Dental health matters No.6 Snoring zzzzz!

Anti-social

Bad for your health

Bad for your work life

Bad for your family life

&

Bad for your sex life !

At the end of Stop Snoring Week 2005, snoring and sleep apnoea have been highlighted in the media.

There are many and varied ways to help reduce or stop this anti-social and potentially dangerous condition which affect both men and women.

S;eep apnoea- breathe holding during sleep can be associated with snoring and with daytime tiredness or drowsiness. Find out more if you feel you may be affected.

Take the Epworth Sleepiness Scale questionnaire test here :>

http://www.putanendtosnoring.com/epworth.htm

Dental appliances can be very effective in some types of snoring. Some of these "mouthguards" are DIY and maybe worth trying, however a professionally made one will fit far more comfortably and be tailored to your requirements.

Here are a number of useful links for you to look into the snoring problem :

This first is a link for you to listen to the snoring item on BBC radio 4's Weekend Woman's World program , broadcast on Saturday 23rd Spril 2005 .

http://www.bbc.co.uk/radio4/womanshour/2003_07_wed_03.shtml

Here are several useful links to different pages of the same website

http://www.britishsnoring.com/
http://www.britishsnoring.com/pdf/nssws.pdf

The next link is a useful information and self-help site which is U.S. based

http://www.putanendtosnoring.com/q-intro.htm

the page which highlights dental mouthpieces can be found here

http://www.putanendtosnoring.com/mouthpiece.htm

Dental Health Matters No.5. Your gum health is so important

Look after your gum health and you will probably keep your teeth for life.

If your smile is a picture and your teeth are centre stage, then your gums are the frame for the picture.

Keeping your gums healthy provides immediate extra benefits, such as

• Fresh taste and Fresh breath.
• Having gums that look pink and firm and healthy
• Having gums that don't bleed when they are brushed
• Giving you confidence when you smile
• What about kissing? What about your partners gums ?

The long-term benefits of healthy gums are even more important

• You may well keep your teeth for life
• You will avoid years of halitosis and gum bleeding
• You will avoid having your teeth drift out of position
• You will avoid teeth which become loose or gappy
• Your teeth will remain firm and so if needed they can be crowned or support bridgework
• It may even reduce your chances of heart disease !

The dental team at St.Mary's House have always taken your gum health seriously. We screen every patient for gum disease and inform you if we find that you a have gum problem.

We measure the gum attachment to the teeth regularly. Gum pockets, are gaps which develop around the teeth between the gum and the tooth. Gum recession involves a change in the height of the gum attached to the tooth, Very often the gum is healthy pink and firm but has risen up the side of the tooth. The causes are complex and may involve aspects which are genetic, dietary, stress related, localised or generlised bite problems, hormonal changes and lifestyle in nature. These may all affect or be reflected by the state of health of your gums as may other more serious conditions such as Diabetes .

We check for early warning signs of gum problems and monitor changes. You will have an individual program of therapy and advice tailored to help improve your gum health or treat any gum disease we may find, even if it is only affecting one side of one tooth only.

Remember, gums which bleed when you brush are not healthy , so seek advice.

We use the Basic Periodontal Examination (BPE) method to quickly and regularly assess your gums and to guide us as to the most appropriate treatment or advice for you. This quickly scores each of 6 zones or groups of teeth. Here is how it works:

Score 0 = Healthy gums

Score 1= Some bleeding and treatment and adsvise is simple

Score 2 = As per Score 1 plus tartar or rough fillings to clean or smooth over

Score 3 = Early stages of gum disease which need two or more visits to begin treating and then requires regular reviews and possibly more therapy

Score 4 or * = Established or advanced gum disease requiring more prolonged and specfic detailaled treatment depending on the exact nature of the problem. Regular gum treatment and monitoring of progress is needed every 2 or 3 months. Very occasionally referral to a specialist is needed.

There is no pill or magic wand to "cure" gum problems but they can be contolled, improved and managed.

Dental Hygiene Products

Are you mystified when you go to the chemist or supermarket by the vast choice of dental hygiene products? I am not surprised. These days the choices are almost neverending and no two people need the same ones.

Our dental hygienist, Nicky Smith, will advise you personally on the vast array of products, and then review your progress and continue to monitor your gum health and fine tune the best methods for you.

