Sleep Apnea must be diagnosed by your physician. However, today more and more physicians are beginning to work with dentists who have specialized training in the field of sleep medicine. Legally, any dentist can treat snoring/sleep apnea. However, that does not mean that every dentist takes advanced training to provide the proper therapy.
If you think you have sleep apnea, the first thing is to talk it over with your physician or dentist. We have a preliminary screening that is done here at the offices of James R. Donley, DDS.
Obstructive Sleep Apnea (OSA) happens when the airway is blocked and causes sleep disruption. When this occurs, the tongue and soft tissues at the back of the throat collapse when you are sleeping. Enlarged tonsils also can block the airway. These produce pauses in your breathing and can occur from a few times to several hundred times a night and disturbs your sleep.
OSA is very serious and causes or contributes to the following.
- Excessive daytime sleepiness
- Increases the risk of high blood pressure
- Leads to higher rates of stroke, arrhythmias, heart attack and even death.
- Awakenings with gasping and choking
- Fragmented, non-refreshing, light sleep
- Poor memory
- Irritability, personality changes
- Morning headaches
- GERD (Gastro-esophageal Reflux Disease)
- Obesity
- Diabetes
Sleep Apnea is often linked to snoring. The following facts have been compiled by several sleep medicine groups.
- About 30 million (1 in every 8) Americans snore.
- Snoring individuals have a higher likelihood of developing sleep apnea.
- About 18 million Americans have sleep apnea.
- Men over age 65 have a 28% chance of suffering from sleep apnea.
- Up to 50% of people who have sleep apnea also suffer from high blood pressure.
- Up to 10 times higher frequency of automobile accidents.
- Worsens with increasing age and/or weight.
- Special dental appliances can improve and often prevent sleep apnea episodes.
- Insurance specialists estimate that sleep disorders add about $15.9 billion to healthcare.
- Increased work-related accidents
Dentists cannot legally make the diagnosis of sleep apnea. This must be done by a physician after a "Sleep Study" has been performed. Physicians have been prescribing the continuous positive airway pressure "CPAP" machine for many years to help people with OSA. The Academy of Sleep Medicine has established new practice parameters which validate the effectiveness of dental appliances as a viable treatment for people who have mild to moderate OSA, or are unable to comply with CPAP treatment. Today, CPAP is still indicated for people with severe OSA. If someone is unable to tolerate the CPAP, an oral appliance may be used. In some cases the two may be used in combination to reduce the air pressure of the CPAP.
Today, there are many dental appliances that can be used to treat Sleep Apnea. Some dentists, including Dr. Donley, have taken advanced training to provide the proper dental treatment recommended for this problem. Dr. Jim is a member of the American Academy of Dental Sleep Medicine and attends training courses in sleep medicine. There is no single appliance that will cure everything for everybody so beware of any dentist or ad that claims they have the "secret" or "exclusive appliance" that will end your problem forever.
If you think you are having a problem with snoring or sleep apnea, Dr. Jim will be happy to discuss this life threatening problem with you. By working with your physician he will be able to help you get started on the treatment that is best for you and your health.
The answer varies from person to person. While regular manual toothbrushes are fine for most people, electric toothbrushes can be useful to those who need a little extra help.
Children often need help with brushing. Young children often do not have the dexterity to access all areas of their mouths. An electric toothbrush helps because they just need to "drive" it around and let it do the scrubbing work.
Even when children have the dexterity, many do not have the patience to brush for the amount of time it takes to clean their teeth properly. Many electric toothbrushes have the two minute timer feature which helps to remind children of how long they should brush.
For this age group, the Oral B Vitality brush is a good choice. It is fairly inexpensive (around $18) but works better than the $6 battery operated toothbrushes. It is a rechargeable version of a battery operated toothbrush. Most toothbrushes at this price point are similar in the way they clean teeth. Choice should be made on what toothbrush features the consumer desires.
Adults have a couple of good options for electric toothbrushes. The ultrasonic toothbrushes have the edge on plaque and stain removal and are the "Cadillacs" of the toothbrush world. The Oral B Professional Care SmartSeries 4000 and the Phillips Sonicare Flexcare are two of the best. Both of these brushes use sonic technology to blast bacteria. Sonic vibrations break down bacterial cells walls which in turn mean fewer bacteria and a cleaner mouth. These brushes are great for people who have limited dexterity or for those who just want to do a better job at keeping their teeth clean. The Sonicare brush has two heads, one of which is compact that works great on those who have small mouths. It is also a bit gentler than the Oral B brand, which may or may not be desirable. The Oral B brand gets excellent reviews for its movement over teeth, ease of use and battery life. If you like gimmicks, the Oral B tracks battery charge, notifies you when the brush head needs replacing and rewards you with a smiley face when you've completed two minutes of brushing time.
When choosing a brush, ask your dentist and hygienist what they recommend. Generally speaking, dental professionals try every type of brush, toothpaste, floss, etc. so that educated recommendations can be made to patients.
Consumers should also read reviews of toothbrushes before making an expensive purchase. A number of websites exist that are helpful in making decisions on which brush is best for you, consumers could check out consumersearch.com, reviews.pricegrabber.com and webmd.com. The pricegrabber website has actual reviews from consumers who have purchased these products and use them on a daily basis and are unbiased in their reviews.
Hopefully, Santa brings you a new electric toothbrush this year!
Dr. Jason Yap, director of marketing for Raffles Hospital, a leading private care facility in downtown Singapore suggests that the U.S. healthcare system is "complex" compared to the Singapore system. He further describes their system as "first class, cheap and market-driven." In the U.S. our cost of healthcare is 17% of GDP. In Singapore it is 4%.
The complexity of our current healthcare system and the cost to maintain it are the subject of much discussion. Some of the proposed healthcare reform plans are 2,000 pages and will add costs.
Whatever happens in the coming weeks with healthcare reform legislation in the United States, the conversation and the work of crafting a sound system is just beginning.
Accordingly, I am suggesting a different approach, "Healthcare Inc.: A Better Business Model" for your consideration.
This proposal comes from our own passion about health care and well-functioning systems. This plan is an outline of a system that allows practitioners to do what they do best without excessive or undue interference, incorporates service vendors in free market competition and uses federal funding as a logical and efficient administrative function.
It includes measures for quality assurance and sets spending proactively as a percentage of the gross domestic product agreed to in democratic fashion by participants each year.
Most importantly, it gives people control of their own health care choices while rewarding prudent behavior as health care consumers, with individually controlled accounts backed by a larger pooled fund for catastrophic coverage.
This brief description of Healthcare Inc. is the result of input from medical peers, legislators and lay people as well as long discussions and research. Too many of the plans being proposed come from recrafting old approaches rather than starting anew. I believe that the voices of the "experts" - physicians and other providers, practice managers, and the people who will use the system - have not been heard enough in the reform discussions to date. I believe that you would benefit from the chance to consider this promising approach, and that all of us would benefit from the kind of dialog that might ensue among us.
I invite each of you to take the time to review the entire plan at http://www.healthcareinc.net.