Posts for category: Oral Health

YourDentistMayHavetheSolutiontoYourSnoringandSleepApnea

Your snoring isn’t just an annoyance to other members of your household — it could indicate a serious health issue. Fortunately, there are treatments, some of which your dentist might be able to provide.

Snoring is the result of soft tissue structures in the back of the throat, including the tonsils, the uvula, the tongue or fat deposits, collapsing on each either and obstructing the flow of air into your lungs. The obstructions produce a vibration that is the source of the snoring.

These obstructions could lead to a serious condition known as Obstructive Sleep Apnea (OSA). As the name implies, the obstruction causes a complete cessation of airflow for several seconds. As oxygen levels drop, the body responds by waking for one to three seconds (known as “micro-arousals”) to restore airflow. These disruptions can occur several times a night, as much as fifty times an hour. The depletion of oxygen and resulting low quality of sleep can contribute to high blood pressure, a higher risk of heart attack or stroke, and the possibility of accidents caused by lower alertness during the day.

You can help reduce the effect of OSA by losing weight and exercising. You may also be a candidate for Continuous Positive Airway Pressure (CPAP) therapy, which utilizes a device that delivers pressurized air into the airway while you sleep.

Depending on the exact cause and extent of your OSA, you might also benefit from treatments provided by your dentist. We can develop a custom-fitted oral appliance, similar to an orthodontic retainer or sports mouthguard, which you wear while you sleep. These devices work by repositioning the lower jaw forward, thereby maintaining an open airway by also moving the soft tissue of the tongue forward. For more advanced conditions, certain surgical procedures that realign the jaw or remove excess tissue, the tonsils and adenoids, or parts of the uvula or soft palate could be considered.

To know your best treatment course, you should schedule a complete oral examination to determine the exact cause of the obstruction, and possibly a polysomnogram, an overnight study performed in a sleep lab. And as your dentist, we might be able to provide the key for a better night’s sleep and a healthier tomorrow.

If you would like more information on how we can address your problems with 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 “Snoring & Sleep Apnea.”

UltrasonicScalerscanEffectivelyCleanMostPatientsGumTissues

While you may most associate professional dental cleanings with that “squeaky” clean feeling you have afterward, there is a much higher goal. What is also referred to as “non-surgical periodontal therapy,” these cleanings seek to remove bacterial plaque and tartar (hard deposits) not only from the visible portions of the tooth but also the root surfaces (scaling), so as to reduce the risk and occurrence of periodontal gum disease.

For generations, this was primarily achieved by dental hygienists using hand-held instruments specially designed to manually remove plaque from tooth surfaces. Since the 1950s, though, a new technology known as ultrasonic or power scaling has become more prevalent in use. Initially only used in the outer most portions of the gum tissue (the supra-gingival area) power scaling is increasingly employed to clean the sub-gingival area, much closer to the tooth roots. As this technology has developed, it’s been shown to be just as effective, if not superior in some cases, to manual scaling for removing plaque and tartar.

Ultrasonic or power scalers work by emitting high vibration energy that crushes and removes plaque and calculus (tartar). The resulting shockwaves also tend to disrupt bacterial cell function. The hygienist uses water to flush away the dislodged calculus. They have a number of advantages over manual scaling: they’re quite effective on deep gum pockets, especially when specially designed tips are used; they require less time than manual scaling; and when used correctly power scalers are gentler to tooth structures.

However, they do have a few drawbacks. Because they produce an aerosol effect, power scalers can project contaminants from the patient’s mouth into the atmosphere, requiring special protective equipment for the hygienist. They’re not recommended for patients with hypersensitive teeth, especially regarding temperature change, or for teeth with areas of de-mineralization (the loss of mineral content in the enamel). Care should be taken when they’re used with implants or porcelain or composite crowns — specially designed tips are necessary to avoid scratching the restoration. They may also have an effect on cardiac pacemakers.

In the end, the best approach is a combination of both power and manual scaling techniques. Depending on your individual needs, ultrasonic scaling can do an effective job in removing plaque and tartar and help you avoid gum disease.

If you would like more information on ultrasonic cleaning techniques, 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 “Dental Cleanings Using Ultrasonic Scalers.”

By Dr. Manson
April 01, 2014
Category: Oral Health
Tags: tooth decay   toothache  
WhatToDoAboutAChildsToothache

It's 3:00 PM, your child has just come back from the school playground — and she's complaining of a toothache that's making her miserable. She can't seem to say if there was a particular injury or a blow, but the more she talks about it, the worse it gets. You're the parent... what are you going to do now?

If you've ever been through this type of situation, you know that a calm demeanor and a little TLC can go a long way. But how do you know whether you're facing a dental emergency, or a routine booboo? Here are a few general rules that may help.

First, relax: Without a fever and facial swelling, a child's toothache isn't usually an emergency. But any tooth pain that keeps a child up at night or lasts into the next day should be evaluated by a dentist. Even if it's nothing but a small cavity (the most common cause of toothache) you don't want to let it go untreated. That could allow it to turn from a small discomfort into a major problem — like a painful abscess.

