Dental Tribune U.S. Edition

COSMETIC TRIBUNE The World’s Cosmetic Dentistry Newspaper · U.S. Edition who authored an article about snor- ing for CNN Health. “If they did, I recommend treatment, usually with an oral appliance, sometimes with CPAP.” Sleep apnea awareness has grown steadily. SLEEP Journal noted in 2008 that loud snorers are 10 times as likely to have atherosclerosis, which has motivated doctors and dentists to identify treatments. Even Dr. Mehmet Oz has jumped on the sleep apnea bandwagon. Recently on “The Dr. Oz Show,” Oz explained the difference between snoring and obstructive sleep apnea. According to Oz, the best solu- tions are to lose weight and then consider surgical solutions. Sec- ondarily, Oz mentioned CPAP, and finally. oral appliances to pull the mandible forward. “I’m seeing a growing demand in my patient base,” reports Dr. Mark Weiser, a Santa Barbara dentist and member of the American Academy of Cosmetic Dentistry who treats sleep apnea and snoring. “But a lot of the appliances I’m making are Sleep dentistry is changing the way patients with sleep disorders are treated. Traditionally, sleep apnea has been the exclusive responsibility of MDs, neurologists or pulmonolo- gists, but dentists are now focusing their energies on how patients who snore can improve their quality of sleep. When patients are diagnosed as sleep apneic, they are usually placed on a CPAP machine, which involves a mask and breathing tube that they wear while sleeping. Until recently, surgery was one of the few alterna- tives to CPAP. Dentists have started treating sleep apneic patients because they understand how occlusion and the position of the jaw can influence a patient’s airway. Many dentists offer oral sleep apnea and anti-snoring devices to help patients who don’t wish to undergo CPAP treatment or surgery. “I now always discuss, in my report and with my patients, wheth- er they had loud, steady snoring,” said Dr. Lisa Shives, a sleep expert for CPAP patients that can’t stand their mask and whatnot, so they’re going to Google and looking for other options.” “As a dentist, I feel I have an opportunity to ‘bridge the gap’ so to speak, and help catch more cases of sleep apnea,” adds Dr. Don Low- rance, who practices in Corpus Christi, Texas. “They’re in my chair, and it doesn’t take that much time to ask some simple questions that tell whether or not a sleep study is warranted.” Omaha sleep apnea dentist Dr. Roger Roubal routinely asks his patients if they snore. “It’s a simple question, but by ask- ing it, we’re potentially saving lives in the dental office.” The American Academy of Cos- metic Dentistry will offer several lectures on sleep apnea, among many other dental topics, at the annual scientific session in Boston, May 18–21. Drs. Gary Alex, Kent Smith, Beth Thompson and Lee Ann Brady will focus on sleep apnea in their lectures for the individual den- tist and dental team. For more infor- mation, visit www.aacdconference. com CT Is sleep dentistry for you? g CT page 2C Figs. 1a, b: Over the years, Donna had forgotten how to smile. When first prompted to smile, this was the best she could do. (Photos/Provided by Dr. Samaha) By Lisa Maria Samaha, DDS, FAGD, PC Our 58-year -old patient had a lifetime of periodontal disease and rampant decay. As a young woman, Donna’s dental disease was diag- nosed and treatment was recom- mended. Having had a series of trau- matic childhood dental experiences, she was deathly afraid to proceed with recommendations. By the time we met Donna, this well-educated, pleasant woman had not received dental care in nearly 30 years. During that time, Donna suffered a great deal of pain and embarrassment, and many of her teeth had fallen out on their own. Her life had been severely impacted by her dental disease. Motivated for change Donna had read stories about some of our patients who had similar den- tal histories. Those stories, along with her only child’s upcoming wed- ding, were the driving forces that gave her the courage to call our office. Donna wanted to be able to smile proudly at her daughter’s wedding and not be an embarrassment to her family. We had three weeks to elimi- nate Donna’s lifetime of disease and fashion her a new smile. Within a couple of hours of meeting Donna, we reviewed a treatment plan with her. Donna was ready. We made a place for her on our schedule the next day. The only condition was that Donna would be without teeth dur- ing her post-op healing period while we prepared her denture. Donna agreed. She was visibly relieved to know that her years of dental suffer- ing would end within 24 hours. The next morning, Donna presented for her full-mouth surgery. Treatment Because of severe periodontal infec- tion and rampant decay, full-mouth extractions and replacement with maxillary and mandibular complete dentures was necessary. Along with extractions, a copious amount of granulation tissue was removed, soft tissue was biopsied and alveoloplas- ty and gingival recontouring were performed. Bone grafting and guided tissue regeneration were performed for maximum ridge preservation. All treatment was accomplished in one session, with no sedation. Throughout her postoperative healing, Donna required only two doses of Motrin 800 mg for pain. Complete dentures were delivered one week later. Summary Less than three weeks transpired from the day we met this severely phobic patient and the day we deliv- ered her final dentures. Donna was elated with the transformation and responded with tears of joy. When she greeted her husband in the reception room, they both cried. Life-changing dentistry March 2011 www.dental-tribune.com Vol. 4, No. 3 Fig. 1a Fig. 1b (Photo/ProvidedbytheAACD)