By Randall J. Bartoe, DDS, PLC
June 16, 2019
Category: Oral Health
Tags: oral health   snoring   sleep apnea  
YourDentistcanHelpGuideyouintheBestTreatmentOptionforSleepApnea

Do you still feel tired or unfocused even after a full night’s sleep? Do others complain about your snoring? It’s possible these are signs that you may have sleep apnea.

Sleep apnea is a condition in which you stop breathing while you sleep. Your brain will awaken you to breathe, although you may not consciously realize it since the waking period can be less than a second. But it does disrupt your sleep rhythm, especially during the all-important deep sleep period called Rapid Eye Movement (REM). These disruptions don’t allow your body to receive the full benefit of sleep, hence your lack of energy and focus during the day.

One of the most common causes for sleep apnea is the collapse of soft tissues near the throat as they relax during sleep that restrict the airway. Snoring is an indication this may be occurring: air vibrates rapidly (and loudly) as it passes through this restriction when you breathe in.

As your dentist, we’re well-trained in the anatomy and function of the entire oral structure, and qualified to offer solutions for sleep apnea. If you’ve been diagnosed with sleep apnea (after a complete examination, including an observation session at a sleep laboratory), we can then help you decide on a treatment approach. The following are three such options, depending on the severity of your sleep apnea.

Oral Appliance Therapy. An oral appliance you wear while you sleep is a first line treatment for mild or moderate sleep apnea. The appliance, which we custom design for you, helps hold the lower jaw in a forward position: this moves the tongue and other soft structures away from the back of the throat, thereby opening the airway.

Continuous Positive Airway Pressure (CPAP). Intended for more moderate to severe forms of sleep apnea, a CPAP machine produces continuous air pressure to the throat through a mask you wear during sleep. This forces the tongue forward and the airway open.

Surgical Intervention. These procedures remove excess tissue that may be obstructing the airway. Due to its invasiveness and permanent alteration of the throat area, surgery is reserved for patients who haven’t responded to other therapies in a satisfactory manner.

Whether mild or severe, it’s possible to effectively treat sleep apnea. If successful, not only will you benefit from better sleep and greater alertness, you’ll also improve your long-term health.

If you would like more information on treating sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

By Randall J. Bartoe, DDS, PLC
June 06, 2019
Category: Dental Procedures
HowShawnMendesandMileyCyrusGotTheirStellarSmiles

The 2019 Grammy Awards was a star-studded night packed with memorable performances. One standout came from the young Canadian singer Shawn Mendes, who sang a powerful duet of his hit song "In My Blood" with pop diva Miley Cyrus. But that duo's stellar smiles weren't always quite as camera-ready as they looked that night.

"I had braces for four and a half years," Mendes told an interviewer not long ago. "There's lots and lots and lots of photo evidence, I'm sure you can pull up a few." (In fact, finding one is as easy as searching "Sean Mendes braces.")

Wearing braces puts Mendes in good company: It's estimated that over 4 million people in the U.S. alone wear braces in a typical year—and about a quarter of them are adults! (And by the way: When she was a teenager, Miley Cyrus had braces, too!)

Today, there are a number of alternatives to traditional metal braces, such as tooth-colored braces, clear plastic aligners, and invisible lingual braces (the kind Cyrus wore). However, regular metal braces remain the most common choice for orthodontic treatment. They are often the most economical option, and can be used to treat a wide variety of bite problems (which dentists call malocclusions).

Having straighter teeth can boost your self-confidence—along with helping you bite, breathe, chew, and even speak more effectively. Plus, teeth that are in good alignment and have adequate space in between are easier to clean; this can help you keep your mouth free of gum disease and tooth decay for years to come.

Many people think getting braces is something that happens in adolescence—but as long as your mouth is otherwise healthy, there's no upper age limit for orthodontic treatment. In fact, many celebrities—like Lauren Hutton, Tom Cruise and Faith Hill—got braces as adults. But if traditional braces aren't a good fit with your self-image, it's possible that one of the less noticeable options, such as lingual braces or clear aligners, could work for you.

What's the first step to getting straighter teeth? Come in to the office for an evaluation! We will give you a complete oral examination to find out if there are any problems (like gum disease or tooth decay) that could interfere with orthodontic treatment. Then we will determine exactly how your teeth should be re-positioned to achieve a better smile, and recommend one or more options to get you there.

If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Lingual Braces: A Truly Invisible Way to Straighten Teeth.”

By Randall J. Bartoe, DDS, PLC
May 27, 2019
Category: Oral Health
Tags: oral hygiene  
TestYoureBrushingandFlossingSuccesswithaPlaqueDisclosingAgent

Brushing and flossing your teeth provides a lot of benefits, including a brighter smile and fresher breath. But the primary benefit—and ultimate goal—is removing dental plaque. This biofilm of bacteria and food remnants on tooth and gum surfaces is the number one cause for dental disease.

Brushing and flossing can effectively keep plaque under control. Unfortunately, plaque can be a stubborn foe, hiding in areas easily missed if you're not thorough enough.

So how do you know you're doing a good job brushing and flossing? One quick way is to use your tongue or dental floss to feel for any grittiness, a possible sign of remaining plaque. Ultimately, your dentist or hygienist can give you the best evaluation of your hygiene efforts during your three or six-month checkup.