As a team, Nicky and I will carry out almost all the treatment or therapy required from the simple to the complex. We will advise on diet or lifestyle changes which are important or beneficial too.

Smokers, please remember ,any gum problems you have will be made worse by smoking and will be much slower to improve.

Dental Health Topics No.4"TMJ" Headaches Your Bite and You A new and simple treatment method

Do you suffer from any or more than one of the following ?

• Tension Headaches
• Face-ache in the morning
• Clicking jaws
• Migraine (some types of)
• Bruxism (tooth grinding)
• Jaw clenching (habit or stress related)
• Bulging cheek muscles
• Neck/shoulder pain
• Repeated breakage of fillings
• Cracks in your teeth
• Worn down front teeth
• Gum recession

Question - What do all of these problems have in common?

Answer ...

TMJ(ds)

Temperomandibular Joint (Dysfunction Syndrome)

and TMJ problems

First let's look at TMJ(ds)

If your bite is misaligned, even by a tiny amount, then your jaws cannot find a stable and comfortable resting place. Your jaw joints are the most complex in your body in the way they move and your teeth position direclty guides the range of jaw movements - opening, side to side ,forward and back and so on. Together with your jaw muscles, the back teeth and front teeth as distinct groups of teeth, form a complicated, yet wonderful system.

If your teeth (whether natural or filled,crowned or bridged) are misaligned then your jaw joints (TMJs) cannot smoothly move in all directions as they should.

You have a large group of powerful muscles which operate the jaw movements and if these are overstretched or uncoordinated due to your uneven bite, then they go into spasm. You get jaw muscle cramp.This manifests itself as faceache,migraine, tension headache (especially over the temples) but can also affect your neck and shoulders too.

However some people manage to find a way of coping with their misaligned bite. They grind their teeth in an effort to find that happy resting position, or they posture their jaws in various ways to avoid the clashing teeth contacts. This is what leads to cracks in teeth, worn down front teeth and repated breakage of fillings.

So how can I help if you have these problems?

To begin with I have been treating people with TMJ for many years. The process begins with a thorough examination and discussion and questionairre to identify if TMJ or TMJ(ds) are real problems for you.

A full survey or analysis of the bite is often needed. Models of your teeth are created from accurate impressions (moulds) and special measurments of the jaw position at rest as well as your jaw joint axis position, which is special to you are made. These measuements are used to transfer the models of your teeth to our highly accurate

dental articulator

Kavo Protar 9 Articulator.

This articulator is a beautifully engineered,mechanical jaw complete with two fully moveable joints which are set to mimic your own jaw movements and tooth positions.

I can then analyse your bite in detail and from all angles to determine if and how your bite is "wrong". At a second consultation we discuss the findings and look at the possible treatment options. These are many and varied and may range from a single adjustment to the shape of one of your fillings, to short,medium or long term use of a bite guard, often at night only.

Treatment involves a combination of threrapies and investigations: One or more types of bite guard may be prescribed. These either better assess your specific problem or begin the healing process.

Several years ago we also began to use a new simple style of night guard for some of our patients.

This is the NTI(tss) appliance

If you have broadband and can view streaming video, watch this first.

http://www.nti-tss.com/video/wrcc.html

Otherwise click on the NTI(tss) link above

This american designed device has gained increasing interest and evidence of success in recent years. It is simple to make and simple to wear.

The following link contains a video with detailed information about this method of helping facial pain, headaches and some migraines.

For the technically minded even more detailed and, comprehensive information about jaw joint and jaw muscle activity, jaw clenching and grinding habits can be found on the NTI(tss) general website can be found here.

The NTI has been approved by the ADA ( American Dental Association)

http://www.nti-tss.com/

Please call for a consulation and examination if you feel we may be able to help recurrent jawache,facial pain,headaches,migraine or even neck or shoulder pain.

01635 47757

Occasionally more involved treatment may be indicated including replaement of old or faulty fillngs or crowns and sometimes tooth straightening with orthodontics is needed. Hoever would almost always need to test how a new bite might feel to you by using a bite guard to mimic to the ideal bite position. If this works then we would go on to considering a more permanant change in your tooth arrangement along the same lines.

