We all know how much better we feel after a good night’s sleep: refreshed, energized and ready to handle — even excel at — our day-to-day responsibilities. Yet millions of people, young and old, are robbed of a good night’s rest by sleep-related breathing disorders such as sleep apnea, in which the soft tissues in the back of the throat block the airway during sleep. This temporarily disrupts airflow, causing numerous “micro-arousals” (sleep interruptions) that we may not even be aware of. A lack of sleep can make us drowsy, irritable and unfocused. In children, these typical symptoms of sleep apnea can lead to mistaken diagnoses of Attention Deficit Hyperactivity Disorder (ADHD).
The relationship between sleep apnea and behavioral problems has been highlighted in several recent scientific journal articles, including a major study published several years ago in Pediatrics, the official journal of the American Academy of Pediatrics. The lead author, Dr. Karen Bonuck, said at the time: “We found that children with sleep-disordered breathing were from 40 to 100 percent more likely to develop neurobehavioral problems by age 7, compared with children without breathing problems. The biggest increase was in hyperactivity, but we saw significant increases across [other] behavioral measures.” Therefore, an accurate diagnosis of a child’s behavioral problems — leading to the right treatment — is crucial. While sleep apnea must be diagnosed by a physician, treatment for the condition is often provided by a dentist.
What can be done for children suffering from sleep apnea? The most common treatment is surgical removal of the tonsils or adenoids. This treatment can sometimes be performed by an oral and maxillofacial surgeon, a dentist who has received several years of post-graduate surgical training. There are several other procedures oral surgeons can perform to open the airway, depending on what anatomical structures are blocking it.
Sometimes a child with sleep apnea can benefit from a procedure to expand the palate (roof of the mouth) to enlarge the airway. This is not a surgical treatment but rather an orthodontic one. An orthodontist (a dentist who specializes in moving teeth) will fit the child with a palatal expander, a butterfly-shaped device that gradually separates the two bones that form the upper jaw and roof of the mouth. This is often done to prevent crowding of teeth and other bite problems, but has been shown in some cases to improve airflow.
There is another dental approach used to treat adults and older children, whose jaw growth is complete. It’s called oral appliance therapy, and it involves wearing a custom-made device during sleep that resembles a sports mouthguard or orthodontic retainer. An oral appliance can maintain an opened, unobstructed, upper airway during sleep in various ways, including: repositioning the lower jaw, tongue, soft palate and uvula; stabilizing the lower jaw and tongue; increasing the muscle tone of the tongue.
If your child has been diagnosed with sleep apnea, we can help you find the best treatment approach. For more information, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders & Dentistry” and “Snoring & Sleep Apnea.”
If you follow the hit TV reality show Amazing Race, you know that professional-hockey-playing brothers Bates and Anthony Battaglia won the $1 million prize in the latest globe-spanning competition. You may also have witnessed Anthony removing his false front teeth from time to time — like when he had to dive for pearls in Bora Bora. Since he plans to resume his sports career, Anthony wears a partial denture to fill the gap in his classic “hockey mouth.” He has said that when he finally hangs up his skates, he will use some of his Amazing Race prize money to get new, permanent teeth. When it's time to get that new smile, Anthony, like many people, will have to choose between two good options for permanent tooth replacement.
The preferred option for most people is dental implants. In this system, tiny titanium posts substitute for the root part of your missing tooth (or teeth). These are placed beneath your gum line in a minor surgical procedure we perform right here at the dental office. The amazing thing about dental implants is that they actually fuse to your jawbone, allowing your replacement teeth to last a lifetime.
The titanium implant itself is not visible in the mouth; the part of an implant tooth that you see is the lifelike crown. Virtually indistinguishable from your natural teeth, the crown is attached to the implant above the gum line. Dental implants can be used to replace a single tooth, multiple teeth, or even all your teeth. You don't necessarily need one implant for every tooth because implants can support bridgework or even a complete set of prosthetic teeth.
The second-best option is a natural-tooth fixed bridge. In this system, we use healthy natural teeth on either side of the empty space left by a missing tooth (or teeth) as supports for one or more of the prosthetic teeth that will fill the gap. The downside is that in order to turn these healthy teeth into supports (which are referred to in dentistry as “abutments”), we need to remove some enamel and then cap them. This procedure can leave those teeth more prone to decay than they were before. But with regular dental exams and good oral hygiene on your part, bridgework can last many years.
Which system is right for you? That's a question we would be happy to help you determine... even if you haven't won a large jackpot or gone pearl diving in Bora Bora. If you've been looking forward to the day when you can have permanent replacement teeth, why wait? Contact us or schedule an appointment for a consultation. We will help you find your ideal solution to the problem of missing teeth! For more information, please see the Dear Doctor magazine articles “Dental Implants vs. Bridgework” and “Dental Implants: Your Third Set of Teeth.”