Fillings

For those who have never consulted a dentist about treatments for sleep apnea and snoring, it may be time to make an appointment. Dental sleep medicine is a growing segment of dentistry that focuses on managing snoring and sleep apnea with oral appliance therapy (OAT) – an effective alternative to the standard continuous positive airway pressure (CPAP) machine and mask. According to the American Academy of Dental Sleep Medicine (AADSM), up to 50 percent of sleep apnea patients do not comply with or tolerate CPAP.

Oral appliance therapy (OAT) uses a “mouth guard-like” device worn only during sleep to maintain an open, unobstructed airway. OAT devices prevent the airway from collapsing by either holding the tongue or supporting the jaw in a forward position. For many, oral appliance devices are more comfortable to wear than a CPAP mask. The devices are also quiet, portable and easy to care for. Research suggests that oral appliance therapy often can equal CPAP in effectiveness and offers a higher patient compliance rate than CPAP. There are more than 80 different styles of oral appliance devices that have received FDA clearance.

 

The many faces of OSA are revealed by examining frequently associated conditions such as: high blood pressure (hypertension), heart failure, heart rhythm disturbances, Atherosclerotic heart disease, pulmonary hypertension, insulin resistance, and even death are some of the known complications of untreated obstructive sleep apnea. Cognitive impairment (memory problems), depression, anxiety, and gastro esophageal reflux disease (GERD) are also among possible complications of untreated sleep apnea. Dentists can treat the vast majority of patients with OSA and have the ability to screen for it, at a minimum, within our patient population. The most commonly quoted statistics on OSA are summarized below.

1/3 of population suffers from some sleep disorders (20M OSA 10M PLMD, 20M Insomnia)

Snoring prevalence 67% general population. NSF 2005 (habitual snorers 35% Parati)

94% of OSA population snores, 6% are silent apneics
Wisconsin Study 1938: 17-20% of general population have some OSA (AHI>5)

Sleep Heart Health Study: 22% have OSA (Smoking gun intermittent Hypoxia)

Young in 1993, Wisconsin Study : AHI>5 w/o EDS (excessive daytime sleepiness), 9% females, 24% males
Metabolic Syndrome effects 24% of general population

Weight loss of 10% can decrease AHI (apnea-hyponea index) 30-50%

We are now providing oral appliance therapy for sleep-related breathing disorders.  It’s our goal to treat this disorder working with your physician and health care provider and improve your health and well being. 

The American Academy of Sleep Medicine now recommends oral appliances as a primary or first line of treatment for mild to moderate obstructive sleep apnea. The guidelines state that patients should always be offered the choice of an oral appliance if they have mild to moderate OSA.

 For Mild to Moderate Obstructive Sleep Apnea:
Oral appliances (OAs) are indicated for use in patients with mild to moderate OSA who prefer OAs to Continuous Positive Airway Pressure (CPAP), or who do not respond to CPAP, are not appropriate candidates for CPAP, or who fail treatment attempts with CPAP or treatment with behavioral measures such as weight loss or sleep position change.

For Moderate to Severe Obstructive Sleep Apnea:
The American Academy of Sleep Medicine recommends Continuous Positive Airway Pressure (CPAP) for the treatment of moderate to severe sleep apnea. If patients have tried and failed CPAP, they should be offered treatment with an oral appliance. 

Patients with severe OSA should have an initial trial of nasal CPAP [prior to trying oral appliances]. Reference:  1.American Academy of Sleep Medicine website http://www.aasmnet.org

 Below is a SECURE CONFIDENTIAL LINK to complete our online sleep disorder/apnea evaluation forms.  

  Sleep History/Exam/Workup

Sleep Consultation

 

 

Sleep Screening Consultation SleeSleep Screening Consultation Sleep Screening Consultation Sleep Screening Consultation  Sleep Screening Consultation Sleep Screening Consultatio Please have the following available before you begin.  This registration will take about 15-20 minutes to complete so please save enough time.  Once we have your information, we can visit further about your symptoms.

  1. your insurance card
  2. a list of your physicians
  3. a complete medication list and dosage 

 

Online Dental Education Librarycontact us contact us

Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.

Online Dental Education Library

Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us at 785-738-3758,   

                      

Know your Teeth

BCBS Delta Dental Care Credit

Frequently asked questions: dental fillings

Are dental amalgams safe? Is it possible to have an allergic reaction to amalgam? Is it true that dental amalgams have been banned in other countries? Is there a filling material that matches tooth color? If my tooth doesn't hurt and my filling is still in place, why would the filling need to be replaced? Read this interesting and informative discussion from the American Dental Association.

FDA consumer update: dental amalgams

The Food and Drug Administration and other organizations of the U.S. Public Health Service (USPHS) continue to investigate the safety of amalgams used in dental restorations (fillings). However, no valid scientific evidence has shown that amalgams cause harm to patients with dental restorations, except in rare cases of allergic reactions.

ATSDR - public health statements: mercury

The Centers for Disease Control and Prevention offers some scientific background on mercury (contained within silver-colored fillings), and whether it believes the substance presents any health hazards.

