Thursday, May 23, 2019



Bedwetting is a common finding in children.  A child drinks fluids before bedtime, constipation, or an episode of emotional stress can cause a nighttime bedwetting accident.  For most children, nighttime bedwetting does resolve itself over time.  If nighttime bedwetting accidents become frequent; the child should be checked and evaluated for possible sleep-disordered breathing.
What is sleep-disordered breathing?
According to the American Academy of Otolaryngology (ENT), sleep-disordered breathing (SDB) is a general term for breathing difficulties during sleep.  It is a medical condition where part, or all, of the airway is blocked repeatedly during sleep. These are some of the symptoms of pediatric SDB:
·            Snoring
·       Irritability
·       Bedwetting-SDB can cause increased urine production at night, which may lead to bedwetting
·       Learning difficulties
What does a tongue tie have to do with sleep?
Dr. Richard Baxter’s article, Tongue-Ties and Sleep Issues, published from Dental Sleep Practice in winter 2018 discusses the following:
·        “A tongue that is held down by a tie is unable to rest in the palate.  The only place left for the tongue to go is backward, which closes off part of the airway.”  Snoring from upper airway resistance can be a warning sign of obstructive sleep apnea (OSA) or sleep disordered breathing.
·       “After tongue tie release, patient notices a deeper quality of sleep and the parents notice less snoring, less waking, and better mood in their child.”

Tongue Tie and Bedwetting 
Dr. Richard Baxter’s book, Tongue-Tied, discusses the association between tongue tie and bedwetting.
·       Sleep-disordered breathing causes lack of deep sleep in children and adults
·       Lack of deep sleep can cause bedwetting
·       Sleep-disordered breathing causes frequent arousals (interruptions), which can cause the child to have the urge to urinate
·       Recent systematic review of removing tonsils and adenoids showed that bedwetting improved in more than 60% of the patients and 50% had a complete resolution of symptoms.
·       Tongue tie release can allow the child to achieve deeper sleep levels and stop bedwetting
·       Removal of tonsils and adenoids, the application of maxillary expander (orthodontic treatment), and tongue tie release can all work together to improve sleep quality.
Dr. Anna Lee is a general & cosmetic dentist in Glendora, CA.  Dr. Anna Lee is an experienced provider for Laser lip and tongue tied frenectomy (releases) for infants, children and adults.  If you have any questions about lip and tongue tied frenectomy, please visit us at www.annaleedds.com or call for a consultation at 626-335-5114.

 

Thursday, May 2, 2019

Periodontal Disease = Gum Disease



Periodontal disease is also known as gum disease is a bacterial infection of the gum tissues and bone that hold the teeth in place.  It is caused by the bacteria in plaque, a sticky and colorless film that forms on the teeth. The early stages of gum disease can often be reversed and maintained with proper brushing, flossing and regular dental cleaning & check up with the dentist.  Gum disease that is left untreated would lead to tooth loss and other periodontal complications and problems.
This is the American Academy of Periodontology (AAP) classification of Periodontal Disease:
Type I  Gingivitis
·       Earliest stage of gum disease
·       No loss of attachment, no bone loss
·       Bleeding on probing may be present
·       At this early stage in gum disease, damage can be reversible since there is no bone loss.
·       Proper brushing, floss and regular dental cleaning help to remove plaque
Type II  Early Periodontitis
·       Pocket depths or attachment loss: 3-4mm.  Bone loss is present.
·       Periodontal pockets are formed as the dental tissues (gums and supportive ligaments) begin to pull away from the tooth.  These pockets trap bacteria and causes gum infection
·       Localized area of gingival recession; gums pull away and exposes the root
·       Bleeding on probing may be present
·       Damages caused by gum disease is irreversible
Type III  Moderate Periodontitis
·       Pocket depths or attachment loss: 4-6mm.   Bone loss is present.
·       Bleeding on probing
·       Furcation involvement
·       Teeth show mobility (loose)
·       Damages cause by gum disease is irreversible
Type IV  Advanced Periodontitis
·       Pocket depths or attachment loss: greater than 6mm.   Bone loss is present.
·       Supporting tissues and bone are destroyed. 
·       Bleeding on probing
·       Furcation involvement
·       Teeth show increased mobility (loose).  Some teeth are so loose that they may need to be extracted.
·       Damages caused by gum disease is irreversible

Signs of Periodontal Disease
·       Gums are red, swollen or tender
·       Gums that bleed during brushing or flossing
·       Teeth that look longer due to gum recessions
·       Formation of deep pockets between teeth and gums
·       Loose or shifting teeth
·       Persistent  bad breath or bad taste in the mouth
·       Changes of the teeth fit together when biting (occlusion)
·       Changes of the fit of the partial denture
Gum disease can occur at any age.  If gum disease is detected and treated at early stages, it can be reversed and maintained.  Currently, there is no cure for gum disease. 
If you notice any signs of periodontal disease, please contact Glendora Dentist, Dr. Anna Lee for a dental checkup.  You don’t have to lose teeth to periodontal disease.  Dr. Anna Lee can help to save your teeth. Call and schedule a free consultation at 626-335-5114 or visit us at www.annaleedds.com