for children to have their teeth assessed for orthodontic treatment before the age of seven. The whole process can be done more easily while their teeth are coming in and their jaws are still growing.

However, if your teeth are overcrowded, you have an overbite or an underbite, or your teeth are misaligned in other ways, it is never too late. If you “missed the boat” on orthodontic treatment before, here are seven reasons to consider doing it now.

1. Orthodontic treatment brings teeth, lips and face into proportion, resulting in a beautiful smile.
2. An attractive smile contributes to self-esteem, self-confidence and better self-image.
3. Because of improved self-esteem, you may see improved social and career success.
4. Teeth that are in proper alignment will function and wear better over the years as you age.
5. Properly aligned teeth are easier to keep clean, making you less prone to periodontal (gum) disease.
6. If you have any missing teeth that need to be replaced, this can be done more effectively if your remaining teeth are put into their correct spacing and position first.
7. Current options for treatment include fixed appliances (traditional braces) in which bands and brackets are bonded to the teeth and wires are threaded through them — or as an adult you may be able to use removable clear aligners. These consist of a series of nearly invisible computer-generated clear plastic trays that progressively move the teeth into better alignment.

Take the first step: call our office for an orthodontic evaluation. Having orthodontic treatment as an adult may be just the thing to give you an attitude boost as you move forward in your life.

Contact us today to schedule an appointment to discuss your questions about teeth straightening. You can also learn more by reading the Dear Doctor magazine article “Why Straighten Teeth?”

On the day when braces come off, most people feel that their orthodontic treatment is over. When they are then asked to wear retainers, they may wonder what this additional requirement will accomplish. Wasn't the work of moving their teeth to desired positions already completed? To understand the answer to this question, you need to understand how orthodontics works.

How does orthodontic treatment remodel your smile?

Although they give the appearance of being stable and unmoving, teeth and their surrounding structures (gums, jawbones, and ligaments) are living tissues and are actually in a constant state of change.

Teeth are rooted in bone and are attached by a fibrous tissue called the periodontal ligament (from peri meaning around and odont meaning tooth). One side of the ligament attaches to the cementum (part of the tooth's root) and the other side is attached to the bone, with the tooth suspended in between.

These tissues are constantly remodeling themselves, but pressure from the lips and cheeks on one side and from the tongue on the other create a balance that keeps the teeth suspended in the same location. When mild forces are placed on the teeth, such as the forces from the wires used in orthodontic treatment, the tissues slowly adapt and rebuild, resulting in a new position for the teeth.

What are retainers?

Orthodontic retainers are devices usually made of a clear plastic section that is fitted to the roof of the mouth, with thin wires that fit over the teeth.

What is the purpose of retainers?

The remodeling process keeps going after the orthodontic treatment stops, so time is needed for the teeth to reach a new balanced state. The retainer stabilizes them in their new position so that bone and ligament can reform around the teeth and hold them there. This works well for adolescents, whose jaws are in a state of growth, but adults may need outside assistance to stabilize their teeth for a longer time. They may be asked to wear retainers indefinitely to make sure their teeth do not move from their new positions.

What happens if you don't wear your retainers?

If you don't wear your retainers, your teeth are likely to return to the positions they had prior to your orthodontic treatment. This can happen fairly rapidly, underscoring the importance of wearing retainers as instructed.

What are the different types of retainers?

Most retainers are removable devices as described above. For people who require long-term use of retainers, thin retainer wires can be bonded to the inside surfaces of their front teeth. Such wires are usually left in place for several years, relieving them of the need to remove and replace their retainers.

Contact us today to schedule an appointment to discuss your questions about orthodontics and retainers. You can also learn more by reading the Dear Doctor magazine article “Why Orthodontic Retainers?”

Losing a baby tooth is an important milestone in a child's life. Be sure to take a photo of that toothless smile — it will be something you treasure as your child grows up.

You may be wondering what is really happening when a baby tooth becomes loose and eventually falls or is pulled out. Read on for some answers.

What are baby teeth?
An infant's teeth begin to form before birth, by the fifth to sixth week after conception. When the baby is born, 20 primary (baby) teeth are almost completely formed inside the jaws. These first teeth, also called deciduous teeth, begin to erupt through the gums at about the time the baby begins to eat solid food. The front teeth (incisors) are usually the first to come in, at age six months to a year.

Why are they called deciduous teeth?
Deciduous means “falling off at maturity.” The same term refers to trees that lose their leaves every fall. In many mammals, including humans, it refers to the first teeth, which need to come out to make room for the larger permanent teeth to come in.

What causes the deciduous teeth to become loose?
While your child is using his primary teeth to bite and chew, his adult (permanent) teeth are quietly growing inside his jawbone. Starting with tooth “germs” (the word comes from germination, meaning the start of growth), the top part of each tooth, called the crown, grows first. Then the bottom part, or root, begins to grow and elongate. As the roots develop and the permanent teeth take up more room in the child's jaw, they begin to push against the baby teeth. This causes the roots of the baby teeth to melt away or resorb. Eventually little or nothing is left to hold the baby teeth inside the child's gums, they become wiggly, and finally they can easily be pulled out. This may leave a little bleeding gum tissue that quickly heals.

What should you watch for in the transition from primary to permanent teeth?
As the permanent teeth erupt (push through the gums and become visible), you may notice that they are too crowded, have too much space between them, or are crooked. It's a good idea to have an orthodontic (from ortho, meaning straight and dont, meaning tooth) evaluation at age five to seven. Watch to see that the baby teeth are lost in the right sequence. If one is lost prematurely, for example from decay, make sure that the space that it occupied is maintained to make room for the adult tooth that will replace it. We can help you with this.

Contact us today to schedule an appointment to discuss whether your child's baby teeth are being lost in the right sequence and if the adult teeth are coming in correctly. For more information see the Dear Doctor magazine article “Losing a Baby Tooth.”