Why in the US dentists and doctors are not all trained as physicians and then specialize in different areas of medicine including dentistry, I do not know. Different degrees can cause problems in the insurance billing world. Insurance will often pay for a certain procedure covered by an MD, but will not cover the same procedure performed by a dentist, or the other way around. The Temporomandibular Joint (TMJ) and its therapy needs are not covered by dental insurance and for the most part not covered by medical insurance either. People generally must pay cash for TMJ/TMD treatments. The jaw joint is a joint just as, if not more, important than say the knee, but receives no respect or reimbursement from medical insurance. Strange! You may have read my articles on Sleep Apnea and the use of an oral sleep appliance to treat it, instead of C-PAP (the mask that fits over your nose) machine helping you to breathe. Legally a dentist cannot diagnose and have a person tested for sleep apnea, only a Physician can do that. I refer people I suspect of having sleep apnea to sleep specialty doctors all the time for a diagnosis. The sleep doctors test and make the appropriate diagnosis of sleep apnea. The treatment MD’s most often prescribe a C-PAP machine, but if the patient refuses or cannot tolerate a C-PAP then an oral sleep appliance is most often the alternative. We are blessed in this area to have true experts in the field of sleep medicine. I love the change our combined efforts make in people’s lives. I believe I play an important role in patient care as a dental sleep medicine dentist.

The post Dental Sleep Medicine…. What? first appeared on Hallmark Dental Group.

So, what is pain, really? Pain has been described medically as follows “an unpleasant sensory and emotional experience with actual potential tissue damage or described in terms of such damage.” In the region of the head and neck, the site and the source of the pain are often different. This is especially true with temporomandibular disorders including problems and pain associated with the TMJ (temporomandibular joint). The muscles of mastication and facial expression can refer pain to many different structures or areas like the ear, or the teeth, or the eyes. These muscles often impinge or put pressure on nerves leading to headaches.

My training is to sort out the source of the pain and then treat the source and not the area of the pain. Unfortunately, many dentists have resorted to root canal treatments of teeth and yet still have pain after their treatment. Worse yet, they resort to pulling the tooth, only to have the pain still remain. The pain was coming from an overused muscle which could have easily been treated without losing the tooth. Sometimes pain perceived by the brain can be maintained by the autonomic nervous system. The structure or area of damage is healed yet the pain persists. A knowledge of neuro anatomy as related to the head and neck is important. The knowledge of the way nerve signals can become mixed up to make the brain perceive the pain is coming from somewhere else than the actual pain source, is essential in sorting out the true source of pain. The right diagnosis is essential to success in treating pain disorders of the head and neck.

The post Head and Neck Pain first appeared on Hallmark Dental Group.

You don’t have to be a dentist to observe some of these things.

If you have some of the other symptoms for Sleep Apnea like daytime sleepiness, difficult breathing events at night, snoring, and obesity, then you need help. Breathing normally, and providing adequate oxygenation, is essential for life. Remember, apnea means the absence of breath. If you or your spouse have the physical characteristics or symptoms I’ve described, I urge you to come to my office for a free consultation and referral if appropriate to a Board Certified sleep specialist. We will also explain how, in many cases, the oral appliance works well instead of using a CPAP machine. Medical insurance covers you and my staff will pre-approve your treatment. I have a great working relationship with all the MD sleep specialists in Saint George.

The post Sleep Apnea And The Palate first appeared on Hallmark Dental Group.

Tongues are the main culprit in obstructive sleep apnea. When we are asleep lying down they slump back and close off our airway. Not only but especially in a REM stage of sleep, there is no muscle tension or motor activity stimulation to keep them out of your airway. They can vibrate causing snoring sounds. They grow larger as we gain weight. Large tongue equals getting up going to the bathroom more often in the night. Why? Because your brain try’s to arouse you by sending signals to the tongue to come to attention and quite blocking your airway. You don’t wake up all the way but just enough to think you have to go to the bathroom.

Big, weird tongue equals probable sleep apnea and shorter life span.

The post Check Their Tongue! Maybe Yours Too! first appeared on Hallmark Dental Group.

TMD stands for temporomandibular dysfunction. When someone has pain in their “jaw joint” they say they have “TMJ.” That’s like saying I have knee when you have pain in your knee joint. The more meaningful description is to say I have TMD or I have pain in my jaw joint or pain in my facial muscles. Anyone will know what you mean when you say I have TMJ, but to a dentist trying to figure out exactly where your pain is coming from, he will ask you to point to that area of you face where you feel pain. Then he will ask you, “When does it hurt? How long have you been hurting this way? Is there anything that makes this pain go away or that makes the pain worse. Have you EVER been in an automobile accident? Were you ever struck in the jaw? Do you have arthritis or other inflammatory diseases? Do you have popping or clicking when you chew or open your mouth? Is the popping or clicking painful?”

When should you seek treatment for a TMD condition? There are three things to remember to answer this question: One, is their pain? Two, is there dysfunction (popping, clicking, grinding on opening, are your jaw muscle painful when you open close or chew something)? Three, is your quality of life affected by this jaw pain (can you chew or open your mouth wide without pain?). If you have two out of the three things listed above, then you need to see a dentist that is knowledgeable at treating jaw joint or facial pain conditions. Not all general dentists know how to treat TMD. There is no dental specialty recognized by the ADA (although there should be) that treat TMD or head and neck related pains. There are academies or groups of dentists that pursue advanced learning in these areas. I have made the effort to learn these skills and love helping people with “TMJ” TMD problems.

