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Sicker than you think you are

11/5/2015

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I can't help but write about what happened with a patient today.  He was taking a day off work to get his yearly physical and dental exam.  He made the comment, "Im not looking forward to this physical because it is going to be a complete physical."  This was something he has never had before. "Complete" to him meant running every test available instead of his company's yearly exam of eyes, ears, tapping the chest, breathing deep and nodding of the head.

This man is in his middle 50's, just when high blood pressure, strokes, heart disease and diabetes usually begins.  Anyone this age and above is just waiting for the doctor to tell him it is pill-taking time.  Because of my experience in screening for apnea, I was quite sure this man had breathing issues, especially at night, and I wanted to make sure the physician addressed it, so I brought up  the issue.  He smiled and said, "To tell you the truth, my wife is making me go to this appointment because she is tired of my snoring."

I asked him what he would do if someone tried to choke him as he slept. I had asked and Army Special Forces veteran patient the day before, and his immediate answer was, "Your eyes and throat would be gone."  His response is a perfect example of the fight-or-flight response when danger approaches.  You either fight or flee. Either way, when danger approaches, adrenaline is released, putting the body on high alert.

I use the choking analogy because it brings home the seriousness of sleep apnea.  Apnea simply means to quit breathing.  No breathing, no oxygen, and without oxygen, death occurs within a few minutes.  No oxygen not only starves the body's tissue, it created the fight-or-flight response, and this increases blood pressure. Increased blood pressure causes heart and stroke problems.  Everything becomes a vicious cycle when a person cannot get enough oxygen.  Oxygen is the No. 1 drug the body needs.

This patient also said he just couldn't see himself sleeping strapped with a mask and tethered to a machine.  He felt if he had a sleep study, he would go home with a CPAP.  He was unaware he could wear a dental appliance that is FDA-approved and is recommended treatment of mild to moderate sleep apnea.  We showed him what they look like, and he was pleased.

Dentists, with special training in sleep dentistry, can make a sleep appliance that holds the jaw forward.  When the jaw is forward, the tongue follows and opens up the airway, allowing the needed oxygen.  It also allows much more room for the tongue.  These devices work extremely well and, in many cases, can totally replace the CPAP.

Dentists cannot diagnose sleep apnea, but they can and should screen for it.  I work with special trained sleep physicians and sleep clinics.  If we make a patient a sleep device, it is imperative to prove that it is effective.  The first step is to know if the patient is getting enough oxygen or not.  We do this by sending a small wrist band pulse oximeter home with the patient after the appliance is delivered.  The next day, I plug it into the computer to check the night's oxygen level.  If the percentages are not above 90, I adjust and check again. 

Once the results look good, this information is sent to the sleep physician, and then another and hopefully last formal sleep study is performed and read by the physician.

Please remember that oxygen is life's No. 1 drug.  Without it you die, and with too little oxygen, you are tired, run down, and quite frankly, sicker than you think you are.  When the doctor or spouse talks about it, pay attention.  

If you think you can order your anti-apnea products over the internet without the help of the medical/dental profession, you are playing Russian roulette.  

-By Mac Lee

​https://dailyhealthpost.com/aspartame-is-linked-to-leukemia-and-lymphoma-in-landmark-study-in-humans/?fbclid=IwAR3sHBe071rTBFRMZrWuNBAJi7TQTdPB4EVZ0fg3q25kFi9Bf93bGmcP-Dg
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Dental Humor

10/19/2015

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Cute but very informative video on Oral Cancer.... don't ignore the signs!!!

5/26/2015

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15 Uses for Old Toothbrushes

5/7/2015

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Old tooth brushes are one of my favorites items in my cleaning arsenal. There are endless uses for old toothbrushes in and around the home and you’re saving a good chunk of money on cleaning products by re-purposing something you already have. We try to keep up to date with changing our toothbrushes – I even mark a date on mine (if I remember) with permanent marker to remind me to start using a new one, so we have a regular supply for reusing elsewhere.

Before reusing a toothbrush I leave them to soak in a sink of hot water with a cap full of bleach or a solution of 50/50 white vinegar and water for a couple of hours. Then rinse and leave to air out and dry. 


15 USES FOR OLD TOOTHBRUSHES


1. An old tooth brush is perfect for cleaning the grime filled spots around taps. How do they get so dirty so fast? Wet the area with white vinegar and get straight in there with the tooth brush for a good scrub.

2. Do you like to grate garlic? You may find your grater can get a bit pongy. Enter an old toothbrush and some bicarbonate of soda. Dip the toothbrush into the bicarb and scrub across the grater in circular motions. Rinse thoroughly until all smells gone.

3. Remove mud from the tread of shoes.

4. An old toothbrush is perfect for cleaning computer keyboards.

5. Give the bristles on brushes and teeth on combs a good scrub with an old toothbrush when you come to cleaning them.

6. Soften your old toothbrush with hot water and soap and lightly rub over a splinter. It should very gently bring it to the surface.

7. Keep your lips buffed up and kissable by sloughing off any rough or dead skin with an old toothbrush.

8. They’re very handy for cleaning fiddly bits in slatted blinds or even curtain rings or tracks which can easily get dusty or gungy.

