Snoring and Sleep Apnea

It is estimated that 30-50% of patients snore while sleeping- the incidence of snoring increases with age and men snore more frequently than women. Most people are unaware that there is professional help available for snoring.

A related condition, sleep apnea or obstructive sleep apnea (OSA) is a condition where the breathing space in the back of the mouth is closed off. OSA causes significant pauses in breathing and can be life threatening.

Dentists are associated with the treatment of both snoring and OSA. However, a team approach is a safe and effective means to treat these conditions. Dentists work with dental laboratories; sleep technicians and board certified sleep physicians as a team to curb snoring and sleep apnea.

Causes of snoring are partial or complete closure of airway is the cause of snoring as seen in:

Obstruction of nasal airway

Weak throat muscles

Lower jaw being too far back closing off throat

Sleeping posture- sleeping on back causes closure of breathing space

Fat accumulation in and around throat

Loss of muscle tone related to aging

Use of muscle relaxants including alcohol and sedative hypnotics

Snoring Effects:

Sleep deprivation

Social and marital challenges

Increased potential for heart attack and stroke

Snoring can be reduced or eliminated with relative ease but the associated condition of OSA needs more consideration. The pauses in breathing in children and adults happen between 5- 30 times an hour and causes daytime fatigue, slow reaction time and vision problems. About 15% of the American population suffers from sleep apnea. It is a serious condition that can be life threatening. Since OSA is associated with snoring, it must be addressed as part of the treatment for snoring.

Types of Sleep Apnea:

Obstructive sleep Apnea- occurs when soft tissue in the back of throat relaxes during sleep and blocks airway and causes loud snoring

Central Sleep apnea- much less common condition and occurs when the nervous system fails to signal the muscles that control breathing

Complex Sleep apnea- a combination of OSA and central sleep apneas and is associated with significant medical problems

All forms of sleep apnea often go unnoticed and can become serious when left untreated over time.

Snoring and Sleep Apnea Treatments:

Continuous Positive Airway Pressure (CPAP)

Anti snoring oral appliances / mouthpiece for snoring

Surgery

Medications

Losing Weight

Stopping Smoking

Sleeping on Side

Over the Counter Nasal Sprays

Nasal Strips or Clips

Anti Snoring Pillows

CPAPs and anti snoring devices are the most used and most successful treating options. Severity of snoring and OSA condition is measured by a sleep monitoring device to select appropriate treatment. Assuming that the OSA is not severe, sleep apnea dental appliances can easily control snoring and OSA.



Potential Side Effects of Oral Appliances:

Jaw/facial pain

Bite Changes

Tooth Pain

Jaw Joint Pain

Drooling

Dry Mouth

Sound, restful and peaceful sleep is possible. Cost of our sleep apnea dental appliances, or our mouthpiece for snoring are very minimal considering the huge benefits of sound sleep and increased productivity. 

Visit www.smileartistrychino.com for more information on our services.

Antibiotics and Dental Procedures

The mouth is packed with various strains of bacteria, which in a healthy individual maintain optimal oral health. During daily routines like chewing, brushing or flossing, the bacteria can enter the blood stream but don’t present a problem for most of us  when the immune system is healthy. In compromised health, bacteremia (bacteria entering blood stream) can cause infections elsewhere in the body.

Specific heart conditions and orthopedic implants such as artificial joints have known to be the more vulnerable sites for potential infections. 

Antibiotic prophylaxis, or preventative use of antibiotics prior to a dental visit is recommended in conditions like-

-Artificial heart valves

-History of infection of the lining of the heart or heart valves known as Infective Endocarditis

-A heart transplant

-Congenital heart conditions like Cyanotic congenital heart disease

-Defects repaired with a prosthetic device

The criteria for antibiotic prophylaxis is periodically updated by the American Heart Association and the American Dental Association depending on current research and development. Currently, the AHA recommends prophylactic antibiotics only on patients with a history of endocardial bacterial endocarditis.

American Associations of Orthopedic Surgeons in their revised guidelines no longer recommend antibiotics for patients with artificial joints.

