A recent study revealed that on average there are 22,000 dental injuries in children under the age of 18. This alarming reality makes it clear that parents, caregivers, and coaches need to understand the risks for dental injuries so that they are best equipped to prevent them...or at least be prepared to manage one should it occur. The four most common categories for measuring risks associated with sports injuries are:

• Age: Age is an important factor when accessing risk. Sports-related dental injuries tend to spike during the teenage years. Recent research shows that children under the age of 13 tend to not be injured as often.
• Gender: Gender is probably the second most influential factor. The facts are that males top the list for experiencing dental injuries during sports or vigorous activities. However, more and more females are playing highly competitive and contact sports or activities; thus, their risk of injury is increasing.
• Shape and position of your teeth: Both the condition and positions of the teeth affect their risk of injury. More prominent or “buck” teeth are considered a higher risk for injury than teeth in a more normal position. Furthermore, 80% of all dental injuries involve the upper front teeth.
• Sports type: This last category is the one most often asked about, as parents, caregivers and athletes want to know which sports or activities have the highest risks for dental injuries. And while baseball and basketball top the list, the American Dental Association (ADA) has put together a comprehensive list of sports and activities. To review this list, read the Dear Doctor article, “Athletic Mouthguards.” The ADA also urges athletes to wear professionally-fitted mouthguards to protect against dental and facial injuries.

Knowing the above categories can help you assess your risk for a dental injury while playing in a sport or recreational activity. To learn more about sports-related dental injuries, read, “An Introduction To Sports Injuries & Dentistry.” Or if you have a traumatized, damaged, chipped or missing tooth from a sports or any other type of injury, contact us to discuss your situation or to schedule an appointment.

Sleeping disorders impact people in different ways. For some people, they may feel they do not have a problem — except for the fact that their sleeping partner complains about their snoring. For others, they may know they have a snoring issue because they constantly wake themselves up gasping for air. This is a dangerous condition known as Obstructive Sleep Apnea OSA (“a” – without; “pnea” – breath). If any of these scenarios sound like your experience, then you may have OSA or another type of Sleep Related Breathing Disorder (SRBD). However, before jumping to conclusions, you need to obtain a thorough examination from a primary-care physician who is trained in sleep medicine in conjunction with our office. We have received training in the diagnosis and treatment of sleep disorders. But the good news is that sleep apnea is a treatable condition.

As for your question, yes, there are many things we can do to treat your snoring after the cause of your problem is properly established. One helpful approach is through the use of a specially designed oral appliance that we custom make and fit to your mouth. It is easy to use during sleep. Once in place, it will keep your lower jaw in a forward position so that your tongue is held forward to stop blocking your upper airway (i.e. the back of your throat and area causing your snoring and hindering your breathing while you sleep). Another option is to use a Continuous Positive Airway Pressure (CPAP) machine. This specialized machine requires you to sleep with a mask that covers your mouth and/or nose. While you sleep, it delivers continuous pressure to your windpipe so that your tongue is forced away from your airway.

If your snoring is keeping you or your loved ones awake, we are a good place to start. Contact us today to discuss your questions about snoring or to schedule an appointment. You can also learn more about snoring and sleep disorders when you continue reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

Dentistry has ventured into the new area of sleep medicine by helping snorers — and their exasperated sleeping partners — with custom-made anti-snoring devices. These oral appliances, which resemble orthodontic retainers or sports mouthguards, keep the snorer's airway clear and the bedroom quiet. To see how they work, you have to understand the mechanics of snoring.

Snoring occurs when the upper airway (back of the throat) becomes blocked by the tongue or other soft-tissue structures, such as large tonsils or a long soft palate. The vibrating of these obstacles creates the sound we call snoring.

Snoring is often worse when sleeping on one's back because that position encourages the lower jaw to fall back and the tongue to close off the airway. This is where Oral Appliance Therapy comes in. These custom-fitted devices are designed to keep the upper airway open during sleep by pulling the lower jaw forward, which in turn brings the tongue away from the throat. Dentists, and our office in particular, are the only source for Oral Appliance Therapy.

People who snore should have a thorough examination to rule out Obstructive Sleep Apnea (OSA), a potentially dangerous condition in which airflow can be cut off completely for 10 or more seconds (“a” – without; “pnea” – breath), reducing blood-oxygen levels. Chronic, loud snoring is a common finding with OSA.

Please remember that sleep is an integral part of health and well-being. In fact, we spend about a third of our lives doing it. If you are snoring or have any sleep-related breathing disorders that are waking you or your bed partner, be sure to tell our office. There are plenty of examples of the havoc wreaked by sleep-deprived individuals. Remember the Exxon Valdez?

