Oral Appliance Therapy

What is Obstructive Sleep Apnea?

Obstructive Sleep Apnea (OSA) is a serious medical condition in which breathing repeatedly stops and starts while the patient is asleep.  OSA is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. These stops in breathing usually lasts about 10 seconds and are often followed by snorts, gasps, or choking sounds as the patient’s body fights to resume breathing again.

What is Oral Appliance Therapy (OAT)?

Oral appliances for the treatment of sleep apnea continue to increase in popularity for many sleep apnea sufferers.  Over 100 different oral appliances are FDA approved for the treatment of sleep apnea.  These appliances are worn in the mouth, just like a sports mouth guard or an orthodontic appliance while sleeping.  Oral appliances hold the lower jaw forward just enough to keep the airway open and prevent the tongue and muscles in the upper airway from collapsing and blocking the airway.  Two common oral appliances are the mandibular repositioning device and the tongue retaining device.

·       Mandibular repositioning device (MAD): it pushes the lower jaw and tongue slightly forward.  It prevents the throat muscles and soft tissues from collapsing back into the airways and allowing for normal breathing during sleep.

·       Tongue retaining device: It is similar to MAD, but it has a small compartment that fits around the tongue that uses suction to keep it held forward.  This prevents the tongue from collapsing back into the airway.

The American Academy of Sleep Medicine (AASM) has approved Oral Appliance Therapy (OAT) as the first line treatment for patients diagnosed with Mild to Moderate Sleep Apnea.  AASM recommends oral appliance for patients with severe OSA, who are unable to tolerate wearing the Continuous Positive Airway Pressure (CPAP).  Another option for people with severe OSA is Combination Therapy (wear CPAP and an oral appliance together) to help reduce the pressure on a CPAP machine, making it more comfortable to use.

Why use an Oral Appliance for sleep apnea?

·       Oral appliance supports the lower jaw in a forward position to help maintain an open upper airway

·       An effect treatment option for patients with mild and moderate sleep apnea

How can an Oral Appliance help with sleep apnea?

·       Ease of use: more comfortable and tolerable than wearing a CPAP mask (no skin irritation, itchy and dry nose)

·       Small and easy to transport at travel

·       Patients tend to be more compliant

Side effects of wearing Oral Appliance Therapy

·       Soreness of the mouth, sore teeth and/or gums

·       Excessive salivation

·       Damage or permanent change in position/bite of the jaw

Dr. Anna Lee is a dentist trained in sleep apnea who can assist you with the treatment.  Dr. Anna Lee conducts a full evaluation of your teeth, mouth and temporomandibular joint (TMJ) to ensure that your teeth and jaw structure are healthy enough to wear an oral appliance. If you have any question about oral appliance therapy, please call us for a FREE CONSULTATION at        626-335-5114 or visit our sleep website at www.glendorasleep.com

Women with Obstructive Sleep Apnea

The cause of death of a famous movie star, Carrie Fisher, was sleep apnea and “other undetermined factors” in December 2016.  She was 60 years old.  Typical obstructive sleep apnea patients are usually men who are overweight and snore loudly with choking or gasping sounds at night.  While obstructive sleep apnea patients are common in men, many women suffer from OSA and go undiagnosed and misdiagnosed.  Obstructive sleep apnea patients come in all shapes, size, genders, races and some have atypical symptoms.

These are some of the reasons women with OSA who are undiagnosed and misdiagnosed:

·       Women present atypical symptoms

·       Men are less likely to complain about their wives snoring

·       Doctors are less likely to ask women about sleep related symptoms

According to a study at The University of Chicago, “Sleep apnea presents itself differently for women, which may lead them to go undiagnosed.”                                                                              Some of the atypical (not classic) symptoms in women with OSA:

·       Insomnia

·       Restlessness in legs

·       Tired or fatigue

·       Depression

·       Daytime sleepiness

·       Morning headaches

·       Fibromyalgia

·       Concentration or memory difficulties

·       Frequent urination at night

·       Heartburn at night

·       Night sweats

·       Lack of energy during day

·       Dry mouth on awakening

·       A feeling of being overwhelmed

·       Uncontrollable high blood pressure

·       Obesity

The classic symptoms in men with OSA are snoring, gasping for air during sleep, drowsiness and sleepiness during the day, at work, or while driving.

*Note:  Not everyone who snores has sleep apnea.                                                                                     *Note:  Not everyone who has sleep apnea snores.

Women & Sleep Apnea Toolkit: raises awareness of sleep-disordered breathing (OSA) in women

·       November 29, 2017, the Society for Women’s Health Research released the toolkit

·       Purpose of toolkit: provide women and their health care providers with gender specific information about obstructive sleep apnea and sleep disordered breathing

·       Patient page asks women about their daytime and night time symptoms

Daytime symptoms of OSA: feeling depressed, anxious, irritable, impatient, tired or drained.  Women with OSA may notice that they struggle to stay awake and may fall asleep at the wrong time or place.  Cognitive difficulties, such as forgetfulness, foggy or fuzzy thinking

Nighttime symptoms OSA:  snoring is not the only symptom with OSA.  Women have difficulty falling asleep, frequent awakenings and restless sleep

·       Toolkit guides the women and their health care providers to improve diagnosis, treatment and management of sleep disorders

Some treatment options for women with OSA:

·       CPAP (Continuous Positive Airway Pressure): In 2006, the American Academy of Sleep Medicine (AASM) reviewed all available evidence for CPAP and concluded that treatment was effective for patient s with moderate to severe OSA

·       Oral Appliance Therapy (OAT) is a treatment option for patients with mild to moderate OSA

·       Life style changes:  lose weight

Obstructive sleep apnea is a serious medical problem for men and women.  If you are experiencing any of the classic or atypical (not classic) symptoms of sleep apnea, contact Glendora dentist,                   

 Dr. Anna Lee.  She is a trained dentist in sleep apnea who can assist you with treatment.  For more information, please visit our sleep website at www.glendorasleep.com  or call our office at 626-335-5114 for a FREE sleep apnea Consultation.