Sometimes the misaligned bite manifests itself in another way. If your jaw joints click or pop when you open and close or yawn then the jaw joint itself is affected. Here, the little disc which sits in between he top of your lower jaw and the joint socket has become misaligned. This may be to a greater or lesser extent and usuually gets gradully wose over time, sometimes many years.

The longer it is left untreated the more difficult it usually is to treat. Any or all of the TMJ(ds) treatments above may well help joint problems in the early stages. Later stages of joint problems may even sometimes require surgery to remove the disc, or re-shape or re-position the disc.

Please ask for more information or a consultation if you are concerned or troubled by TMJ(ds) or joint popping or clicking.

If your problem is complex, then referral to an appropriate specialist will be arranged.

Useful links:

http://tinyurl.com/dfxme

http://www.temporomandibular.info/tmj.html

Dental Topics No2 Are you very anxious about having dental treatment

Have you ever considered some light sedation to help get you through your dental treatment visit? We have had a great deal of success over many years in helping people who are anxious, even very anxious about receiving dental treatment. We offer two types of conventional sedation techniques.

Relative Analgesia (RA) or "Happy air" and Intravenous Sedation. Click on the links for more information.

Read several patient's own stories of how they were helped by RA click here>RA Testimonials

I have over 25 years experience of successfully helping people who are anxious about the dental situation using the "RA" techqniue. For the last three years I have been running courses to teach other dentists how to use RA for their patients. They have come to Newbury from all over the UK and indeed , recently from the Republic of Ireland too.

Click this link to find out what they have said about their experinces of the courses I run.

Richard's RA courses for other dentists

If you feel you or a family member or friend are truely phobic then hypnotherapy may well be helpful (as it is for those who fear spiders or flying). Why not try Roland Bulliavant who consults on the floor above us at St.Mary's House. Several of our patients, staff and my own family members have benefitted from his hypnotherapy service, helping with exam or driving test anxieties for example. Contact him directly or speak to us for further advice.

Richard's Professional Development2005

I have always striven to keep abreast of the latest teaching and thinking in Dentistry to bring the benefits to my patients.

In the last 2 years I have been invited to join two study clubs. Each meets on a regular basis to provide ongoing updates of particular topics of interest to the group.

ADAPT has been in existence for about 10 years and meets monthly in Kew at the practice of Dr Howard Stean. Howard is a highly experienced UK dentist, providing dental implants and laser surgery from his bespoke Kew practice.

ADAPT stands for Aesthetic Dentistry and Professional Testing.
We have regular speakers from the dental world. Last month the UKs formost expert on the Invisalign system gave us all an update on this latest means of tooth straightening without the need for conventional braces. It is important to understand that this method is only suitable for some people, but there is no harm in you asking !
The group also regularly sample new materials designed to improve the services we can provide. Many of these come from outside the UK, the US in paricular. The group is currently involved in a full-scale clinical tral of a particluar tooth-coloured filling from one of the leading mnanufacturers.

Later this month I will be attending a one day seminar by Dr. Stean on facial aesthetics. This ties in aspects of dentistry, bite alignment, joint function, smile design, lip and cheek support to improve the aesthetics of facial appearance.

I also trek over to Hemel Hempstead about every two months to join another group of like minded dentists to discuss more tooth related matters.

Finally I log onto an 800 member dental discussion group on the internet most evenings again to kep abreast of 1001 issues.

So even though we are tucked away on the first floor in Newbury, we are able to bring you the benefits available in almost any dental practice in the UK.

Next month in May, Chris and I are flying up to Edinburgh to the Edinburgh International Conference Centre. Here we will attend a high-powered 3-day conference of the Association of Dental Implantology (UK) of which, I am a member. Here, anyone who is anyone in the UK in the field of Dental implants will gather to hear some of the world's leading experts in this field. The presentations will ensure we are up to date with the very latest ideas and teaching in this exiting field.

If you feel that yu might benefit from dental implants, please ask us about them.

Then in June the whole practice team will be at the Queen Elizabeth II Conference Centre in Westminster for the annual World Aethetic Congress.
Top UK and International speakers gather to bring help us bring you more beautiful smiles !

Later in the Autumn, Chris and I will attend the British Academy of Aesthetic Dentistry for its annual 3 day conference, this year in London. I have attended every 3 day conference in the last 10 years. That's an awful lot of teeth to look at in triple slide show presentations !

Well that's about it for now.