Nightly snoring can be a sign of a dangerous condition called sleep apnea (from “a” meaning without and “pnea” meaning breath). When someone snores the soft tissues in the back of the throat collapse onto themselves and obstruct the airway, causing the vibration known as snoring.

If the obstruction becomes serious, it is called obstructive sleep apnea, or OSA. In such cases the flow of air may be stopped for brief periods, causing the person to wake for a second or two with a loud gasp as he attempts to catch his breath. This can cause heart and blood pressure problems, related to low oxygen levels in the blood. The obstruction and mini-awakening cycle can occur as many as 50 times an hour. A person with this condition awakens tired and faces the risk of accidents at work or while driving due to fatigue.

Studies show that sleep apnea patients are much more likely to suffer from heart attack, congestive heart failure, high blood pressure, brain damage and strokes.

What can be done to treat OSA?
Snoring, apnea, and OSA occur more frequently in people who are overweight. So start with losing weight and exercising.

At our office, we can design oral appliances to wear while sleeping that will keep your airway open while you sleep. These appliances, which look like sports mouth guards, work by repositioning the lower jaw, tongue, soft palate and uvula (soft tissues in the back of the throat); stabilizing the lower jaw and tongue; and increasing the muscle tone of the tongue.

Another approach is to use a Continuous Positive Airway Pressure (CPAP) bedside machine. These machines send pressurized air through a tube connected to a mask covering the nose and sometimes the mouth. The pressurized air opens the airway so that breathing is not interrupted.

Much less frequently, jaw surgeries may be recommended to remove excess tissues in the throat. These would be done by specially trained oral surgeons or ear, nose and throat specialists.

Diagnosis and treatment of OSA is best accomplished by joint consultation with your physician and our office. Contact us today to schedule an appointment to discuss snoring and OSA. You can learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Snoring and Sleep Apnea.”

Having someone tell you that you have bad breath can be humiliating, but it can also be a sign that you need to see your dentist. Bad breath (or halitosis) can be a sign of an underlying dental or health problem, so before you run out and stock up on breath mints, make an appointment with our office. Using breath fresheners will only disguise the problem and not treat the root cause.

It's important to remember that if you have bad breath, you're not alone — it's the third most common reason people seek a dental consult. We use a systematic approach to determine the cause of your halitosis and offer a solution.

Causes: Ninety percent of mouth odors come from mouth itself — either from the food you eat or bacteria that may be present. Most unpleasant odors originate from proteins trapped in the mouth that are processed by oral bacteria. When left on the tongue, these bacteria can cause an unpleasant smell. Dry mouth, sinus problems, diet and poor oral hygiene can also cause bad breath. In rare cases, a medical condition may be the cause.

Treatment: The best solution will depend on determining the real cause of your halitosis. If bad breath emanates from the mouth, it most commonly is caused by gum disease or even tooth decay, which need to be treated to correct the problem. If halitosis is of systemic (general body) origin, a more detailed examination might be needed from a physician. But the solution may also be as simple as demonstrating how to effectively remove bacterial plaque from your teeth, or offer instruction on proper tongue cleaning. If the cause is gum disease, we may suggest a deep cleaning and possible antibiotic therapy.

Contact us today to schedule an appointment to discuss any questions you may have regarding bad breath. Read more about this topic in the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”

A number of factors can lead to dental caries (tooth decay). To find out if you are at high risk, ask yourself these questions.

Is plaque visible in my mouth?
Dental plaque is a whitish film of bacteria that collects on your teeth. If it is clearly visible, it means that there is a lot of it. Among the bacteria in the plaque are those that produce tooth decay, particularly in an acidic environment. (A normal mouth is neutral, measured on the pH scale, midway between the extreme acidic and basic ends of the scale.)

Do I have a dry mouth?
Saliva protects your teeth against decay by neutralizing an acidic environment and adding minerals back to the outer surface of enamel of your teeth, so reduced saliva is a high risk for caries. Many medications can cause dry mouth as a side effect.

Do I eat a lot of snacks, particularly unhealthy ones?
Frequently eating sugars, refined carbohydrates, and acidic foods promotes the growth of decay-producing bacteria. The more frequently you eat, the longer your teeth are bathed in sugars and acids. Acidic foods not only promote bacterial growth, they also directly cause erosion of the tooth's hard surface by softening and dissolving the minerals in the enamel.

Do I wear retainers, orthodontic appliances, bite guards or night guards?
These appliances are recommended for various conditions, but they tend to restrict the flow of saliva over your teeth, cutting down on the benefits of saliva mentioned above.

Do my teeth have deep pits and fissures?
The shape of your teeth is determined by your heredity. If your teeth grew in with deep grooves (fissures) and pits in them, you are at higher risk for bacterial growth and resulting decay.

Do I have conditions that expose my teeth to acids?
If you have bulimia (a psychological condition in which individuals induce vomiting), or GERD (Gastro-Esophageal Reflux Disease), your teeth may be frequently exposed to stomach acids that can cause severe erosion to your teeth.

Do I already have cavities?
Visible cavities can range from those only visible with laser technology or x-ray examination to those a dentist can see with a naked eye. If you already have small cavities, you are at high risk for developing more.

Do I have white spots on my teeth?
White spots are often the first sign of decay in a tooth's enamel. At this point, the condition is often reversible with fluorides.

Have I had a cavity within the last three years?
Recent cavities point to a high risk of more cavities in the future, unless conditions in your mouth have significantly changed.

If you have any of these indications of high risk, contact us today and ask us for suggestions for changing the conditions in your mouth. You can also learn more by reading the Dear Doctor magazine article “Tooth Decay.”

Both diabetes and gum (periodontal) disease are chronic inflammatory diseases that have negative consequences for millions of people worldwide. But before we continue, let's define these two diseases:

Periodontal disease is a condition in which biofilms of dental bacterial plaque stick to teeth near the gum lines causing the gum tissues to become inflamed and infected. If not treated properly and in an early stage, it can cause severe damage to the bone that supports the teeth, resulting in tooth loss. It occurs in the absence of good oral hygiene which includes ineffective daily brushing and flossing and neglecting to see your dentist.

Diabetes is a chronic condition in which blood glucose (sugar) levels become excessive. Glucose is the body's main source of sugar for energy. The hormone insulin, among other mechanisms, normally controls glucose. Prolonged elevated blood sugar levels are harmful and ultimately can even be life threatening if left untreated. With type 1 diabetes, insulin injections (shots) are required to maintain the proper blood sugar levels because the body no longer produces its own blood sugar. Type 2 diabetes is generally less severe and can usually be treated with a combination of diet and medication.

And while both of these diseases share the same common enemy, you, there is scientific evidence revealing links between the two. Diabetes increases the risk factor for developing periodontitis, and conversely, periodontal disease makes it more difficult for diabetics to control blood glucose levels.

Want To Learn More?

Learn more about these two diseases and their relationship by reading, “Diabetes & Periodontal Disease.” Or if you have diabetes but haven't had a dental exam and cleaning in a long time, contact us today to schedule a consultation. You can also use this consultation to discuss any questions or concerns you have about your oral health and its relationship to your diabetes.

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.”