The post TMD or TMJ What’s The Difference? first appeared on Hallmark Dental Group.

Some of the common reasons people give for being C-PAP intolerant are the following:

1. Mask leaks air all the time
2. Just can’t get the mask to fit properly
3. Too much discomfort caused by straps and headgear
4. Disturbed or interrupted sleep caused by the presence of the device
5. Noise from the device disturbs them and their bed partner
6. C-PAP restricts movements during sleep
7. Pressure on upper lip hurts or chin strap pressure hurts TMJ
8. Claustrophobic feeling
9. Unconscious removal of mask every night
10. Patients don’t like the lines made on their face every day
11. Leaking air around mask hurts eyes or dries eyes
12. Stomach fills with air
13. Air leaking around and out of mouth gives a terrible dry mouth

These are just a few of the reasons patients have given for not wearing their C-PAP device. Fortunately more and more the sleep physician, when they know there is a problem, will send them to me to make an oral appliance. Oral appliances have some draw backs as well, but are generally more universally accepted by patients. After one year, patients who have been prescribed the oral appliance are more compliant vs. patients who have been prescribed the C-PAP. Oral appliances can be recommended initially over C-PAP in cases where the patients’ Sleep Apnea is mild to moderate in severity.

The post When Is An Oral Sleep Appliance An Alternative Treatment To C-PAP? first appeared on Hallmark Dental Group.

Chronic clenching for many years is a common cause of this condition. If you try to force your mouth open when the disc is locked forward, the disc becomes pinched and inflamed, making it even harder to resume its normal position. Once this disc remains in the wrong place for very long it becomes possible permanently stuck there and it take a person some five years to gradually be able to open wide again. If you hear the loud pop and your joint becomes locked like this try opening by moving your jaw from side to side from one extreme to the other as you gently try to open wide again. If you cannot achieve wide opening again come and see me quickly. If you come soon enough I can usually get you unlocked and through treatment, keep you there and out of pain.

The post Loud Jaw Pop, Then Limited Opening? first appeared on Hallmark Dental Group.

Ignoring the symptoms of Sleep Apnea can bring on other complicating health conditions called co-morbidities of Sleep Apnea much earlier. They include high blood pressure, diabetes, stroke, heart attack, atrial defibrillation, and other suspected conditions indicative of poor health. Tissue and nerve damage occur throughout the body the longer a person is not treated for their apnea.

Signs of Sleep Apnea

Some signs of Sleep Apnea are the following: morning headaches, snoring, dry mouth in the morning, gasping for breath in the night, stopping breathing as witnessed by your bed partner, frequently waking and having to go to the bathroom in the night. Treatment is not always the dreaded C-PAP machine. It can often be the use of an oral appliance fitted by an experienced dentist in the treatment of Sleep Apnea. Non-treatment is deadly in the end. “He just died in his sleep!”

The post The Genetics of Sleep Apnea first appeared on Hallmark Dental Group.

The National Sleep Foundation surveys show that 75% of Americans report at least one sleep symptom and approximately 60% of adults drive while drossy. Between the ages of 30 and 60, 24% of men and 9% of women have Obstructive Sleep Apnea. Within the obese population 50% of men and 60% of women have Obstructive Sleep Apnea. The national epidemic of obesity is why there are so many people from youth to the aged that have sleep apnea. Left untreated, people complain of excessive daytime sleepiness, memory problems, and other health issues. Sleep Apnea tends to bring on problems with high blood pressure, heart attack, stroke, weight gain, diabetes, atrial fibrillation, to name a few. You see the odds are high that you may have sleep apnea. Come to my dental office to for a free consultation. I will make a referral to a sleep physician specialist to diagnose your condition. I will let you know if you are a possible candidate for an oral sleep appliance that can treat your Obstructive Sleep Apnea. It is covered by medical insurance.

The post Could You Have Sleep Apnea And Not Even Know It? first appeared on Hallmark Dental Group.

As oral hygiene declines, dental plaque increases. Gum tissues that were healthy and firmly attached around the teeth and bones now become horribly inflamed, causing deep periodontal pockets to form around the necks of the teeth. Soon thereafter, people who haven’t had a cavity in years, now have multiple sites of decay deep around the roots of their teeth or around the margins of their crowns. These seniors, coping financially with retirement, cannot afford to restore their teeth and have no help from dental insurance that they lost upon retiring.

Here are a few of my suggestions on how to cope with dental disease in your latter years:

1. See your dentist’s hygienist more often, maybe 3-4 times per year.
2. Purchase an electric toothbrush if your dexterity is lagging or if arthritis is affecting your hands.
3. Use a fluoride mouth rinse every night before bedtime.
4. Control the amount of sugar in your diet.
5. Use dental hygiene products that help with dry mouth syndrome.
6. Anticipate and plan for dental care in your budget.
7. In cases of Dementia or Alzheimer’s, include in the instructions to your family, that they take you to a dentist for cleaning every 2-3 months, and also see to it that someone brushes your teeth daily.
8. Last of all, but very important, if your teeth are in very poor condition, and you have lost many of them already, a possible, practical solution is to have all of your remaining teeth removed and be fitted for dentures that are held in place by implants.
9. Being in your latter years and having an abscessed tooth removed when you have many serious medical conditions can actually be life-threatening.

With resolve and good planning, you should be able to avoid the heartache of pain and suffering from your teeth in your latter years.

The post Seniors Susceptibility To Dental Disease first appeared on Hallmark Dental Group.