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May 2016

apnea

Does your bed partner complain about your snoring? Are you unusually sleepy during the day and don’t know why? These are two of the most common symptoms of obstructive sleep apnea (OSA), a sleep related breathing disorder that can cause you to stop breathing dozens or even hundreds of times each night.1 According to The Canadian Lung Association, these breathing episodes usually last for 10 to 30 seconds not long enough to fully wake you up but enough to prevent you from enjoying the restful sleep your body needs to recharge its batteries and stay healthy.

A Canadian Community Health Survey conducted in 2009 by the Public Health Agency of Canada found that an estimated 858,900 Canadian adults, 18 years and older, reported being told by a health professional that they have sleep apnea.2 breathe properly all night.

“Only a physician can diagnose obstructive sleep apnea,” says Dr. Deborah Saunders, a dentist practising in Sudbury, Ont. Dentists do not diagnose OSA.

However, a dentist may see patients who they suspect may be at risk and will refer them to their family physicians for further diagnostic followup.

As they do with discussing tobacco intervention or oral cancer with patients, dentists have advantages over other health-care professionals in identifying patients at risk of OSA, because dentists generally see their patients on a more frequent and consistent basis. As well, because the jaws and related structures may influence OSA, dentists play an important role in identifying patients who should be assessed [by a physician] and helping to institute treatment in selected

Treatment options

The most effective treatment for mild or moderate sleep apnea, says The Canadian Lung Association, is continuous positive airway pressure (CPAP). With CPAP you wear a special mask attached to a CPAP machine. A steady stream of air is blown though the mask, into your nose and down your throat. The pressure helps keep your airways open so you can lifestyle changes such as losing weight, avoiding alcohol and sedatives and sleeping on your side, not your back.

Your doctor may also recommend that you use a dental (or an oral appliance) that fits over your teeth and prevents your tongue and jaw from blocking your airway. In comparison to CPAP devices, these appliances are sometimes regarded as a convenient, silent and more bed partner-friendly choice, says Dr. Alan Lowe, Professor and Chair of the Division of Orthodontics, University of British Columbia’s Faculty of Dentistry.

There are more than 80 different oral appliances currently available.6 These should only be prescribed by your family physician, who may refer you directly to your dentist, says Dr. Saunders.

A cautionary note from Dr. Saunders:

Some patients who have been diagnosed with sleep apnea may be curious about ordering prefabricated devices over the Internet. “Think twice,” she says. “You may end up with jaw pain or other problems. That could be significant and serious.”

For more information on sleep apnea including a quiz to help identify the main symptom of sleep apnea, daytime sleepiness — visit The Canadian Lung Association’s website at www.lung.ca.

Other signs and symptoms of sleep apnea may include:

• high blood pressure

• irritability

• gasping or choking during sleep

• depression

• problems concentrating

• morning headaches

• memory problems/memory loss

If you have any of these symptoms and think you may have sleep apnea, you might want to discuss them with your family doctor.

chewinggum

Go ahead, have a piece of (sugarless) gum and make your dentist happy!

Chewing gum is thought to be the world’s oldest candy — we’ve been chomping down on it for more than 5,000 years! But what do dentists think of all that chewing? While the people who care for our teeth aren’t usually fans of candy, when it comes to sugarless gum, most dentists give it the nod.

“Chewing sugarless gum is a great way to help stimulate saliva flow in patients with dry mouth,” says Dr. Deborah Saunders, Your Oral Health.ca’s Editor-in-Chief. That salivary stimulation also helps protect your teeth from decay-causing bacteria, so if you aren’t able to brush your teeth after eating, chewing sugarless gum can help.

Dr. Rick Caldwell, ODA President (2013-14), agrees. “Chewing sugarless gum can help freshen breath in the short term; although gum doesn’t bleach the teeth, it can help remove some surface stains.”

Who shouldn’t chew gum? “Patients with temporomandibular joint disorders (TMJD) shouldn’t chew gum as this may make their condition worse,” says Dr. Saunders, Medical Director of the Dental Oncology Program at Northeast Cancer Centre in Sudbury, Ont. (See TM-what? for more on TMJD.)

Adds Dr. Caldwell, a general practitioner in New Liskeard, Ont., “With TMJD problems, the joint requires rest, not extra use. Also, people with facial muscle spasms shouldn’t chew gum, and, for those with sensitive teeth, depending on the source of their sensitivity, chewing gum can be quite uncomfortable.”