Analysis reveals significant drop in children's tooth decay

Children have significantly less tooth decay in their primary (baby) and permanent teeth today than they did in the early 1970s, according to the Journal of the American Dental Association (JADA). The analysis reveals that among children between the ages of six and 18 years, the percentage of decayed permanent teeth decreased by 57.2 percent over a 20-year period. In addition, children between the ages of two and 10 years experienced a drop of nearly 40 percent in diseased or decayed primary teeth.

Alternative Materials

Advances in modern dental materials and techniques increasingly offer new ways to create more pleasing, natural-looking smiles. Researchers are continuing their often decades-long work developing esthetic materials, such as ceramic and plastic compounds that mimic the appearance of natural teeth. As a result, dentists and patients today have several choices when it comes to selecting materials used to repair missing, worn, damaged or decayed teeth.

The advent of these new materials has not eliminated the usefulness of more traditional dental restoratives, which include gold, base metal alloys and dental amalgam. The strength and durability of traditional dental materials continue to make them useful for situations where restored teeth must withstand extreme forces that result from chewing, such as in the back of the mouth.

Alternatives to amalgam, such as cast gold restorations, porcelain, and composite resins are more expensive. Gold and porcelain restorations take longer to make and can require two appointments. Composite resins, or white fillings, are esthetically appealing, but require a longer time to place.

Here's a look at some of the more common kinds of alternatives to silver amalgam:

  • Composite fillings - Composite fillings are a mixture of acrylic resin and finely ground glasslike particles that produce a tooth-colored restoration. Composite fillings provide good durability and resistance to fracture in small-to-mid size restorations that need to withstand moderate chewing pressure. Less tooth structure is removed when the dentist prepares the tooth, and this may result in a smaller filling than that of an amalgam. Composites can also be "bonded" or adhesively held in a cavity, often allowing the dentist to make a more conservative repair to the tooth. In teeth where chewing loads are high, composite fillings are less resistant to wear than silver amalgams. It also takes longer to place a composite filling.
  • Ionomers - Glass ionomers are tooth-colored materials made of a mixture of acrylic acids and fine glass powders that are used to fill cavities, particularly those on the root surfaces of teeth. Glass ionomers can release a small amount of fluoride that help patients who are at high risk for decay. Glass ionomers are primarily used as small fillings in areas that need not withstand heavy chewing pressure. Because they have a low resistance to fracture, glass ionomers are mostly used in small non-load bearing fillings (those between the teeth) or on the roots of teeth. Resin ionomers also are made from glass filler with acrylic acids and acrylic resin. They also are used for non-load bearing fillings (between the teeth) and they have low to moderate resistance to fracture. Ionomers experience high wear when placed on chewing surfaces. Both glass and resin ionomers mimic natural tooth color but lack the natural translucency of enamel. Both types are well tolerated by patients with only rare occurrences of allergic response.
  • Porcelain (ceramic) dental materials - All-porcelain (ceramic) dental materials include porcelain, ceramic or glasslike fillings and crowns. They are used as inlays, onlays, crowns and aesthetic veneers. A veneer is a very thin shell of porcelain that can replace or cover part of the enamel of the tooth. All-porcelain (ceramic) restorations are particularly desirable because their color and translucency mimic natural tooth enamel. All-porcelain restorations require a minimum of two visits and possibly more. The restorations are prone to fracture when placed under tension or on impact. Their strength depends on an adequate thickness of porcelain and the ability to be bonded to the underlying tooth. They are highly resistant to wear but the porcelain can quickly wear opposing teeth if the porcelain surface becomes rough.

Sealants

Research has shown that almost everybody has a 95 percent chance of eventually experiencing cavities in the pits and grooves of their teeth.

Sealants were developed in the 1950s and first became available commercially in the early 1970s. The first sealant was accepted by the American Dental Association Council on Dental Therapeutics in 1972. Sealants work by filling in the crevasses on the chewing surfaces of the teeth. This shuts out food particles that could get caught in the teeth, causing cavities. The application is fast and comfortable and can effectively protect teeth for many years. In fact, research has shown that sealants actually stop cavities when placed on top of a slightly decayed tooth by sealing off the supply of nutrients to the bacteria that causes a cavity.

Sealants act as a barrier to prevent bacteria and food from collecting and sitting on the grooves and pits of teeth. Sealants are best suited for permanent first molars, which erupt around the age of 6, and second molars, which erupt around the age of 12.

Sealants are most effective when applied as soon as the tooth has fully come in. Because of this, children derive the greatest benefit from sealants because of the newness of their teeth. Research has shown that more than 65% of all cavities occur in the narrow pits and grooves of a child`s newly erupted teeth because of trapped food particles and bacteria.

Application

Sealant application involves cleaning the surface of the tooth and rinsing the surface to remove all traces of the cleaning agent. An etching solution or gel is applied to the enamel surface of the tooth, including the pits and grooves. After 15 seconds, the solution is thoroughly rinsed away with water. After the site is dried, the sealant material is applied and allowed to harden by using a special curing light.

Sealants normally last about five years. Sealants should always be examined at the child`s regular checkup. Sealants are extremely effective in preventing decay in the chewing surfaces of the back teeth.

Insurance coverage for sealant procedures is increasing, but still minimal. Many dentists expect this trend to change as insurers become more convinced that sealants can help reduce future dental expenses and protect the teeth from more aggressive forms of treatment.