A good night's sleep...have you been getting them lately? While everyone knows that sleep is important, did you know that we all spend about one-third of our lives asleep? And did you know that when deprived of sleep, the negative impact is detrimental on both an individual as well as at the societal level? These important facts are just some of the reasons why there has been an increased interest in studying sleep, sleep loss and sleep disorders.

If you have issues with sleep, you might have a sleep disorder — an epidemic problem that impacts approximately 50 to 70 million people in the US alone. Obstructive Sleep Apnea (“a” – without; “pnea” – breath) (OSA) is a medical condition that occurs when your tongue collapses against the back of your throat causing a significant reduction in your intake of air or even total temporary blockage. If left untreated, OSA can lead to an irregular heartbeat, heart attacks, high blood pressure, and other forms of heart disease plus strokes and even impotence.

Please note that while your responses to the questions below do not equate to a diagnosis, sharing them with our office can be extremely beneficial in helping us properly evaluate and treat issues related to poor sleeping habits.

• Do you weigh 15 pounds or more than the normal weight range for your height, sex and age?
• If you are male, is your neck measurement 17 inches or more? Or if you are female, is it 16 inches or more?
• Do sleep partners routinely tell you that you are a loud snorer and/or that during your sleep you choke, gasp for air or briefly stop breathing?
• Do you often wake up still feeling tired after 8 or more hours of sleep?
• Do you often find yourself falling asleep at work or home during periods when you should be awake?
• Do you suffer from irritability, depression, loss of memory, poor judgment and/or concentration?

The first and most important step in treating sleep apnea is to obtain a proper diagnosis. Contact us today to schedule an appointment to discuss your questions about sleep apnea. We can assist in the diagnosis and treatment of sleeping disorder along with a physician trained in this area. And rest assured that we have many treatment options we can use to help you get a great night's sleep. To learn more about sleep apnea, continue reading the Dear Doctor magazine article “If You Snore, You Must Read More!”

Nightly snoring can be a sign of a dangerous condition called sleep apnea (from “a” meaning without and “pnea” meaning breath). When someone snores the soft tissues in the back of the throat collapse onto themselves and obstruct the airway, causing the vibration known as snoring.

If the obstruction becomes serious, it is called obstructive sleep apnea, or OSA. In such cases the flow of air may be stopped for brief periods, causing the person to wake for a second or two with a loud gasp as he attempts to catch his breath. This can cause heart and blood pressure problems, related to low oxygen levels in the blood. The obstruction and mini-awakening cycle can occur as many as 50 times an hour. A person with this condition awakens tired and faces the risk of accidents at work or while driving due to fatigue.

Studies show that sleep apnea patients are much more likely to suffer from heart attack, congestive heart failure, high blood pressure, brain damage and strokes.

What can be done to treat OSA?
Snoring, apnea, and OSA occur more frequently in people who are overweight. So start with losing weight and exercising.

At our office, we can design oral appliances to wear while sleeping that will keep your airway open while you sleep. These appliances, which look like sports mouth guards, work by repositioning the lower jaw, tongue, soft palate and uvula (soft tissues in the back of the throat); stabilizing the lower jaw and tongue; and increasing the muscle tone of the tongue.

Another approach is to use a Continuous Positive Airway Pressure (CPAP) bedside machine. These machines send pressurized air through a tube connected to a mask covering the nose and sometimes the mouth. The pressurized air opens the airway so that breathing is not interrupted.

Much less frequently, jaw surgeries may be recommended to remove excess tissues in the throat. These would be done by specially trained oral surgeons or ear, nose and throat specialists.

Diagnosis and treatment of OSA is best accomplished by joint consultation with your physician and our office. Contact us today to schedule an appointment to discuss snoring and OSA. You can learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Snoring and Sleep Apnea.”

Can chewing gum prevent cavities? Yes! It can if the gum is sweetened with xylitol.

What is xylitol?
Xylitol is a type of “sugar alcohol,” similar to sorbitol and mannitol, sugar replacements that are used in many low calorie foods. Xylitol occurs naturally in many fruits and vegetables and is obtained from the bark of birch trees, coconut shells and cottonseed hulls. It looks and tastes like sugar and is a diabetic-safe, low-calorie carbohydrate.

How does xylitol stop cavity formation?
Decay starts when certain bacteria break down sucrose (regular table sugar) and produce acids that dissolve the minerals in the enamel, the outer protective layer of your teeth. When the decay-causing bacteria try to consume xylitol, they are unable to break it down, and instead they begin to starve.

A normal mouth contains a large population of bacteria, and it is better for your teeth to have more “good” bacteria of the kind that do not cause cavities. Xylitol also stops your saliva from becoming acidic, so your mouth becomes a better environment for the “good” bacteria.