In an abundance of caution, our office coordinates with the patient’s physician to determine the appropriate antibiotic protocol. 

Visit www.smileartistrychino.com to E mail us at lovemydentist@gmail.com

Wisdom Teeth

Wisdom teeth are third molars that normally erupt between the ages of 17 and 21.  Since they are the last teeth to erupt into the mouth, usually at the time of young adulthood; an age associated with budding maturity and wisdom; they are more popularly known as "wisdom teeth".

Wisdom teeth, when properly positioned can add to being able to chew well but are not always necessary for optimal function.  Because of their position so far back in the mouth, they can be difficult to clean.

As we, as a society; evolve into consuming more refined foods, which require lot less vigorous chewing, the need for teeth and the corresponding jaw size diminishes. The Aborigines of Australia, supposedly still have their 42 teeth.!

 Wisdom teeth are often impacted  as a result of the discrepancy in the size of the jaws and the number of teeth.  When impacted, the third molars are trapped beneath the gum and bone and against the teeth in front of them.

 The 3 major categories of impaction are-

Horizontal Impaction or a sleeping tooth is where the third molar grows into the mouth horizontally , heading straight towards the root surface of the second molar. These teeth, unless symptomatic are best left alone.

Angular Impaction  is a third molar growing into the mouth at an angle, only partially erupting and trapping food deposits often resulting in pain, swelling  and infection. These are the teeth most likely to need removal to prevent  pain, infection and teeth migration.

Vertical Impaction is  less common and is generally found when the jaws are under developed. Often, these impactions do not cause any pain and are  discovered in dental exams with radiographs ( X rays).

Wisdom extractions can be  performed under local anesthesia and pain or anxiety- reducing medications are available when appropriate.

Teeth positions have a significant bearing on facial profile and timely removal of  impacted teeth is an important aspect of managing facial forms and dental health.

Visit www.smileartistrychino.com for information on additional services or to schedule an appointment.

Dental Fear, Phobia and Anxiety

Going to the dentist triggers feelings of anxiety and fear. It is estimated that around 15 percent of Americans, over 45 million people; suffer from dental anxiety or dental phobia.     
The causes of dental anxiety and phobia can range from a fear of pain, fear of needles or doctors to past experiences of stress and discomfort.  An individual's predisposition to anxiety can also play a key role.

Dental Fear, Phobia or Dental Anxiety?
Though the phrases dental anxiety, dental fear and dental phobia are often used interchangeably to describe a range of symptoms and reactions to dental practices in general, important distinctions can be drawn between them, which can be useful in finding effective dental treatment options.
Anxiety refers to the sense of unease associated with the unknown. If you suffer from dental anxiety, you may find that working with a dentist who is sensitive to your needs and communicates with you to create a comfortable atmosphere can greatly improve your experience and help you to overcome your anxiety.
A phobia is an intense and possibly irrational reaction to a specific situation or object that is perceived as threatening. If you suffer from dental phobia you may react to the sound of a drill, the expectation of pain or another aspect of dentistry for which you have a strong dislike or fear.
Overcoming dental phobias, especially if they are particularly intense, can be more complicated than dealing with anxieties and may require professional assistance. Dental fear is the term often used for a more mild form of dental phobia.
“Our office has had great success with addressing dental fear by simply spending one on one time with our patients.  This builds trust and confidence quickly abolishing fear and apprehension” says Dr. Cherukuri from her Chino, California dental practice.

Digital Radiographs (X rays)

Digital Radiography is a high tech replacement for traditional dental X rays.

 Thanks to modern upgrades in dental technology, patients receive dental treatment  without the pain and time associated with traditional dentistry.

With digital radiography, a sensor is inserted into the mouth to capture images of the teeth.  The image captured is projected on a screen for immediate viewing without the waiting  associated traditional film developing.

Once projected on the screen, images can be enlarged, magnified for more accurate diagnosing of hard to see lesions.  The same images can be electronically transferred to specialists and other health care facilities without duplicating procedures.

Another benefit to digital radiation techniques is a significant reduction of radiation exposure, a significant health benefit to those with radiation  exposure concerns. Digital X rays use up to 90% less radiation than traditional film X rays

Digital x rays are also better for the environment because there are no harmful chemicals involved in their processing.