Options to Improve Your Smile

Your smile plays an important role on self-esteem, confidence, and how you think others perceive you.  Your smile may affect your career success and social relationships with others. According to the American Academy of Cosmetic Dentistry (AACD), 74% of people find that an unattractive smile can get in the way of their career success.  Most people think that attractive smile is an important social asset.   These are some of the options to improve your smile:

Teeth Whitening

There are two types of stains that cause teeth discoloration; intrinsic and extrinsic stains.  Intrinsic stains can be from a mother’s use of antibiotics during pregnancy or childhood exposure to fluoride.  Extrinsic stains are the result of smoking, some medications, beverages (coffee, tea and soda), foods and fruits (blueberries), aging and other factors.

·       In-office Teeth Whitening (chairside) is performed in the dental office for about 60-90 minutes.  Prior to the procedure, an informed consent discussion form is reviewed and signed.  The discussion includes patient’s diagnosis, proposed treatment, risks and treatment.  Most patients are happy and satisfied with the result. Their teeth are whiter and they smile with greater self-confidence!

·       Take-Home Whitening-the dentist takes impressions and fabricates custom fitted bleaching trays for the upper and lower teeth.  The patients are instructed to load the whitening gel into the custom fitted bleaching trays and fit over the upper and lower teeth.  Whitening at home may be more convenient but it can take two to four weeks or longer to whiten teeth or get the result you want.

·       Over-the-Counter Tooth Whitening products can be purchased at the drug stores and on-line.  The American Dental Association (ADA) cautions patients to use accepted whitening products under professional supervision for safety.  Some examples are the whitening strips, brush-on whitening and whitening gum.

*Consult with your Glendora Cosmetic Dentists to determine the type of stain you have and decide which whitening option treatment would work best for you.

Composite Filling/Tooth Colored Filling

Composite filling is a tooth colored material used to close the gaps between teeth; repairs little chips and restores teeth with tooth decay.

·       Esthetics, shades of composite filling material match very closely to the shades of the enamel and dentin

·       Close spaces/gaps between teeth, restore chipped, broken, stained or cracked teeth

·       Minimal tooth structure reduction

·       Inexpensive

·       Single visit procedure

Veneers

Veneers are thin shells of porcelain or composite resin that are custom made to fit over the front surface of teeth.  Veneers provide a natural tooth appearance and they can restore chipped, stained, misaligned and worn down teeth.  There are 2 types of veneers; composite resin veneer and porcelain veneer.

Composite resin veneer

·       Resin material that is bonded over the front surface of the tooth

·       Treatment can be completed on the same day

·       No lab work is required

·       Correct small chips, cracks and discoloration of the tooth

·       Not stain resistant

Porcelain veneer

·       Thin layer of porcelain bonded over the front surface of the tooth

·       Requires minimal tooth reduction

·       Treat teeth with intrinsic staining

·       Provide a natural tooth appearance

·       Gum tissues tolerate porcelain well

·       Change tooth’s color and shape

·       Stain resistant

*Consult with your Glendora Cosmetic Dentists to learn about your treatment options.

Ceramic Crowns

Ceramic crowns are fabricated entirely out of a glass-like compound such as porcelain.

·       Esthetic; color and translucency mimic natural tooth; life-like appearance

·       Restore anterior (front) and posterior teeth (back molars)

·       Biocompatible; no allergy problem; teeth tolerate well

There are 2 ceramic materials that are the clinician’s favorites today: Lithium Disilicate and Zirconia. Lithium Disilicate restorations are good choices for single unit restorations, both anterior (front) and posterior (back) teeth.  Zirconia restorations are good choices for single unit restorations for the posterior (back) teeth.

Enamel shaping and Contouring

Enamel shaping or contouring involves with contouring the dental enamel to improve the appearance of the teeth.  This procedure is best for patients who just need minimal adjustments of the teeth.

·       Cost, an inexpensive way to improve the look of the teeth

·       Painless, no anesthesia, no discomfort during the procedure

·       Improves health of teeth, minimal shaping/contouring of overlapped teeth may decrease the risk of tooth decay and gum disease

·       Chipped and irregular teeth

·       Minor bite problems

Braces

People of all ages are benefiting from braces.  Braces can straighten crooked/crowded teeth, close spaces/gaps, improve an irregular bite, and correct jaw positioning. 

·       Clear aligners are worn every two weeks to progressively move and straighten crooked or crowded teeth

·       Aligners can be removed while eating, brushing and flossing

Implants

One of the options to replace missing teeth is Dental Implants and restored with Implant Supported Crown. A dental implant feels and looks very close to a natural tooth.  It is a metal post surgically placed beneath the gum which fuses to the bone in the jaw and acts like the root of a tooth.  The dentist makes a custom artificial tooth (Implant Supported Crown) and fits it onto the post portion of the implant.

·       Implant Supported Crown is firmed attached to the implant

·       Esthetic, similar to a natural tooth, comfortable

·       Adjacent teeth do not have to be involved

·       With proper care, implant and implant crown can last for a long time

Dr. Anna Lee is a general & cosmetic dentist in Glendora, CA.  If you are not quite happy with your smile, call for a FREE consultation to discuss the different options to improve your smile. Please visit us at www.annaleedds.com or call 626-335-5114.