There are some things you can do at home to try and get a handle on what's causing the pain. Encourage the child to show you exactly where the pain is located, and to tell you when and how it started. Then, examine the area closely. Look for obvious brown spots, or even tiny cavities (holes) on biting surfaces or between teeth, which might indicate decay. Also check the gums surrounding the tooth, to see if there are sores or swelling.

You may find evidence of a traumatic injury, like a cut or bruise — or, if only swelling is apparent, it may mean an abscess has formed. If nothing looks amiss, try gently flossing on either side of the hurting tooth. This may dislodge a particle of food that's causing pain and pressure.

If the pain persists, you can try giving an appropriate dose of ibuprofen or acetaminophen, or applying an ice pack on the outside of the jaw — one minute on and one minute off. But even if you can make the immediate pain go away, don't neglect the situation that caused it. Unless you're absolutely sure you know why the toothache occurred, you should bring the child in for an examination. It will put your mind at rest — and maybe prevent a bigger problem down the road.

If you have questions about toothaches in children, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “A Child's Toothache.”

By Dr. Manson
March 24, 2014
Category: Oral Health
Tags: gum disease   loose teeth  
TreatingLooseTeethandtheUnderlyingCauses

Adult teeth aren’t meant to be loose — it’s a sign that something is wrong. And while there are treatments, time is of the essence before permanent tooth or bone loss occurs.

Loose teeth can occur for many different reasons. Bite-related problems are fairly common, referred to as occlusal trauma (“occlusal” – bite; “trauma” – injury). This could be the result of excessive force placed on otherwise normal teeth and jaws — chronic clenching or grinding habits, for example. On the other hand, even normal biting or chewing can cause teeth to loosen if bone loss from gum disease has become excessive, reducing the remaining attachment to bone to inadequate levels. In some cases it can be a result of both excessive force and weakened bone levels.

Of these reasons, the most common cause is the weakened attachment of the teeth to the bone due to gum disease. If this is the case, it’s important first to treat the gum disease by an appropriate strategy for the disease present and then implement an effective dental hygiene program to inhibit reoccurrence.

As for the problem of loose teeth, there are measures to address it. Occlusal bite adjustment reduces the degree of force when biting or chewing by reshaping the biting surfaces through selective grinding. Splinting is another technique in which the teeth are joined together to make them more rigid and to redistribute the biting force among several teeth. This can be done with material bonded across the outside of several teeth or with a metal splint affixed within a pre-cut channel across the teeth. A more permanent option is to create a series of crowns to affix to the teeth and then fuse them together.

Although more complex, orthodontics to correct misaligned teeth is another option. Not only will it improve the bite and potentially reduce bite forces, it may also improve the health of the supporting periodontal attachment.

Before undertaking any treatment, you should first undergo a thorough exam to determine the true cause of your loose teeth and any underlying conditions. From there we can recommend the best approach for treating and preserving your teeth.

If you would like more information on treatments for loose teeth, 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 “Treatment for Loose Teeth.”

PlanYourSportsNutritionandHydrationtoReduceToothDecayRisk

If you or your family has an active sports lifestyle, you probably already know the importance of food and liquids for energy and hydration. But what you eat and drink (and how often) could unintentionally increase your teeth’s susceptibility to tooth decay. With that in mind, you should plan your nutrition and hydration intake for strenuous exercise to maximize energy and reduce the risk of tooth decay.

On the general health side, carbohydrates are your main source of energy for sports or exercise activity. You should eat a substantial carbohydrate-based meal (such as pasta, cereal or sandwiches) a few hours before a planned event. An hour before, you can snack on something easily digestible (avoiding anything fatty) to prevent hunger and as additional energy fuel.

It’s also important to increase your liquid intake before strenuous activity to avoid dehydration, usually a couple of hours before so that your body has time to eliminate excess fluid. During the activity, you should drink three to six ounces of water or sports drink every ten to twenty minutes to replace fluid lost from perspiration.

While water is your best hydration source, sports drinks can be helpful — they’re designed to replace electrolytes (sodium) lost during strenuous, non-stop activity lasting more than 60 to 90 minutes. They should only be consumed in those situations; your body gains enough from a regular nutritional diet to replace lost nutrients during normal activity.

In relation to your oral health, over-consumption of carbohydrates (like sugar) can increase your risk of tooth decay. The acid in most sports drinks also poses a danger: your teeth’s enamel dissolves (de-mineralizes) in too acidic an environment. For these reasons, you should restrict your intake of these substances — both what you eat and drink and how often you consume them. You should also practice regular oral hygiene by brushing and flossing daily, waiting an hour after eating or drinking to brush giving your saliva time to wash away food particles and neutralize the acid level in your mouth.

Knowing what and when to eat or drink is essential to optimum performance and gain in your physical activities. Along with good oral hygiene, it can also protect your oral health.

If you would like more information on the best sports-related diet for both general and oral health, 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 “Nutrition for Sports.”



Contact Us

Steven B. Manson, DDS, FAGD

Long Island City, NY General Dentist
36-01 31st Street
Astoria, NY 11106
(718) 729-8383
Manhattan, NY General Dentist
136 East 57th Street
         Suite 1604
New York, NY 10022