Chewing xylitol gum also increases your flow of saliva. Saliva contains calcium and fluoride and helps give these minerals back to your teeth (re-mineralization), undoing some of the effects of the cavity-causing bacteria. This makes chewing xylitol gum a particularly good solution for people who suffer from dry mouth.

How much xylitol do you need to prevent cavities?
We recommend that you chew or suck on two pieces of xylitol gum or two pieces of xylitol candy for five minutes following meals or snacks, four times daily — if you are at moderate to extreme risk for cavities. The target dose of xylitol is 6 to 10 grams (one or two teaspoons) spread throughout the day. Prolonged gum chewing is not advised, so most xylitol-sweetened products contain flavor that only lasts a short time to discourage excessive chewing. The only side effect of too much xylitol ingestion is that it may have a mild laxative effect.

I don't like chewing gum. Is there another way to get xylitol?
People who don't like to chew gum have the option of using xylitol in mints, candies, mouthwash, toothpaste, or mouth sprays. For these individuals, a minimum dose is 5 to 6 grams (one teaspoon) three times per day.

So now you can add xylitol to the list of ways to fight cavities: daily brushing and flossing, and regular professional cleanings — and chewing xylitol gum.

Contact us today to schedule an appointment to discuss your questions about xylitol and other methods of preventing tooth decay. You can also learn more by reading the Dear Doctor magazine article “Xylitol in Chewing Gum.”

You probably know that tooth decay results when the bacteria in your mouth release acids after consuming sugars. After you eat sugars, particularly the type of sugar known as sucrose, increased acid in your mouth begins to dissolve the enamel and dentin in your teeth, and you end up with cavities.

What are the Types of Sugars?
Modern diets include several types of sugars. Most of these are fermented by oral bacteria, producing acids that are harmful to teeth.

• Sucrose (commonly known as sugar)
• Glucose (released from starch consumption)
• Lactose (milk sugar) — Less acid is produced from this type of sugar
• Fructose (found naturally in fruit and also added to many processed foods)
• Maltose

Recommended intake of “free sugars” is no more than 10 teaspoons per day. Note that a can of soda contains over 6 teaspoons! Soft drinks are the largest source of sugar consumption in the U.S. In 2003, for example, Americans drank an average of 52 gallons of soft drinks. Average per capita consumption of all sugars in the U.S. was 141.5 pounds (64.3 kg) one of the highest levels in the world.

Sugar substitute xylitol (which is chemically similar to sugar but does not cause decay) can be part of a preventive program to reduce or control tooth decay. Chewing gum sweetened with xylitol stimulates saliva flow and helps protect against decay.

Sugars Released from Starches
Starches are foods like rice, potatoes, or bread. When you eat refined starches, such as white bread and rice, enzymes in your saliva release glucose. However, these foods have a lower potential to produce decay than foods with added sugars. When sugars are added to starchy foods, as in baked products and breakfast cereals, the potential for decay increases.

Less refined starches such as whole grains require more chewing and stimulate secretion of saliva, which protects from harmful acids.

The Case for Fruit
Fresh fruit has not been shown to produce cavities, so it makes sense to eat them instead of sugary desserts and snacks. Dried fruit is more of a problem because the drying process releases free sugars.

Contact us today to schedule an appointment to discuss your questions about diet and oral health. You can also learn more by reading the Dear Doctor magazine article “Nutrition & Oral Health.”

Your son just crashed his skateboard and cracked a tooth, or maybe your daughter fell off the monkey bars at school and now has a chipped front tooth. For children, and some adults, repairing chipped or damaged teeth with tooth-colored restorative materials directly bonded to the teeth may be the perfect solution to restore their smiles.

What is Involved: Composite bonding is a technique that has been developed to correct chipped teeth and other minor dental imperfections. It may also be used to correct mild crookedness or gaps between teeth. The procedure requires the application of a tooth-colored composite resin material to the surfaces of teeth, which is then sculpted to the desired shape. It can be performed in a single visit for one or multiple teeth. The procedure usually takes between one and two hours, and the end result is a beautiful, natural-looking smile.

Advantages for Kids and Adults: Composite resin bonding is a good choice for kids and teens since their jaws are still growing and developing, and they may still be engaged in high-risk activities. After your child's teeth and jaws are fully developed, we can discuss options for more permanent restorations such as porcelain veneers or crowns. These require removal of more tooth structure, which could compromise the long-term health of your child's teeth if done too soon. Composite resin restorations, which bond straight to the teeth and require little to no tooth preparation or drilling are therefore a good option for fixing chipped teeth, and they're less expensive than choosing veneers.

Disadvantages: The longevity of composite resin restorations is related to how well you maintain your teeth. Many people can go for ten or fifteen years before they need to have the bonded resins repaired or replaced. Others will tend to stain and wear after only one or two years and will need some touch-up work.

Contact us today to schedule an appointment to discuss any questions you may have regarding dental bonding. Read more about this topic in the Dear Doctor magazine article “Repairing Chipped Teeth.”