How the dentist can save your life while you sleep.

February 21, 2011 by · Leave a Comment


At www.thegentledentist.com we are always interested in providing the most up to date care for our patients.  One of the most beneficial services we provide is the treatment of obstructive sleep apnea for our patients who stop breathing at night. 

Obstructive sleep apnea is a condition where one will encounter periodic episodes of losing their breath during sleep.  The airway can be restricted when there is too much soft tissue in the space and the patient will struggle at times to breathe, eventually taking a gasp of air after laboring to get in a breath for over 10 seconds.  Common risk factors are:

  • high BMI (body mass index).  Obesity is rampant in Americans due to a lack of exercise, fast foods and other factors
  • small size of the lower jaw- if the lower jaw is too small then the soft tissue is packed into a small space which can prevent adequate air from moving down the trachae.  In a larger lower jaw the tissue moves with the jaw and therefore space isn’t such a problem.
  • The chronic use of alcohol can relax muscles of the neck to the point where they collapse into closing the air space.

The gold standard in obstructive sleep apnea is the cpap machine.  This machine provides positive pressure forcing air down the trachea and into the lungs during the night .  The problem is that this is not very comfortable and is not well tolerated by the patient or the spouse.  The machine makes a rumbling noise which is from the compressor.  It is important to remain sleeping on the back with such a device because the mask needs space and if one rolled onto the stomach the mask would press against the face.

The oral appliance moves the jaw forward to open up the space.  Because the soft tissue is attached to the lower jaw, when it is positioned forward all of the tissue comes with it. 

The oral appliance can be adjusted to move the jaw forward but there are limitations on how far.  As the jaw moves forward it displaces the TMJ (tempro mandibular joint), the joint in which the jaw hinges on.  As the joint is moved there are some clicking and potential joint problems that can be be experienced and this is why your dentist needs to be aware of the workings of the bite and jaw joint. 

On Frank, this treatment has been very successful and compared with a cheap over the counter device it is a worth while investment (financially and health wise).

For more information please call Dr. Antolak, The Gentle Dentist at (586)247-3500 or email at DrAntolak@TheGentleDentist.com

Filed Under: Dental Patient Testimonials, Dental Videos, General Dentistry, Health Implications, Oral Conditions, Sleeping Disorders Tagged With: , , ,

Mouth Breathing and its effect on your body

January 18, 2011 by ·

Mouth breathing:

  1. Can increase asthma, high blood pressure, heart disease and other medical problems
  2. Reduces the levels of oxygen exchange in the blood/lung interface. The lungs extract oxygen from the air we breathe primarily on the exhale. Because the nostrils are smaller then the mouth, air exhaled through the nose creates back pressure when one exhales. It slows the air escape so the lungs have more time to extract oxygen from them.
  3. During sleep, it predisposes one to loud snoring and irregular breathing and can lead to a serious condition called Sleep Apnea and heart conditions.

Nose Breathing:

  1. Proper nose breathing reduces high blood pressure or hypertension and stress for most people. Kind of like a speed control (governor) on a car engine.
  2. The nostrils and sinuses filter and warm the air going into the lungs. The mouth breather bypasses this.
  3. Maintaining a keen sense of smell is very important for enjoying life and for safety and social acceptance.  There are receptors in the nose, known as olfactory bulbs, are direct extensions of a part of the brain known as  the hypothalamus. This extension regulates the heartbeat, blood pressure, thirst, appetite, and of course, the cycles of sleeping a waking. The hypothalamus is also responsible for generating chemicals that influence memory and emotion.
  4. Lessening of the common cold is another good reason for nose breathing. The mucous (white blood cells that kill germs) membrane lining the nose extends all the way from the inner linings of the nostrils down the trachea to the bronchi the directly enters the lungs. Germs get caught and die in the mucous.

Long term mouth breathers experience difficulty in swallowing pills, increased gagging response, increased mucous production and other difficulties.

Mouth breathers do not adjust the way they swallow as an infant.  Typically infants project their tongues out to swallow and transition at around 8 months old so that their tongue is positioned along the top of their palate when swallowing.  Pacifiers and thumb sucking also affects the tongue position during the developmental years. If they aren’t removed early enough the tongue continues to push out beyond the front teeth preventing normal jaw and teeth development.  The relationship of the upper and lower teeth is also affected since they have to accommodate the tongue.  I have seen in adult patients the affects of this and it is almost impossible to change the jaws without surgery.  They usually have an open bite on their front teeth so that when they bite together the front top teeth don’t overlap the lower front teeth.  This is not cosmetically appealing and it has negative effects on the health of the jaw joint.

Allergies also are responsible for the mouth breathing tendencies.  The pharynx (back of throat) swells blocking off the nasal passage preventing smooth airflow through the nose.  It is important to determine what children are allergic to as soon as possible so that the destructive forces of mouth breathing are minimized.

As an adult it is best to retrain yourself to nose breathe during the day.  There are devices you can put in your mouth at night to retrain your tongue and help with nose breathing.  In fact, I had a patient the other day who was having a very difficult time breathing.  His CPAP breathing machine wasn’t functioning properly and I had him a Breathe Rite Strip to enlarge his nasal passage.  He was shocked at the difference he felt and the ease in which he could breathe.

