Posts for: August, 2017
Question: What oral health issue do teenagers who wear orthodontic retainers and older folks who wear dentures have in common?
Answer: Both need to pay particular attention to cleaning their oral appliances.
The same goes for anyone who wears a nightguard to control tooth grinding, a mouthguard to protect teeth while playing sports, or a clear aligner for orthodontic treatment. Yet many people aren’t sure how to properly clean their appliances — so here are a few handy tips:
- Use toothpaste on your appliance — the ingredients in toothpaste, which are designed to polish the hard enamel of your teeth, are too abrasive for the soft plastic of oral appliances, and will cause scratches.
- Boil your appliance, or use bleach to clean it — both will end up breaking down and destroying the appliance. Don’t even use very hot water, as it can deform the plastic and make the appliance useless.
- Leave your appliance out on the nightstand, or anywhere else — pets and small children have been known to find (and destroy) oral appliances left lying around. Instead, store it properly in its special case.
- Use liquid dish detergent or hand soap to clean your appliance. A little mild soap plus warm water will do a great cleaning job. While you’re at it, get a brush just for the appliance — because, while it’s fine for plastic, you don’t want to brush your teeth with soap!
- Put a towel in the sink basin when you clean your appliance. Soapy appliances (especially dentures) can be slippery, and can be damaged by dropping — and that’s an expensive mishap.
- Consider investing in an ultrasonic cleaner. These inexpensive countertop devices are an excellent way to get the tiny ridges and crevices of your appliance really clean.
Whether you rely on dentures for everyday use, or just need to wear a retainer for a period of time, your oral appliance serves an important function. It may also represent a significant investment. That’s why it’s worthwhile to spend a few minutes each day giving these important items the care they need.
A few days before the Oscars, Vanity Fair magazine asked Academy Awards host Neil Patrick Harris to name his most treasured possession. Was it his Tony award statuette for best leading actor in a musical? His star on the Hollywood Walk of Fame? The stethoscope he wore while playing teenaged doctor Doogie Howser on TV? No, as it turns out, the 41-year-old actor’s most treasured possession is… his wisdom teeth. Yes, you read that correctly. “Oddly, I still have my four wisdom teeth,” Harris said. “I refuse to let them go or I’ll lose my wise parts.”
How odd is it for a 41-year-old to have wisdom teeth? Actually, not that odd at all. While it is true that wisdom teeth are often removed, there’s no one-size-fits-all approach to this. It all depends on whether they are causing problems now, or are likely to cause problems in the future.
The trouble wisdom teeth cause is related to the fact that they are the last molars to come in, and that molars are large in size. By the time wisdom teeth appear between the ages of 17 and 21, there often is not enough room for them in the jaw. Sometimes it’s because you may have inherited a jaw size that’s too small for your tooth size; and generally speaking, the size of the human jaw has evolved to become smaller over time.
If room is lacking, the adjacent molar (that came in earlier) can interfere with the path of eruption — causing the wisdom tooth to come in at an odd angle. The wisdom tooth can hit up against that other tooth, possibly causing pain or damaging the adjacent tooth. This is known as “impaction.” Sometimes the wisdom tooth breaks only partway through the gum tissue, leaving a space beneath the gum line that’s almost impossible to clean, causing infection. A serious oral infection can jeopardize the survival of teeth, and even spread to other parts of the body.
If a wisdom tooth is impacted, will you know it? Not necessarily. A tooth can be impacted without causing pain. But we can see the position of your wisdom teeth on a dental x-ray and help you make an informed decision as to whether they should stay or go. If removal is the best course of action, rest assured that this procedure is completely routine and that your comfort and safety is our highest priority. If there is no great risk to keeping them, as Neil Patrick Harris has done, we can simply continue to monitor their condition at your regular dental checkups. It will be particularly important to make sure you are reaching those teeth with your brush and floss, and that you keep to your schedule of regular professional cleanings at the dental office. All healthy teeth are indeed worth treasuring.
If you would like more information about wisdom teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
Your nightly snoring has become a major sleep disturbance for you and other family members. But it may be more than an irritation — it could also be a sign of sleep apnea, a condition that increases your risk for life-threatening illnesses like high blood pressure or heart disease.
Sleep apnea most often occurs when the tongue or other soft tissues block the airway during sleep. The resulting lack of oxygen triggers the brain to wake the body to readjust the airway. This waking may only last a few seconds, but it can occur several times a night. Besides its long-term health effects, this constant waking through the night can result in irritability, drowsiness and brain fog during the day.
One of the best ways to treat sleep apnea is continuous positive airway pressure (CPAP) therapy. This requires an electric pump that supplies constant pressurized air to a face mask worn during sleep to keep the airway open. But although effective, many patients find a CPAP machine clumsy and uncomfortable to wear. That's why you may want to consider an option from your family dentist called oral appliance therapy (OAT).
An OAT device is a custom-made appliance that fits in the mouth like a sports mouthguard or orthodontic retainer. The majority of OAT appliances use tiny metal hinges to move the lower jaw and tongue forward to make the airway larger, thus improving air flow. Another version works by holding the tongue away from the back of the throat, either by holding the tongue forward like a tongue depressor or with a small compartment fitted around the tongue that holds it back with suction.
Before considering an OAT appliance, your dentist may refer you to a sleep specialist to confirm you have sleep apnea through laboratory or home testing. If you do and you meet other criteria, you could benefit from an OAT appliance. There may be other factors to consider, though, so be sure to discuss your options with your dentist or physician to find the right solution for a better night's sleep.
If you would like more information on sleep apnea treatments, 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 “Oral Appliances for Sleep Apnea.”