Cosmetic Dentistry Blog #1 Timothy C Adams DDS,LVIM,ACSDD Carmel, Indiana

Teeth that are less than ideal in their shape, color or size can make you feel like you have an unattractive smile, even if your teeth are otherwise healthy. Your self esteem can be affected and your confidence diminished when you smile. Bleaching is certainly the first line of defense due to its conservative nature. But bleaching can only affect the color of the teeth. If you have a size and or shape concern then porcelain veneers may be a viable option. Porcelain veneers are a very effective and relatively affordable way to improve on the color, shape and size of the underlying teeth. They are thin pieces of porcelain used to replicate the natural tooth. Once bonded to the tooth they are strong, durable and can be absolutely breathtaking in their natural beauty. When planned for by a trained dentist and fabricated by master ceramists, they can closely mimic natural teeth. Porcelain veneers can last for many years if they are cared for properly and the occlusion and night time bite are addressed with the appropriate treatment.

Dentists that have been specifically trained to prepare and deliver porcelain veneers have a better understanding of the intricacies involved in treatment planning and delivering realistic expectations for the patient. This special training allows the dentist to have a better chance of understanding exactly what the patient desires and to be able to deliver an extremely high level of patient satisfaction. Every patient has different needs and demands and it is imperative for the dentist to be able to deliver realistic expectations. This is where training and experience are critical to the end result. Timothy C Adams DDS, LVIM, ACSDD Carmel, Indiana

Obstructive Sleep Apnea (OSA) is a condition where there is a total stoppage of breathing that occurs during sleep.

High blood pressure • Memory problems • Morning headaches • Feeling of depression • Gastro-esophageal reflux (heartburn) • Impotence • Nocturia (frequent night time urination) • Weight gain • Limited attention • Lethargy • Poor judgment • Personality issues • Hyperactivity, especially in children Depression • Irritability • Sexual dysfunction • Learning and memory difficulties • Increased risk of accident from falling asleep while driving • High blood pressure • Heart attack, congestive heart failure, cardiac arrhythmia and stroke. CPAPoral appliances sleep apneaObstructive Sleep Apnea (OSA) is a condition where there is a total stoppage of breathing that occurs during sleep. This interruption of breathing can occur 10 to 50 or even 100 times every hour with the duration of these episodes occurring anywhere from 10 to 30 seconds. It has been estimated that up to 25 % of men and 9 % of women can be affected by OSA. What is more disturbing is that it is estimated that OSA is undiagnosed in 80 to 90 % of the people that actually have OSA.

One problem we see in our office is the number of patients that are undiagnosed for OSA, but are instead being treated for high blood pressure, diabetes, depression etc. These patients could be on medications that are not treating the primary underlying cause of their symptoms.

Some of the symptoms of OAS are: Excessive daytime sleepiness, loud snoring, observed episodes of stoppage of breathing, frequent and abrupt awakening accompanied by the shortness of breath, awakening with a dry mouth, sore throat and or sore teeth, awakening with chest pain, morning headaches, snoring, difficulty concentrating during the day, poor job performance, obesity, attention deficit disorder, mood changes such as depression and irritability, difficulty staying asleep (insomnia), diabetes and high blood pressure.

Diagnosis is done by a formal sleep study. This takes place at an overnight facility where you are hooked up by monitors all over your body to measure different parameters such as breathing, heart rate, respiration, brain waves and muscle activity as you sleep. These overnight sessions are attended by a sleep technician who monitors the incoming data and makes sure the patient is doing well via a video monitor. These results are then read by a board certified sleep physician. The sleep physician makes a diagnosis and an appropriate treatment for the patient. Treatment can involve conservative routes such as weight loss, CPAP machine that is a mask hooked up to an air pump that blows a stream of positive air through your nose and or mouth that opens up the airway and prevents it from collapsing, an Oral Appliance(OA) fabricated by a trained dentist or some means of surgery.

Sleep Disorders: Timothy C Adams DDS, Diplomat ACSDD Carmel, Indiana

Sleep disorders are becoming more prevalent due to an increased awareness by both the medical and dental communities and the public. The underlying conditions of sleep related disturbances have been with the patient in many cases for years, but the symptoms and the ability to diagnose these symptoms are becoming more attainable and affordable.
It is important for physicians and dentists to work closely together to form a team to help the millions of patients that suffer from sleep disturbances. Dentistry can be an extremely important portal to screen for sleep due to its ability to observe signs and symptoms of the oral cavity during routine dental prophylaxis appointments. By the same token, it is important to realize that sleep disturbances are a medical condition and only a sleep physician can properly diagnose sleep conditions. The only definitive way to diagnose Sleep disturbances is by either an overnight in lab sleep study called a Polysomnogram (PSG), or a home sleep test. Once a diagnosis is made the sleep physician has the responsibility to recommend what type of treatment is best suited for each individual patient.
These treatments can range from a CPAP machine, Oral Appliance Therapy, surgery, Inspire (Upper Airway Stimulation Therapy), medications, weight loss, smoking and alcohol cessation, nasal decongestants, positional therapy and surgery. Each type of treatment has its own pros and cons and all should be addressed when looking at what would be best for each individual patient.