One last point: If you’ve had orthodontic work done, such as implants, or if you wear a denture, you may want to talk to your dentist before opting to chew gum, since some gum will stick to orthodontic and acrylic work.

Xylitol 101

Xylitol is a naturally occurring sweetener used in many foods, including chewing gum. Unlike sugar and other sweeteners, says Dr. Saunders, xylitol cannot be digested by the plaque-causing bacteria in our mouths, which, in turn, reduces the amount of plaque on our teeth. For best results, she recommends looking for gum that contains at least one gram of xylitol per piece. But, Dr. Saunders also has a few warnings:

• Xylitol can be toxic to dogs, so keep your chewing gum away from Fido.

• When starting to chew xylitol, meeting the recommended five to 10 grams per day should be done gradually over a period of several weeks, to allow the gastrointestinal system time to adjust.

• Since it can cause diarrhea and intestinal gas, people with inflammatory bowel diseases, such as irritable bowel syndrome or Crohn’s disease, should avoid xylitol.

chipped-tooth-smile

If you have a chipped tooth, you might not feel any tooth pain unless the chip is large enough to expose the nerves in the inner layer of the tooth. If a chipped tooth exposes the nerves inside a tooth, you might notice increased tooth sensitivity and pain when chewing or when the chipped tooth is exposed to very hot or very cold food and beverages. A chip on one of the pointed chewing surfaces of the back teeth is called a broken cusp. This type of chipped tooth is rarely painful, but it should be examined by a dental professional. You might need a crown or a dental onlay to restore the shape of the tooth and prevent further damage or decay.

Causes Of A Chipped Tooth

The possible causes of a chipped tooth include:

  • Falling and hitting your mouth
  • Biting on a hard object or food, such as a hard candy or a bone
  • Suffering trauma to the face from a sports injury or accident
  • Cavities which can weaken the teeth and predispose you to a chipped tooth

Immediate Care For A Chipped Tooth

If you have a chipped tooth, make an appointment to see your dental professional as soon as possible. Meanwhile, follow these steps:

  • Rinse: Rinse your mouth with warm water.
  • Press: If there is any bleeding in your mouth as a result of a chipped tooth, use a piece of gauze to apply pressure to the area.
  • Cover: If you can’t see a dental professional the same day that your chipped tooth occurs, cover the chipped tooth with dental cement (available at most drugstores) to protect the remaining tooth until your appointment.

Professional Care For A Chipped Tooth

Treatment of a chipped tooth depends on the size and severity of the injury:

    • Small: If the chip in your tooth is very small, your dental professional might simply smooth and polish the chipped tooth, and no additional treatment will be needed.
    • Medium: If your chipped tooth involves minor damage to the tooth enamel, your dental professional will probably place a filling, crown, or cap over the chipped tooth to restore its normal appearance and function and to protect the inner layers of the teeth from irritation and infection.
  • Large: If your chipped tooth is large enough to expose the tooth nerve, you will likely need a root canal to remove the damaged nerve, plus a crown or cap to replace the chipped tooth. (1), (2)

Your Dental Care After A Chipped Tooth Treatment

After treatment for a chipped tooth, it is important to maintain a regular oral care routine.

Content courtesy crest.com

_89638212_sugardrinks

Health officials in Liverpool are tackling “an alarming level” of child tooth decay in the city by publicising brands with high amounts of sugar.

A new campaign names leading brands such as Lucozade, Coca-Cola, Tropicana, Capri-Sun and Ribena – warning how many sugar cubes are in each drink.

It will target hospitals, GP surgeries, children’s centres and hospitals.

About 2,000 children in the city will have had tooth extractions by the age of five, health chiefs say.

More than a third have suffered from tooth decay and a 14-year-old recently had 15 adult teeth removed, Public Health Liverpool said.

The “Is your child’s sweet tooth harming their health?” campaign highlights that 500ml of Lucozade contains 15.5 cubes of sugar, while an equivalent bottle of Coca-Cola has 13.5 cubes.

The maximum daily allowance of sugar for children is five to seven cubes, depending upon their age.

