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Posts for tag: oral health

By Paul David Epstein, D.M.D. & Associates, P.C.
August 16, 2019
Category: Oral Health
TakeStepstoTreatChronicMouthBreathingasEarlyasPossible

Many things can affect your child’s future dental health: oral hygiene, diet, or habits like thumb sucking or teeth grinding. But there’s one you might not have considered: how they breathe.

Specifically, we mean whether they breathe primarily through their mouth rather than through their nose. The latter could have an adverse impact on both oral and general health. If you’ve noticed your child snoring, their mouth falling open while awake and at rest, fatigue or irritability you should seek definite diagnosis and treatment.

Chronic mouth breathing can cause dry mouth, which in turn increases the risk of dental disease. It deprives the body of air filtration (which occurs with nose breathing) that reduces possible allergens. There’s also a reduction in nitric oxide production, stimulated by nose breathing, which benefits overall health.

Mouth breathing could also hurt your child’s jaw structure development. When breathing through the nose, a child’s tongue rests on the palate (roof of the mouth). This allows it to become a mold for the palate and upper jaw to form around. Conversely with mouth breathers the tongue rests behind the bottom teeth, which deprives the developing upper jaw of its tongue mold.

The general reason why a person breathes through the mouth is because breathing through the nose is uncomfortable or difficult. This difficulty, though, could arise for a number of reasons: allergy problems, for example, or enlarged tonsils or adenoids pressing against the nasal cavity and interfering with breathing. Abnormal tissue growth could also obstruct the tongue or lip during breathing.

Treatment for mouth breathing will depend on its particular cause. For example, problems with tonsils and adenoids and sinuses are often treated by an Ear, Nose and Throat (ENT) specialist. Cases where the mandible (upper jaw and palate) has developed too narrowly due to mouth breathing may require an orthodontist to apply a palatal expander, which gradually widens the jaw. The latter treatment could also influence the airway size, further making it easier to breathe through the nose.

The best time for many of these treatments is early in a child’s growth development. So to avoid long-term issues with facial structure and overall dental health, you should see your dentist as soon as possible if you suspect mouth breathing.

If you would like more information on issues related to your child’s dental development, please contact us or schedule an appointment for a consultation.

By Paul David Epstein, D.M.D. & Associates, P.C.
February 10, 2016
Category: Oral Health
Tags: oral health   tooth wear  
PutanEndtoBadOralHabitstoSlowtheRateofToothWear

While tooth decay and periodontal (gum) disease destroy more teeth than any other causes, both of these diseases are largely preventable with proper oral hygiene and dental treatment. It’s more than possible, then, to enjoy a lifetime of healthy, disease-free teeth.

But even with healthy teeth, the effects of aging will cause tooth wear over time. And although we can’t prevent the aging process from occurring altogether, there are steps we can take not to accelerate the process.

Most tissues, including bone and teeth, have a growth cycle in which older cells are broken down (known as catabolism), removed and replaced by newer cells (anabolism). As we develop during childhood, the growth phase exceeds breakdown; when we reach adulthood, the two phases come into equilibrium. But as we age, breakdown will gradually overtake growth. This aging effect results in, among other outcomes, tooth wear.

“Normal” wear appears to be greatest — and most visible — along the biting surfaces of the teeth. The forces generated when we bite or chew causes enamel to erode over time. Unfortunately, you can accelerate this process through bad oral habits: clenching or grinding teeth, often times at night while you sleep, as well as habitually chewing on hard objects like nails or pencils.

Normal forces generated when we bite or chew are actually beneficial for dental health — they help stimulate bone growth. But when they exceed their normal range as when we clench or grind our teeth, they can increase tooth wear and cause other problems such as diminished function or changes in appearance, such as a shortened facial height.

To slow the rate of wear, it’s important to modify any behaviors that may be contributing to it. In many cases an occlusal night guard worn while you sleep helps prevent teeth clenching. You may also need assistance with stress management, a major trigger for these kinds of habits, through biofeedback therapy or counseling.

If you’ve already encountered excessive wear, bonding techniques using colored composite resin, veneers or crowns that attach directly to the teeth can restore lost function and rejuvenate the appearance and color of your teeth. We can perform a “smile analysis” to determine if one of these techniques is right for you to help you regain a more youthful and attractive smile.

If you would like more information on aging and tooth wear, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How and Why Teeth Wear.”

By Paul David Epstein, D.M.D. & Associates, P.C.
May 11, 2015
Category: Oral Health
Tags: oral health   snoring   sleep apnea  
YourDentistcanHelpGuideyouintheBestTreatmentOptionforSleepApnea

Do you still feel tired or unfocused even after a full night’s sleep? Do others complain about your snoring? It’s possible these are signs that you may have sleep apnea.

