My Blog

Posts for: March, 2019

By Elizabeth Dunkleberger DDS PC
March 29, 2019
Category: Oral Health
Tags: sleep apnea   snoring  
MarchIstheTimetoEvaluateSleepProblems

The month of March brings the first day of spring, when nature seems to wake up after a restful winter slumber. It also brings Sleep Awareness Week, which leads us to ask: How's your sleep? For around one of every three people, the answer seems to be: Not so good! In fact, it's estimated that some 50-70 million people in the U.S. alone have sleep problems, including sleep-related breathing disorders like obstructive sleep apnea (OSA).

People who suffer from this condition seem to sleep fitfully and snore loudly—and they may actually wake up dozens of times every night without even knowing it. These "micro-arousals" make it impossible to get restful sleep, which can lead to fatigue, trouble concentrating, and behavioral issues. Children with sleep disorders like OSA are sometimes diagnosed with attention deficit/hyperactivity disorders because the symptoms are very similar.

If you suspect that you (or someone you care about) may have a serious sleep disorder, it's a good idea to get an examination from a medical professional who specializes in this area. If the diagnosis is OSA, there are a number of treatments that can be effective—one of which is an oral appliance that's available from the dental office.

Dentists are quite familiar with the anatomical structure of the mouth, which is sometimes the root cause of OSA. In many individuals, the soft tissue structures in the back of the oral cavity (including the tonsils, tongue and soft palate) can shift position when muscles relax during sleep and block the flow of air through the windpipe. The lack of sufficient air may cause a person to awaken briefly, gasp for breath, and then relax their muscles—over and over again, all night long.

After a complete exam, we can have an appliance custom-made for you that has proven successful in managing mild to moderate cases of OSA. Shaped a little like a retainer, it is worn in your mouth at night and taken out in the daytime. The appliance helps maintain an open airway by re-positioning the jaw and/or keeping the tongue out of the way.

Oral appliance therapy is one of the most conservative options available for treating OSA: It requires no major equipment or irreversible medical procedures. However, there are a number of other options, including machines that supply pressurized air through a face mask and even oral surgery. It's important to consult with a specialist in sleep disorders when you're facing this issue. If the diagnosis is OSA or a similar sleep problem, remember that help may be available here at the dental office.

If you have questions about sleep-related breathing disorders, please contact us or schedule an appointment for a consultation. You can read more in the Dear Doctor magazine articles “Oral Appliances For Sleep Apnea” and “Sleep Disorders & Dentistry.”


By Elizabeth Dunkleberger DDS PC
March 19, 2019
Category: Dental Procedures
26MillionFansLikeJustinBiebersChippedTooth

Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”

Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.

Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:

A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.

If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.

Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.

Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.

Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.

If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”


By Elizabeth Dunkleberger DDS PC
March 09, 2019
Category: Dental Procedures
Tags: bridgework  
ATraditionalBridgeMightbetheRightSolutionforYourMissingTeeth

We can do a great many things to preserve diseased teeth, from filling cavities to crowning damaged but still viable teeth to protect them and restore their attractiveness. But there may come a point where continued treatment just isn't worth it, and it may be time to remove and replace your troubled teeth.

Dental implants have become the premier restoration for missing teeth. But they have some anatomical limitations and may not work for some situations like excessive bone loss or close nerve proximity. And while a removable partial denture is a solid option, perhaps you'd rather have a fixed solution.

You might then want to consider a fixed bridge to replace one or more missing teeth. This tried and true option has been a mainstay in dentistry for several decades; and while implants may have surpassed them in popularity, they're still available and effective as a restorative option.

A traditional fixed bridge is composed of three or more life-like crowns that are fused together like pickets in a fence. The crown or crowns in the middle fill the empty tooth space; the outside crowns fit over and are bonded to the natural teeth on either side of the empty space to support the bridge. These natural teeth must be reduced in size to accommodate the crowns to fit over them.

Depending on how many teeth are missing, fixed bridges can be a more affordable alternative to dental implants and can achieve life-like results in both form and dental function. But the alterations required for the supporting teeth are permanent and can weaken them. The interface between the natural teeth and the bridge crowns has a higher risk of decay and periodontal disease, so you'll need to be extra vigilant with daily hygiene and regular dental cleanings and checkups.

And even though implants can be more expensive in the short-term, they typically have better durability and less maintenance costs than other restorations. Over the long-term, an implant restoration might actually incur less cost than a fixed bridge.

Still, a fixed bridge can be an effective way to replace missing teeth. Depending on your finances and your overall dental health, a bridge could help you regain an attractive smile.

If you would like more information on options for replacing missing 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 “Crowns & Bridgework.”