If you have any questions about Oral Appliance Therapy, please contact us or schedule an appointment for a consultation.

To learn more about the topic of oral appliance therapy, please see the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

It is not uncommon to have one or more teeth that are particularly sensitive to heat, cold, or pressure. If you have such a tooth, you probably want to know what caused it and what you can do about it. Here are some frequently asked questions, and their answers.

What causes teeth to become sensitive?
The most common cause of sensitivity is exposure of the tooth's dentin, a layer of the tooth's structure that is just below the outer protective layer (the enamel).

The dentin is sensitive but the enamel layer is not. Why?
The enamel is composed of minerals that are hard and protective. It is not living tissue and has no nerve supply. The dentin layer underneath is bone-like living tissue that does contain nerve fibers. It is protected by enamel above the gum line and by gum tissue in the area of the tooth's root, below the gum line. If the tooth's protective covering is reduced, the nerve fibers in that section of the dentin are exposed to changes in temperature and pressure, which they conduct to the inner pulp layer (nerve) of the tooth. The sensations that reach the tooth's interior pulp layer cause pain.

What causes exposure of the dentin layer in teeth?
Often the dentin is exposed by receding gums, causing areas of the tooth that are normally below the gum surface to be uncovered.

What makes gums recede?
One cause of receding gums is excessive, rough brushing techniques. This is particularly common in individuals who have a family history of thin gum tissues. Removing the film of bacteria called plaque requires only gentle action with a soft brush. This is one reason that we stress the value of learning proper and effective brushing techniques. Gum recession becomes worse after the uncovered dentin of the tooth's root is exposed to erosion from sweet and acidic foods and beverages, such as fruit juices.

Doesn't tooth sensitivity indicate decay?
Decay can also cause tooth sensitivity. As decay destroys a tooth's structure, it eventually invades the inner pulp of the tooth, causing greater and greater pain.

How can you prevent or reduce tooth sensitivity?
As we mentioned above, learn proper brushing techniques; we would be happy to demonstrate them. Use a toothpaste that contains fluoride, which increases the strength of the tooth's protective coating. In more serious cases, we can apply a fluoride varnish or a filling material as a barrier to cover sensitive areas. If you experience long-term tooth sensitivity, make an appointment for an assessment and diagnosis so that we can determine the cause and proper treatment.

Contact us today to schedule an appointment to discuss your questions about sensitive teeth. You can also read the Dear Doctor magazine article “Sensitive Teeth.”

More than 2,000 years ago, an ancient Greek physician, Hippocrates, often called the father of Western medicine, devised a mouth rinse of herbs and wine to sweeten bad breath. This problem has been around a long time, and it is still a major problem for many people. According to some studies it is one of the three main reasons people seek dental treatment.

Here are some facts you may not know about bad breath:

• Bad breath is sometimes called halitosis, which comes from the Latin halitus (exhalation) and the Greek osis (a condition or disease-causing process).
• Chronic bad breath is usually caused by certain types of oral bacteria. These particular bacteria are present in about 25% of the population.
• Bad breath has spawned a major industry in the United States. Americans spend nearly three billion dollars a year on gum, mints, and mouth rinses to sweeten their breath. About 60% of women and 50% of men say they use breath freshening products.
• Diseases in the oral cavity such as tooth decay and periodontal (gum) disease can often cause bad breath. If either of these diseases are your cause for bad breath, treatment would be necessary to eliminate this problem.
• The tongue is the most common location for bad breath. Bacteria are relatively sheltered on the back of the tongue, where they live on remnants of food, dead skin cells and post-nasal drip. These bacteria can generate volatile sulfur compounds (VSCs) that are also found in decaying animal or vegetable matter. VSCs are known by an unpleasant rotten egg smell.
• Bad breath can also be caused by dry mouth (xerostomia). This condition affects millions of people and can result from smoking, alcohol or coffee drinking, and it is sometimes a side effect of medications. Another cause may be mouth breathing.
• Halitosis can also originate in other parts of the mouth besides the tongue. These include inter-dental (between teeth) and sub-gingival (under the gums) areas.
• When people are starving (and sometimes when they are dieting to lose weight), their bodies begin burning their fats causing their breath to develop the smell of ketones — which smell like acetone, similar to nail polish remover. If people are not eating or drinking the coating on their tongue increases as well, making VSCs more prominent.

At our office, we want to fight bad breath or halitosis by making sure our patients understand how to clean their teeth, gums, the back of the tongue, and dentures.

Contact us today to schedule an appointment to discuss your questions about bad breath. You can also learn more by reading the Dear Doctor magazine article “Bad Breath: More than just embarrassing.”