But there's another way to find out more definitively how well you're removing plaque in between dental visits: a plaque disclosing agent. These over-the-counter products contain a dye solution that stains plaque so it stands out from clean tooth surfaces.

A disclosing agent, which can come in the form of tablets, swabs or a liquid, is easy to use. After brushing and flossing, you apply the agent according to the product's directions. The dye reacts with plaque to stain it a distinct color. You may also find products with two-tone dyes that stain older and newer plaque different colors to better gauge your overall effectiveness.

You then examine your teeth in the bathroom mirror, looking especially for patterns of missed plaque. For example, if you see dyed plaque running along the gum line, you'll know you need to concentrate your hygiene there.

After observing what you can do to improve your future efforts, you can then brush and floss your teeth to remove as much of the dyed plaque as you can. The staining from the dye is temporary and any remaining will fade over a few hours.

Using a disclosing agent regularly could help you improve your overall hygiene technique and reduce your risk of disease. Ask your dentist for recommendations on products.

If you would like more information on improving your oral hygiene, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Plaque Disclosing Agents.”

By Randall J. Bartoe, DDS, PLC
May 17, 2019
Category: Oral Health
Tags: pregnancy   gum disease  
WhyDentalCareisEvenMoreImportantWhenYourePregnant

Learning you’re pregnant can be a joyous moment. But it also means life is about to change as you focus on protecting you and your child from anything that endangers your health.

Because of these new concerns you might even hesitate about receiving dental care, especially involving anesthesia. But several medical organizations representing doctors, OB-GYN physicians and dentists wholeheartedly recommend continuing regular dental visits during pregnancy.

In fact, you should continue them because you’re pregnant: physical and hormonal changes during pregnancy could increase your risk of dental disease.

For, example, your consumption of carbohydrates (like sugar) could increase, which in turn increases your risk of tooth decay. You’ll also need to be more concerned about dental plaque, a thin bacterial film on your teeth that can cause disease. Hormonal changes during pregnancy may make you more sensitive to plaque, and thus more susceptible to disease — especially periodontal (gum) disease.

In fact, a specific form of gum disease called pregnancy gingivitis affects around 40% of expectant women at some point in their pregnancy. And if you already have gum disease, pregnancy could worsen it. Left untreated the disease could develop into more severe periodontitis, which may significantly damage your teeth’s support structures far below the gum line, leading to bone loss, which could result in the eventual loss of your teeth. Daily brushing and flossing, regular cleanings and checkups and, if your dentist prescribes it, antibacterial mouth rinses can help you stay ahead of it.

But what about other procedures while you’re pregnant? It may be best to wait on elective treatments for cosmetic purposes until after the baby is born. But some situations like deep tooth decay that could require a root canal treatment may become too serious to postpone.

Fortunately, several studies have shown it’s safe for pregnant women to undergo many dental procedures including tooth fillings or extractions. And receiving local anesthesia doesn’t appear to pose a danger either.

The important thing is to remain diligent with your own personal hygiene — brushing and flossing — and making other healthy choices like eating a nutritious diet. And be sure to let your dentist know about your pregnancy to help guide your dental treatment over the next few months.

If you would like more information on taking care of your teeth and gums during pregnancy, please contact us or schedule an appointment for a consultation.

By Randall J. Bartoe, DDS, PLC
May 07, 2019
Category: Uncategorized
Tags: dental implant   bridge  
YourTeenagernotReadyforanImplantHeresWhatWeCanDoInstead

Losing a tooth can be traumatic, but a dental implant can dramatically turn that experience around. Providing functionality, life-like appearance and durability, implants stand out as the premier restoration for lost teeth.

For adults, that is. An older child or teenager with a missing tooth may need to wait a few more years for an implant. The reason: jaw development. A person's jaws, particular the upper jaw, continue to grow with most growth completed by early adulthood. Natural teeth with their periodontal attachments develop right alongside the jaw.

But because an implant attaches directly to the jawbone, its position is fixed: it won't change as the jaw grows and may gradually appear to sink below the gum line. That's why we wait to place an implant until most of jaw maturity has occurred after full jaw maturity. For females, we try to wait until 20 years of age and for males, usually 21 years of age. These are guidelines as some people mature faster and some slower, so a discussion with your dentist or surgeon is necessary to make an educated decision.

While we wait, we can install a temporary replacement for a child's or teenager's lost tooth, usually a partial denture or fixed modified ("Maryland") bridge. The latter affixes a prosthetic (false) tooth in the missing tooth space by attaching it to the back of natural teeth on either side with bonded dental material. It differs from a traditional bridge in that these supporting teeth aren't permanently altered and crowned to support the bridge.

During the time before implants we should understand that the area where the implant will be placed will undergo some bone deterioration, a common consequence of missing teeth. Forces generated as we chew travel through the teeth to stimulate renewing bone growth all along the jawbone. But with a lost tooth the chewing stimulation ceases at that part of the bone, slowing the growth rate and leading to gradual bone loss.

Fortunately, the titanium posts of dental implants stimulate bone growth as bone cells naturally grow and adhere to their surfaces. Before then, though, if the bone volume is diminished, we may need to graft bone material to stimulate bone growth that will enlarge the jaw bone enough for an implant to be placed.

It usually isn't a question of "if" but "when" we can provide your child with an implant for their missing tooth. In the meantime, we can prepare for that day with a temporary restoration.

If you would like more information on dental restorations for teenagers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants for Teenagers.”





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