How a Dentist Tackles Sleep Apnea

Some people have asked us, why are we taking on obstructive sleep apnea? Isn't that the realm of the otorhinolaryngologist (ear/nose/throat doctor)? The answer is sure -- you could get a referral, see a specialist, pay an excessive amount of money for a cure and watch your insurance rates skyrocket. Or, you can see someone you already know and trust to take care of your smile, pay a lot less money, and end up with the same positive result.

How Do We Fix It?

There are a lot of different kinds of obstructive sleep apnea -- or rather, the obstruction can happen in a lot of different places. Obstructions where the tongue slides backwards to block off the throat have to be treated differently than ones where the throat collapses in on itself, which in turn are different from obstructions where the tonsils and palette fall together to block the air.

Depending on which of the kinds of obstructive sleep apnea you have, there are different approaches that can work to fix it. For the tongue-blocking kind of sleep apnea, there's an oral appliance that you can wear while you sleep that will keep your tongue from sliding backward. If you have the tonsils-and-palette kind of blockage, there's a different appliance you can wear that will force your lower jaw forward, which creates enough space that the air can get around your relaxed palette.

In cases severe enough that the dental appliances don't work, or in cases where the problem is further down the throat, there are two options. The first is surgery by a medical surgeon. The second is a machine called a CPAP (Continuous Positive Airway Pressure) machine. You wear a mask over your face while you sleep, and it continuously pushes air into your moth. Between the pressure from the outside and the suction from your lungs expanding, almost any natural blockage of your airways can be overcome.

How Do You Know if You Have Sleep Apnea?

Sleep apnea can be a tricky thing to diagnose. The lucky ones have a partner who pays attention to them while they're sleeping and can tell when they've stopped breathing. But if you live alone, or your partner is a deep sleeper themselves, determining whether or not you have sleep apnea or if something else is keeping you from sleeping properly can be very difficult.

The major symptom of sleep apnea is simple: you're tired no matter how long you sleep. But there are other things that can cause the same symptom, so you'll have to look for a few additional factors to make the diagnosis of sleep apnea.

Here are some other common symptoms related to this condition:

• Morning headaches
• Waking up with a dry mouth or sore throat
• Going to the bathroom frequently during the night
• Insomnia or frequent nighttime awakenings
• Moodiness, irritability, or depression
• Forgetfulness and difficulty concentrating
• Waking up feeling out of breath

Children with sleep apnea may also exhibit additional symptoms:

• Hyperactivity or inattention
• Decrease in school performance
• Developmental and growth problems
• Breathing through mouth instead of nose
• Irritable, angry, or hostile behavior

If you're still not sure, try keeping a sleep diary. Record each night how long you slept, how many times you woke up, and how sleepy you were the next day. If you fall asleep during normal activities, make a note of that. If you find that you're waking up more than twice each night or that you for more than three days in a row without getting restful sleep, you need to talk to an expert.

Finally, if even the diary leaves you uncertain, there's one definite way to figure out once and for all whether you have sleep apnea; record yourself while you sleep. Record one night all the way through, and then listen to it one hour at a time over the next week. Write down every time you hear your breathing stop for 10 seconds or more at a time. If you get a number above a dozen, you have sleep apnea and you need to seek medical help.

In addition to dental services, Drs. Johnson and Risbrudt offer solutions for sleep apnea and snoring. Stop by our office today and start sleeping well at night.

Let's Talk About Sleep Apnea

As Americans get less fit and more obese, there are a number of things that can and do go wrong with our bodies. Some of them are obvious, some of them less so. Many are things that only a specialist doctor -- like a cardiologist -- can handle, others can be tackled at home. Still others can be addressed in some surprising ways, like obstructive sleep apnea -- a soft tissue disorder of the palate and throat that can have disastrous effects on your physical and mental health. Dr. Eric Johnson's office wants you to know that obstructive sleep apnea may be affecting your life -- about one in a thousand of us have it -- and if it is, he's here to help you.

Obstructive sleep apnea happens when, as you sleep, the muscles that support the soft tissues in your nose, tongue, palate, and throat relax. In most people, that's not a problem, but for some of us, the relaxation allows our throat to close up completely, preventing us from breathing. In others, only the nasal passages close up, forcing us to breathe through our mouth all night long.

In order to keep us alive, our nervous systems panic when we stop breathing, and they send just enough of a jolt to our brain to knock us out of sound sleep. We wake up enough to force our throats open and start breathing again -- and usually, we immediately drift back off to sleep, often without ever realizing that our sleep was interrupted.

Unfortunately, even those non-waking interruptions utterly ruin the quality of our sleep...and they can happen hundreds of times every night. For people with obstructive sleep apnea, it's not uncommon to wake up after ten or even twelve hours of sleep and want nothing more than to go back to bed.

If you consistently wake up feeling tired and unrested, and it's been happening for so long that your behavior is changing for the worse, you need to stop by our office and talk to Dr. Johnson about how he can help you combat obstructive sleep apnea. Call and make an appointment today -- you owe it to yourself to get a good night's sleep.

Wisdom Teeth: Should They Stay Or Should They Go?

Here at San Clemente Dentist Dr. Eric Johnson's office, we start looking at a child's wisdom teeth around the age of 16, to make sure there's enough room for them to come in properly, without causing problems. Wisdom teeth are completely non-vital to a child's health, so if it appears that there may be a problem with them, Dr. Johnson suggests having them removed simply to be on the safe side -- and removing them early on is easier than removing them later in life, as their roots will be shallower.