Our human bodies have been designed so intricately that the smallest change in our function can effect so many other facets of how we function and our overall health.  If you have any questions please call me at (586)247-3500 or email me at DrAntolak@TheGentleDentist.com

Dr. Antolak treats his dental patients in a relaxed, friendly atmosphere where you are treated like a guest in the home.  He specializes in cosmetic dentistry, implant dentistry and general dentistry using sedation dentistry if necessary for his high fear patients. He has been treating patients for the past 21 years.

As A reminder: The thermostats are being turned up and it is a good idea to have a humidifier in you room where  you sleep since this significantly helps with dry mouth, sore throats, and adds to the efficiency of heating your home.  I was reminded of this at a recent visit to a nursing home and recommended that a humidifier would help increase the comfort of sleeping for the patient.

Filed Under: Dental Emergencies, General Dentistry, Mouth pain, Nutrition, Oral Conditions Tagged With: , , , , , , , ,

Living a Smoke Free Life

October 7, 2010 by ·

I have recently seen with friends of mine or patients who have become smoke free after  years of smoking and I see the positive effects this process has had on their lives.  I want to pass on some information for the Shelby Twp, Macomb county area people who read this blog and who are tired of the control that smoking has on your life.  To quit it usually takes a plan and commitment to stick to the plan for the changes to take place with any consistency. For those who smoke or live with a smoker I would like to expand on living a smoke free life in this month’s article. 
According to the American Heart Association, about 46 million American adults smoke cigarettes.  This breaks down to 23 percent of adult men and 19 percent of adult women. Most smokers are either actively trying to quit or want to quit. Since 1965, more than 49 percent of all adults who have ever smoked have quit. Leading a smoke free life: Smoking and using spit tobacco are  habits that significantly affect one’s health and well being. 
Why Quit?:
Cigarette smoking causes 87 percent of lung cancer deaths. Lung cancer is the leading cause of cancer death in both men and women. Smoking is also responsible for most cancers of the larynx, oral cavity and pharynx, esophagus, and bladder.
Tobacco smoke contains thousands of chemical agents, including over 60 substances that are known to cause cancer.
According to the Surgeon General:  Cigarette and tobacco smoke, high blood cholesterol, high blood pressure, physical inactivity, obesity and diabetes are the six major independent risk factors for coronary heart disease that you can modify or control.

There are many oral conditions that are negatively affected by tobacco use which include:  periodontal disease, healing with dental implants, oral surgery and high risk for oral cancer.
The Good News:

  • After one year off cigarettes, the excess risk of coronary heart disease caused by smoking is reduced by half. After 15 years of abstinence, the risk is similar to that for people who’ve never smoked. 
  • In 5 to 15 years, the risk of stroke for ex-smokers returns to the level of those who’ve never smoked.
  • Male smokers who quit between ages 35 to 39 add an average of 5 years to their lives. Female quitters in this age group add 3 years. Men and women who quit at ages 65 to 69 increase their life expectancy by 1 year.

The Plan:
In any method used to be smoke free the person really needs to want to quit.  The motivation needs to come from within  rather than from an outside source such as a  spouse.  It needs to be done for yourself and as a result of your effort others will benefit. 

Both acupuncture and hypnotism can effective non-drug methods used to be tobacco free.  There is little scientific evidence that shows these methods are more effective than the use of pharmaceuticals.  For those patients who desire a more holistic approach these methods may be for you.

There are a number of pharmaceutical approaches used for a smoking cessation program.  These include nicotine replacement therapies such as nicotine gum or the patch, the use of zyban, an antidepressant, and a  smoking cessation aide called Chantix. I have current patients who have used Chantix with remarkable results.  According to Jonathan Foulds, the director of the Tobacco Independence Program, Chantix appears to target the nicotine receptors in the brain that are involved in producing the rewarding effects from smoking. Chantix is believed to work via two mechanisms:

1. Chantix binds to nicotine receptors and blocks them so that nicotine can no longer activate those receptors (an effect that pharmacologists sometimes call an antagonist effect). This means that when someone is trying to quit and they lapse and smoke a cigarette, they probably won,t get much satisfaction from smoking it, and will be less likely to smoke another. The take-home message for patients is that it still makes sense to select a target quit-date (day eight) and to try to quit smoking completely on that day. However, if you don’t immediately quit don’t give up on yourself or on the medicines. The evidence suggests that if you keep trying you will likely achieve abstinence, and that Chantix improves your chance s, so long as you keep trying and keep taking the medicine. On the other hand, it is important to be clear that the aim of the game is to quit completely, and it is better in the long run to throw away the cigarettes and get on with it.
 
 

 It is exciting for us to team up with those who want to get control of their lives and finally be smoke free.  Give us a call at (586) 247-3500 or email me at DrAntolak@TheGentleDentist.com for more information on this or previous articles. Please submit questions you may have about dental related topics to the same address on the internet. If you would like to write us, out address is 15055 22 Mile #2,  Shelby Twp.  MI 48315.

Dr. Robert Antolak practices implant, cosmetic and general dentistry in a relaxed “homey” environment where you are  made to feel like family. 

Filed Under: Drug Concerns, General Dentistry, Nutrition, Oral Cancer, Oral Conditions Tagged With: , , , , ,
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