Sleep apnea is a condition in which you stop breathing while you sleep. Your brain will awaken you to breathe, although you may not consciously realize it since the waking period can be less than a second. But it does disrupt your sleep rhythm, especially during the all-important deep sleep period called Rapid Eye Movement (REM). These disruptions don’t allow your body to receive the full benefit of sleep, hence your lack of energy and focus during the day.

One of the most common causes for sleep apnea is the collapse of soft tissues near the throat as they relax during sleep that restrict the airway. Snoring is an indication this may be occurring: air vibrates rapidly (and loudly) as it passes through this restriction when you breathe in.

As your dentist, we’re well-trained in the anatomy and function of the entire oral structure, and qualified to offer solutions for sleep apnea. If you’ve been diagnosed with sleep apnea (after a complete examination, including an observation session at a sleep laboratory), we can then help you decide on a treatment approach. The following are three such options, depending on the severity of your sleep apnea.

Oral Appliance Therapy. An oral appliance you wear while you sleep is a first line treatment for mild or moderate sleep apnea. The appliance, which we custom design for you, helps hold the lower jaw in a forward position: this moves the tongue and other soft structures away from the back of the throat, thereby opening the airway.

Continuous Positive Airway Pressure (CPAP). Intended for more moderate to severe forms of sleep apnea, a CPAP machine produces continuous air pressure to the throat through a mask you wear during sleep. This forces the tongue forward and the airway open.

Surgical Intervention. These procedures remove excess tissue that may be obstructing the airway. Due to its invasiveness and permanent alteration of the throat area, surgery is reserved for patients who haven’t responded to other therapies in a satisfactory manner.

Whether mild or severe, it’s possible to effectively treat sleep apnea. If successful, not only will you benefit from better sleep and greater alertness, you’ll also improve your long-term health.

If you would like more information on treating sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

By Paul David Epstein, D.M.D. & Associates, P.C.
April 09, 2015
Category: Oral Health
FastFoodChainsTakeOneSmallStepforKidsTeeth

Eaten in a fast food restaurant lately? If so, maybe you’ve noticed some changes in the big, colorful signs behind the counters. Many have begun promoting a few “healthier” selections (like salads and grilled items) and giving a more extensive listing of nutritional information. But there’s one thing you might not have noticed on those displays: a listing for soda among the beverage choices in the kiddie meal packages. That’s because they are no longer there.

Recently, Burger King quietly removed sugary fountain drinks from the in-store and online menu boards that show what you get with kids’ meals. They were following the lead of McDonalds and Wendy’s, both of which made similar moves in prior months. You can still get a soda with your kiddie burger if you specifically ask for one, but we’re hoping you won’t; here’s why.

For one thing, youth obesity has nearly tripled in the past three decades. As the U.S. Centers for Disease Control and Prevention (CDC) has noted, it’s now an epidemic affecting more than one in six children and adolescents. Many of the extra calories kids get are blamed on sugary drinks: According to a study by the Harvard School of Public Health, children’s daily calorie intake from these beverages rose by 60 percent in recent years. Obesity makes kids more likely to get many diseases, and can lead to problems in psychological and social adjustment.

But that’s not all. As dentists, we’re concerned about the potential for soda to cause tooth decay, which is still the number one chronic disease in children around the world. The association between sugary drinks and cavities is clear. So is the fact that tooth decay causes pain, countless hours of missed school and work, and expense that’s largely unnecessary, because it’s a disease that is almost 100 percent preventable.

While the new signage at fast food restaurants won’t make soda disappear, it does tend to make it less of an automatic choice. Anything that discourages children from routinely consuming soda is bound to help — and let’s point out that the same thing goes for other sweet and acidic beverages including so-called “sports” and “energy” drinks. It’s best to try and eliminate these from your child’s diet; but if you do allow them, at least limit them to mealtimes, and give your mouth a break from sweets between meals. That gives the saliva enough time to do its work as a natural buffer and acid-neutralizer.

What else can you do to help keep your child’s oral hygiene in tip-top shape? Be sure they brush their teeth twice and floss once every day, and bring them in for regular checkups and cleanings. But if you do suspect tooth decay, don’t delay treatment: Left alone, decay bacteria can infect the inner pulp of the tooth, resulting in severe pain, inflammation, and possibly the need for root canal treatment.

If you would like more information about children’s oral health, please contact us or schedule an appointment. You can learn more by reading the Dear Doctor magazine articles “How to Help Your Child Develop the Best Habits for Oral Health” and “Top 10 Oral Health Tips For Children.”