The Downside of Removal
The downsides of wisdom teeth removal are mostly the same as with any other minor surgery.

• Your child may have an adverse reaction to the anesthetic (very rarely).
• He or she may experience swelling and tenderness in the area of the removed teeth.
• The sutures that are used to close the hole left behind by the removed tooth may open and leave a space that needs to be re-closed.
• A very small number (less than 0.01%) of people who have this procedure have unexplained pain in the jaw that doesn't respond to painkillers and can last for years.

The Upside of Removal The upsides of getting your wisdom teeth pulled are all about the conditions you avoid by having them taken out. With no wisdom teeth crowding their other teeth around, your kids may see the following benefits:

• Their wisdom teeth won't come in at odd angles and be quite so difficult to clean.
• Their other teeth won't get crowded together and require braces to keep straight.
• They won't experience the minor infections common with wisdom teeth eruption.
• They will be able to easily clean the back sides of their rearmost teeth.

There is no cut-and-dried protocol that says your child's wisdom teeth must be removed. It depends on the child and if there is foreseeable problems in the future. Dr. Johnson can inform you and your child of the potential issues or if it is beneficial to keep the wisdom teeth. Check out our Pediatric Patients page of our web site for more information.
 

How To Brush Your Child's Teeth

Dr. Eric Johnson can do a lot for your children's teeth (come in and ask us for a complete breakdown sometime if you're curious) but obviously the parents are the ultimate decider of their children's oral health. But some parents are honestly not sure how to perform basic oral maintenance -- or worse, they think they know, but they're missing a vital step or two. So here's a simple routine for proper tooth-brushing that anyone can follow.

A Simple Guide to Brushing

• The vast majority of damage to the teeth happens while you sleep. It takes a while after the mouth is disturbed for bacteria to settle down and start doing damage, and during the day, we eat often enough that the bacteria doesn't settle down that much. This means that the two most important times to brush your teeth are immediately before going to bed and immediately upon waking up.
• Each tooth has 5 surfaces. Front and back of the tooth. The tongue side or inside of he tooth. The facial side of the tooth or the surface that people can see and then the chewing surface or the incisal edge on the front teeth. There are 20 teeth as a child. Ten teeth on the top and ten teeth on the bottom. There are 32 teeth including the wisdom teeth as an adult. Sixteen teeth on the top and sixteen teeth on the bottom.
• When you brush, you should use a small amount of toothpaste, and you should brush each surface in your mouth for a minimum of 3 seconds. That's a total of 20 seconds worth of brushing.
• Brushing should be done in a circular motion, not just straight back and forth. Going straight back and forth doesn't get the bristles in the cracks between the teeth; a little vertical motion helps get that taken care of.
• If you don't have a tongue scraper, you should brush your tongue for 3 seconds as well.

One final note: Limit highly acidic drinks like Coca-Cola. Ideally eliminating sodas from a child's diet is the best plan. The acid weakens the enamel.

What does a Dentist that sees Children Actually Do?

Dr. Eric Johnson practices several different kinds of dentistry, from restorative to cosmetic, but this month is all about pediatric dentistry -- so what exactly does that entail? The dentist who sees children does a lot more than teeth scrubbing and give free toothbrushes.

Pediatric dentists rarely have to worry about crowns and bridges and fillings, for example -- but it's a lot more than just fluoride scrubs and free floss.

A dentist who sees children...

• Helps to delay and hinder tooth decay, periodontal disease, and other forms of oral disease that can affect a child.
• Follows the growth of baby teeth, tracking them through adolescence when they are lost and replaced with adult teeth.
• Educates the child about the importance of good oral hygiene and the exact techniques the child should use to take care of their mouth at home.
• Educates the parent about tooth-healthy dietary practices, as well as about what to expect next in the child's oral development.
• Addresses a variety of child-specific oral issues such as thumb-sucking or pacifier use.

Dozens of scientific studies have proven that a child's oral health is linked to their social relationships, school performance, self esteem, confidence, and even their long-term cardiovascular health. That's why dentists who see children take their jobs very seriously -- in the long run, it's about a lot more than cavities and plaque.

Dealing With Children's Fear of the Dentist

It doesn't matter if your child is a toddler or about to graduate high school -- almost every young person has some form of fear of the dentist. Whatever it may be, getting the child to the dentist is often the easy part -- actually being treated by a dentist is an entirely different level of challenge.

One of the best things you can do to improve your child's relationship with the dentist is to establish your child's relationship with the dentist. That means taking them in regularly -- at least twice a year -- when they're quite young. Three-year-olds are starting to form long term ideas about the world around them, and learning about the dentist at that age is entirely appropriate even if it it's just to bring them in for a five minute checkup and to become familiar with the dental office and the surroundings.

Another relatively simple step you can take is to arrange to be in the dentist's office with them. Up until about the age when they don't want to be seen getting out of your car at school, they'll be perfectly happy to have you come into the dentist's office and sit next to them while they get their teeth cleaned -- and there's nothing wrong with that.

You can also help by explaining to them exactly what the dentist is doing. It's one thing to say "he keeps your teeth clean" -- and that works quite well for single-digit kids -- but once a child gets into the tweens and teens, they deserve more. Talk to them about oral health in specifics. Ask the dentist to show them some dentures and talk about how to avoid ever needing them. The more they understand how the dentist is helping their future selves keep eating, the more they'll see the dentist as an ally rather than someone to be feared.