Dentist shocked

Rotten teeth

Director of Public Health Liverpool, Dr Sandra Davies, said they are “the first local authority in the country to name how much sugar is in specific brands” to help people “make healthier choices.”

“Many of us are not in the habit of studying labels on drinks… people don’t realise how much sugar is in them.”

Hidden sugar and the frequency at which young people consume drinks are big problems, said Sondos Albadri, consultant in paediatric dentistry at the University of Liverpool.

“It is quite shocking for me as a dentist… I’ve just listed a two-and-a-half-year-old to have eight teeth removed under general anaesthetic.”

Poster

“We are increasingly seeing children aged between 12 and 16… I had to remove 15 adult teeth on a 14-year-old recently, and while that is an extreme case it is by no means a rare occurrence.”

Councillor Tim Beaumont, mayoral lead for wellbeing, said it was also “contributing to the obesity issue” in Liverpool, where “one in four children starting primary school are overweight, rising to 38% for secondary school age pupils.”

Gavin Partington, from the British Soft Drinks Association, said soft drinks companies were “taking practical steps to help consumers” including “reducing the sugar in their products”.

“If this were a genuine education campaign to reduce sugar intake then surely it would look at all sources of sugar consumption and not just target soft drinks, which is the only food category where sugar intake is actually falling year on year,” he said.


The number of sugar cubes (each containing 4g of sugar) in popular drinks, according to Public Health Liverpool:

 

15.5 – Lucozade (500ml)

13.5 – Coca Cola (500ml)

12.7 – Frijj chocolate milkshake (471ml)

8.25 – Capri-Sun (330ml)

7.5 – Tropicana orange juice (330ml)

7.25 – Ribena (288ml)

5.75 – Volvic flavoured water (500ml)

Content courtesy bbc.com

Celiac-505540541852

Celiac disease is an autoimmune disorder according to the Celiac Disease Foundation, and affects about one out of every 100 people worldwide. Those with the disease aren’t able to digest gluten, a protein found in grains like wheat, and the disease damages their small intestine in such a way that makes it hard for the body to absorb many vital nutrients.

Although its effects on the digestive system are well known, you may be surprised to learn there are several oral manifestations of Celiac: teeth defects, dry mouth and canker sores among the most common.

ENAMEL DEFECTS

Enamel quality can become a problem for those with Celiac disease, states the Celiac Disease Awareness Campaign, and can involve discoloration or poor development. Teeth with discolored enamel often have dots that appear brown, yellow or even white. Poorly formed enamel, on the other hand, looks pitted or banded, and the teeth may look translucent instead of opaque.

Unfortunately, enamel defects caused by Celiac disease are permanent, so they won’t go away if you begin a gluten-free diet. Your dentist may therefore be able to deal with this condition with veneers or bonding.

DRY MOUTH SYNDROME

Dry mouth syndrome is exactly what it sounds like – the feeling that your mouth is frequently too dry. The condition can be caused by Sjogren’s syndrome, an autoimmune disorder that attacks your salivary glands and may occur alongside Celiac disease. According to the National Foundation for Celiac Awareness, between 4.5 and 15 percent of people with Celiac disease also have Sjogren’s syndrome.

When you’re not producing enough saliva, you often struggle to chew and swallow food. It may also make it more difficult to speak clearly. This syndrome isn’t just annoying; it’s a medical concern. Because saliva helps to keep your teeth clean, not enough of it may cause you to develop cavities more easily. Your dentist may be able to treat your symptoms with artificial saliva or prescription toothpaste.

CANKER SORES

Canker sores, also known as aphthous stomatitis, are uncomfortable oral lesions that develop on soft tissues – the insides of your cheeks or the roof of your mouth, for instance. Much like dry mouth, these lesions can make it hard for you to eat or speak. According to National Institutes of Health (NIH), studies have shown they affect between 3 and 61 percent of people with Celiac disease.

Canker sores go away by themselves, but they can recur later. If your canker sores are getting in the way of daily activities, your dentist may be able to ease your symptoms with prescription mouth rinses or topical anesthetics.

For people with Celiac, issues that influence enamel, saliva or oral tissues are a legitimate cause for concern. If you’ve got a set of Celiac teeth, make sure your condition doesn’t go ignored. Developing any of these oral manifestations is a perfect reason to see your dentist right away for diagnosis and treatment.

Content courtesy colgate.com

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