Recently a patient asked me why people seem to get tooth decay as they get older after years of being decay free. The answer is that as we age we lose some gum tissue around our teeth and then areas of the root becomes exposed. This part of the tooth is less resistant to bacteria and more likely to become decayed. There are some easy ways to reduce the chances of getting decay. Rinse with a fluoride containing mouth rinse and brush with a prescription strength tooth paste. If your mouth is dry you also need to be sure to use artificial saliva to make sure your mouth stays moist.
Medicare coverage for oral sleep apnea appliances is relatively new. Medicare covers the appliance as a DME ( durable medical equipment). If you have the appliance made by a dentist, who is not a DME provider it will not be covered by Medicare. Make sure your dentist can submit for your appliance as a DME before you proceed. If you have questions about coverage ask us or ask your dentist if they are a DME provider.
There has been lots of discussion in the news in the last few years about the relationship between periodontal disease and heart disease. The latest studies show that there is no cause and effect between having periodontal disease and heart disease. But I believe there is an association. There is a big difference between a cause and effect and an association. In the first case if periodontal disease is not treated that will lead to heart disease in the second if a person has periodontal disease he/she might be more likely to have heart disease. While there have not been any long term studies looking at this relationship I believe that in the future those studies will be done and that will prove to be the case. The association between periodontal disease and heart disease was the reason that researchers got it wrong in the first place. Bacteria do not directly cause the loss of bone in periodontal disease. And bacteria do not cause arthrosclerosis. The cause of both diseases is a defect in healing and a response to injury. In the mouth the bacteria cause inflammation and the body’s response to that inflammation is to lose bone, thus causing the loss of attachment and ultimately the loss of teeth. In the heart small injuries to the blood vessels of the heart do not heal properly and there is scaring. This scaring causes the vessel to fill with plaques and thus causes them to narrow. I believe that the same response to inflammation is in operation in both cases with different results. Patients who have periodontal disease should take care to see their physician to be monitored for heart disease.
Do you hate your CPAP? We can help. We can make a mandibular advancement splint (MAS), an oral appliance to move your jaw forward. This device opens you airway and allows you to sleep without obstruction or the need for CPAP. You can unplug from the wall, get rid of the noise and the tubing. It is much easier to travel with a MAS than with a CPAP. The best thing is that most medical insurance companies and Medicare cover this treatment. Give us a call and let’s see if we can get rid of that CPAP for you.
Disordered sleep or sleep apnea is a common affliction affecting approximately 10% of the population. It usually occurs as we get older but can even affect children. There are many secondary effects of this condition besides the feeling of tiredness during the day. If you have gained weight recently or have a neck size bigger than 17 inches and wake up tired you should consider taking a sleep study. A quick and easy screening test is called the Epworth Sleepiness test. You can take this test but following this link: http://www.stanford.edu/~dement/epworth.html. If you have a total of 9 or above you should talk to your primary care doctor or a sleep physician about a sleep study. If you are diagnosed with sleep apnea we can help you avoid the use of a CPAP with its mask and hoses by using an FDA approved oral appliance.
Is it better to save the tooth or place an implant? Sometimes that is a difficult question to answer. Sometimes the tooth needs endodontic treatment (root canal) to save the tooth. Endodontic treatment is very successful, but if there is a question regarding the long term viability of the tooth the alternative may be to be to place an implant. Implants are also very successful. Faced with this dilemma what is the right thing to do? If the endodontist and your restorative dentist believe the tooth can be saved and the cost of treatment is less than the cost of implant treatment it makes sense to save the tooth, however; if the cost of saving the tooth is more than the cost of the implant treatment it usually makes more sense to have the tooth extracted and an implant placed. The final decision should of course be made with the input of your restorative dentist.