"Although it requires a sizable initial investment in equipment, more than 50% of the dental offices in USA have adopted digital radiography because of the added safety and time saving features," says Dr. Cherukuri from her Chino, California dental practice.

Dental Fear and Dental Phobia:

 What's the Difference?

For many people, the mere thought of going to the dentist triggers feelings of anxiety and fear. Around 15 percent of Americans - over 45 million people - suffer from dental anxiety or dental phobia. 

The causes of dental anxiety and phobia can range from a fear of pain, fear of needles or doctors to past experiences of stress and discomfort. An individual's predisposition to anxiety can also play a key role. 

Dental Fear, Dental Phobia or Dental Anxiety?

Though the phrases dental anxiety,dental fear and dental phobia are often used interchangeably to describe a range of symptoms and reactions to dental practices in general, important distinctions can be drawn between them, which can be useful in finding effective dental treatment options. 

Anxiety refers to the sense of unease associated with the unknown. If you suffer from dental anxiety, you may find that working with a dentist who is sensitive to your needs and communicates with you to create a comfortable atmosphere can greatly improve your experience and help you to overcome your anxiety. 

A phobia is an intense and possibly irrational reaction to a specific situation or object that is perceived as threatening. If you suffer from dental phobia you may react to the sound of a drill, the expectation of pain or another aspect of dentistry for which you have a strong dislike or fear. 

 Overcoming dental phobias, especially if they are particularly intense, can be more complicated than dealing with anxieties and may require professional assistance.

 Dental fear is the term often used for a more mild form of dental phobia. 

"Our dental office in Chino, California has been committed to serving  patients with fear and phobia and has enjoyed a tremendous amount of success over the years" says Dr Cherukuri. 

"The online reviews are a testament of our patients' rehabilitation from dental fear and a source of confidence building for others looking for this care." Dr Cherukuri adds.

Skipping Dental Exams is Tempting But Costly!

It's understandable that you might be tempted to skip regular dental exams/dental checkups when the economy is bad or if you're experiencing a financial crunch. But brushing and flossing aren't enough to keep your dental health in tip-top shape. And the fact is putting professional dental care on hold can result in serious dental problems later - and treatments that are much more costly.

If you have dental insurance, be sure to take advantage of the benefits. Standard coverage usually includes preventive care - dental exams and checkups - as well as X-rays and basic restorative treatments like a tooth filling. Talk to your dental insurance provider to get all the details; knowing what's covered and what's not can be the difference between incurring extra costs and avoiding them. In addition, talk to your dental office's administrator prior to your visits to get an estimate of costs so that you can determine your out-of-pocket expenses (if any).

Even if you don't have dental insurance, there are many payment options available to help you stay on top of regular dental exams and checkups. One option is to directly make payment arrangements with your dental office. Sometimes dental offices will even give you a discount for cash payments, so don't be shy about asking! Many dental offices now accept (or even offer) financing plans such as CareCredit®, which can be used for a variety of health care treatments, including dentistry. Dental schools and community dentists also offer low-cost dental care.

Visit www.chinosmiles.com or Call 909 627- 6699 to take advantage of our National Dental Hygiene Month promotions.

Why A Dental Exam!

There's a common misperception that dental care is a luxury, and it's time to set the record straight. 

Regular dental exams (aka "dental checkups") are just like regular medical exams and physicals - both are preventive measures to help you stay healthy in the long run. What's more, your oral health and overall health are inextricably intertwined: Gum disease has been linked to diabetes, pregnancy has been linked to tooth loss and stress may cause TMJ, dry mouth syndrome and other dental problems.

The best way, if not the only way, to protect yourself against dental health disasters is to stay on top of your dental exams/dental checkups. The ADA recommends a checkup at least once every six months. 

We tune up our cars because we're told that maintenance can improve performance and even increase longevity. This is a great analogy for dental exams/dental checkups; just like our cars, our teeth need tuneups, too. Regular exams/checkups allow your dentist to monitor the health of your teeth, treat problems and even catch problems before they start or get worse. In the long run, these "tuneups" can result in your teeth lasting a lifetime! 

