Roughhousing at School: What to Do about Injured Teeth

Depending on your child and your school, there may or may not be a bit of roughhousing that goes on during the day. While most such play, as long as it doesn't devolve into bullying, is looked upon as a normal part of growing up, it does carry with it the chance of injury. If something happens to your kids at school and one of their teeth is chipped, cracked, broken, or worst of all, comes out, you need to know what to do.

Let's go from worst to least:

Tooth Comes Out

If a kid's first tooth comes out, it's just a matter of waiting until the adult tooth comes in. If an adult tooth comes out of your kid's mouth, it's panic time. They've got less than an hour before the tooth and the socket die and the tooth cannot be reattached.

Here’s what to do:

• Put the tooth in a glass of milk, or, if milk isn't available, in a glass of salty water.
• Take the tooth and the child directly to a dentist who does surgery; preferably a reconstructive dentist.
• Have the tooth put back immediately.
• Expect the child to take the next day or two off of school while they recover -- oral surgery isn't easy.

Broken Tooth

If a tooth actually breaks off -- not just a chip, but a substantial break -- you need to hurry to the dentist. Depending on the break itself, it may be more effective for the dentist to glue the broken piece back on, or it may be better for him to make a porcelain cap to go over the butt of the tooth.

Cracked Tooth

When a tooth is cracked -- as in, the enamel has a visible, jagged opening in it -- it's still immediately dentist time. The child still shouldn't attempt to eat anything even if they feel OK. The dentist will almost certainly fill in the crack with some sort of enamel-like substance, and your kid should be ready for school the next day.

Chipped Tooth

It's not often that you can find the chip when a tooth gets chipped. If you can, you should head straight to the dentist to get it reattached. If you can't, you could way for a day or three, or not, it's up to you, because whether you do or not, the dentist is going to do the same thing -- fill in the chip with a tiny bit of porcelain and seal it in place.

Back to School Tips: Better Sleeping for Better Teeth -- And Grades

This one is for all the kids, but will help teenagers more than the rest. Did you know that according to one study, kids today get an hour less sleep, on average, than we did when we were young? It's not hard to see why -- it's perfectly normal for a kid these days to have school until 3pm, sports until 5, dinner, prime time TV (aka "family time") until 8 or 9, and then 3 hours of homework on top of that.

Add to that the fact that, around 14 or 15, a teen's internal clock changes to allow (and to a degree require) them to stay up later than they did before. But the times they are required to wake up in the morning don't budge -- and you can see the problem. If kids could sleep in an hour later in the morning, they'd be fine -- but they can't, and over the months and months of school, all those lost hours of sleep add up. So a good night's sleep is good for your kid's health.

So how can you help your child get to sleep a little earlier? Here are a few things you can do:

• Turn off all electronic screens at least an hour before bedtime. No TV, computer, iPod, tablet, smart phone -- nothing with an electronic screen.
• Have a story ready. It doesn't have to be in a book. A recording or someone to tell you a story will work, too, but having something for the brain to focus on that isn't the stress of the next day helps your brain relax and fall asleep.

Keep a regular schedule. Dinner at 6, shower at 9, in bed by 10, every night (assuming they have to be up at 6). Falling asleep should be as regular as waking up in the morning.

Naturally, you should schedule at least 8 hours for them to sleep each night.

Oral Hygiene at School: The Importance of Having Floss on You At All Times

There are some things that are just so useful that once you have them on you for a while, you start to wonder how you ever got by without them. Simple, waxed dental floss is one of those things. Just look at what you can do with dental floss:

• Tie up a shoe whose lace has broken.
• Create a makeshift tourniquet to get a cut finger to stop bleeding so much.
• Cut cheese, modeling clay, or other soft things.
• Put a tripwire up across a bathroom stall.
• Combine it with a paper clip and a pencil to create an in-class zipline.
• Use it to tie your hair back should your scrunchie stop scrunching.

Of course, you can -- and should -- also use it to floss your teeth. Why would you want to do something that lame in the middle of the school day?

There are a couple of good reasons:

Something Hurts

It's not all that often that we can identify exactly why something in our mouth hurts, but when it does, it's more often than not in a place that we can't quite get to. It's a bit vulgar to walk around school trying to get between your teeth with a fingernail -- but floss is completely socially acceptable.

Something is Stuck

Along those same lines, there's very little more distracting than having something annoying stuck between your teeth. Also, as it happens, those bits of food stuck between your teeth are quite bad for your oral hygiene -- each of those bits is a source of food for the bacteria that cause plaque, gingivitis, and other diseases of the teeth and gums. Flossing is the best way to get them out efficiently and without causing a fuss during the school day.

Sleep Apnea's Younger Cousin: Profound Snoring

Sleep apnea can make your life miserable -- but sometimes, when your air passages don't actually close off entirely but still sag a bit, you end up with a problem that makes everyone around you miserable; snoring. About 10% of the population snores, and not all of them do it often or loudly enough to disrupt the sleep of the people they live with. If you are -- or live with -- a profound snorer, Dr. Eric Johnson and Dr. Tom Risbrudt want you to know that help is just a phone call away.

Before you make an appointment for an expensive surgery or other route to address your snoring problems, however, here are some things you can do to address the problem at home:

• Lose weight -- for many people, even just losing 4 or 5 pounds is enough to take the weight off of their soft tissues and allow them to breathe without snoring.
• Avoid sedatives -- alcohol, sleeping pills, and relaxants can all cause snoring by encouraging the soft tissues to over-relax during sleep.
• Sleep on your side -- this keeps the tongue and soft tissues out of the back of your throat, allowing the air through. Even if you have to duct-tape a tennis ball to the back of your pajamas so that you don't roll over onto your back in the middle of the night, learning to sleep on your side is great for killing the snore.
• Prop your head up -- again, gravity can help you keep the flesh out of your airways. Just sleep with an extra pillow, or if necessary get a foam wedge that will keep the top of your body a few degrees above flat.
• Open your nose -- nasal strips, neti pots, and even prescription nasal dilators can help you keep breathing through your nose, which prevents about half of all snoring.

If you've tried these things and your companions still complain about your snoring, it's time to tackle the problem professionally. Call Drs. Johnson and Risbrudt's office to make an appointment to come in and get your snore turned off for good.

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.