A standard dental exam for adults typically involves checking for dental problems that can range from cavities, gum disease and tooth root decay to broken teeth, enamel erosion and bite problems like TMD. If it's been longer than year since you've seen a dentist, you'll get a complete set of X-rays, too. Either your dentist or a dental hygienist will give you a professional dental cleaning to remove plaque or tartar buildup. And finally, your dentist will design a dental treatment plan for you based on what he or she finds during your dental exam.

Oral Cancer Screening is an important component of a dental exam that  patients often overlook says Dr. Cherukuri from her Chino, California dental practice

Dental Anxiety

It is estimated that as many as 75% of US adults experience some degree of dental fear, from mild to severe.  Approximately 5 to 10 percent of U.S. adults are considered to experience dental phobia; that is, they are so fearful of receiving dental treatment that they avoid dental care at all costs. Many dentally fearful people will only seek dental care when they have a dental emergency.   People who are very fearful of dental care often experience a “cycle of avoidance,” in which they avoid dental care due to fear until they experience a dental emergency requiring invasive treatment, which can reinforce their fear of dentistry.
Women tend to report more dental fear than men and younger people tend to report being more dentally fearful than older individuals. People tend to report being more fearful of more invasive procedures, such as oral surgery than they are of less invasive treatment, such as professional dental cleanings or prophylaxis.

 Causes

 Direct experiences

Direct experience is the most common way people develop dental fears. Most people report that their dental fear began after a traumatic, difficult, and/or painful dental experience. However, painful or traumatic dental experiences alone do not explain why people develop dental phobia. The perceived manner of the dentist is an important variable. Dentists who were considered "impersonal", "uncaring", "uninterested" or "cold" were found to result in high dental fear in students, even in the absence of painful experiences, whereas some students who had had painful experiences failed to develop dental fear if they perceived their dentist as caring and warm.

 Indirect experiences

• Vicarious learning: Dental fear may develop as people hear about others' traumatic experiences or negative views of dentistry (vicarious learning).

• Mass media: The negative portrayal of dentistry in mass media and cartoons may also contribute to the development of dental fear.

• Stimulus Generalization: Dental fear may develop as a result of a previous traumatic experience in a non-dental context. For example, bad experiences with doctors or hospital environments may lead people to fear white coats and antiseptic smells, which is one reason why dentists nowadays often choose to wear less "threatening" apparel. People who have been sexually, physically or emotionally abused may also find the dental situation threatening.

• Helplessness and Perceived Lack of Control: If a person believes that they have no means of influencing a negative event, they will experience helplessness. Research has shown that a perception of lack of control leads to fear. The opposite belief, that one does have control, can lead to lessened fear. For example, the belief that the dentist will stop

Treatment

Treatments for dental fear often include a combination of behavioral and cognitive strategies to help patients reduce their fear.pharmacological techniques.
Many people who suffer from dental fear may be successfully treated with a combination of "look, see, do" and gentle dentistry. People fear what they don't understand and they also, logically, dislike pain. If someone has had one or more painful past experiences in a dental office then their fear is completely rational and they should be treated supportively. Non-graphic photographs taken pre-operatively, intra-operatively and post-operatively can explain the needed dentistry. Pharmacologic management may include an anxiety-reducing medication.
Most importantly is the need to provide an injection of anesthetic extremely gently. Certain parts of the mouth are much more sensitive than other parts; therefore it is possible to provide local anesthesia (a "novocaine" shot) in the less sensitive area first and then moving the injection within the zone of just-anesthetized tissue to the more sensitive area of the mouth. This is one example of how a dentist can dramatically reduce the sensation of pain from a "shot." Another idea is to allow the novocaine time (5 - 15 minutes) to anesthetize the area before beginning dental treatment.

We are a practice that specializes in patient comfort. Earning the trust of our patients by thoroughly educating them of their dental choices in a caring enviroment eases patient anxieties says Dr. Cherukuri.  "I love taking care of patients of all ages especially those with special needs or those who need an extra touch of TLC".