9. Old toothbrushes make for a very handy nail brush. I keep one in my gardening kit for just this purpose.

10. An very slightly damp toothbrush is perfect for cleaning delicate jewelery.

11. Get the grout between your bathroom or kitchen tiles gleaming with an old toothbrush…it’s strangely satisfying too. Just don’t scrub too hard on or near the sealant because it could break.

12. They’re perfect for cleaning bike chains. Mr Thrifty always seems to have one on him for getting his bike back to good health.

13. We keep one handy for cleaning out our fish tank or any of the fish tank ‘furniture.’

14. You know the hinges on your toilet seat? It’s a grim place to clean but a toothbrush makes it easier to get shiny and clean.

15. Keep an old tooth brush on hand for spot cleaning stains and spills on clothes or around the house.


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Sleep Apnea in women and why it's underdiagnosed

5/7/2015

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Picture the typical person with sleep apnea.

Odds are, you just thought of a man. But studies show that almost one in two sleep apnea patients is a woman. How likely are women to have this disorder…and how often are they treated?   



The Gender GapIt is true that women are less prone to sleep apnea than men, but this doesn't mean that they're not at risk. According to the American Academy of Sleep Medicine, at least 2% of women suffer from obstructive sleep apnea (OSA), compared to 4% of men.

However, the rate of female diagnoses for the disorder is disproportionately low: about 1 woman per 2-3 men. Why are women so underrepresented?

One side of the discrepancy is mental: sleep apnea is often portrayed as a man’s disorder. Historically, sleep apnea was considered an issue that afflicted mainly men and occurred only rarely in women. In fact, studies from the 1970s and 1980s suggested a ratio of prevalence of 1 to 60.Research focused on male subjects and therefore produced a list of symptoms tailored to men. 

Another side of the issue is that properly diagnosing women is just more challenging. Women tend to present more ambiguous symptoms, which can lead to misdiagnosis along the lines of anemia, depression, diabetes, hypertension, hypothyroidism, or hormonal changes during menopause.  Furthermore, experts suspect that women are less likely to report relevant symptoms, such as snoring.   

What are the risk factors and symptoms of sleep apnea in females?One of the biggest risk factors is common to both sexes: obesity. Post-menopausal women are more than three times as likely to have sleep apnea. Pregnant women may also find themselves at higher risk (for more information, see our blog posts on sleep and pregnancy).

Symptoms most often found in females include headaches or swollen feet upon awakening, snoring (though often more subtly than in men), fatigue and daytime sleepiness, insomnia, and frequent awakening during the night. 

Studies have also shown that women are more susceptible to negative health effects resulting from sleep apnea. A study at UCLA found that the heart rate of women with sleep apnea was less likely to adjust during physical activity than that of men with OSA, which could indicate that females are more vulnerable to heart conditions. Other studies found women to be at higher rest of inflammation, hypertension, and dementia.

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Read the following article to find out how serious snoring/sleep apnea can be to your overall health. If you know someone who stops breathing in their sleep, call us. We can help!!!

5/7/2015

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Sleep apnea disorder poses risks, but is treatable By Darla Carter, The (Louisville, Ky.) Courier-JournalUpdated 11/18/2011 9:45 AM

Janet Purlee would wake up several times a night, gasping for air.
An estimated 12 million to 18 million U.S. adults have sleep apnea, according to the sleep guide.


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Sleepiness and sluggishness would dog her during the day and darken her mood.

"I was very depressed because I just was so tired all the time, just extreme fatigue," said Purlee, 53, of Jeffersonville, Ind. "It was just a battle to stay awake during the day."

The married mother of two was also a severe snorer, whose nighttime rumblings would "wake the whole family."

It was "raise-the-roof kind of snoring," Purlee said.

A sleep study determined that Purlee was suffering from a severe case of obstructive sleep apnea. It's a condition in which people have trouble getting enough air into their lungs while they sleep, according to the National Heart, Lung, and Blood Institute.

The problem occurs when there's intermittent blocking of the upper airway, usually when the soft tissue in the rear of the throat collapses, causing a partial or complete closure, according to "Your Guide to Healthy Sleep," an NHLBI handbook.

As the person sleeps, his or her bed partner may hear interruptions in the person's snoring or what sounds like pauses in the person's breathing. These pauses may occur 20 to 30 times or more an hour, according to the guide. But the person with sleep apnea may have no awareness of what's going on.

They may simply report that "they're waking up not refreshed" in the morning, said Dr. Kenneth Anderson, a specialist in pulmonary and sleep medicine at the Baptist Hospital East Sleep Disorders Center.

Snoring and daytime sleepiness are among the most common symptoms, said Dr. William Lacy, a physician with Sleep Medicine Associates in Louisville.

"I have had people who have significant sleep apnea and their bed partners swear they don't snore, but that's fairly uncommon," said Lacy, who treats patients at the sleep center at Sts. Mary & Elizabeth Hospital.

In addition to the snoring nuisance, sleep apnea can lead to serious health consequences, ranging from car wrecks to cardiovascular issues, the doctors said.

For example, "severe sleep apnea increases your stroke risk three times over your normal risk," and it's "an independent cause of hypertension, so the cardiovascular risks are very important," said Anderson, a vice president and chief medical officer for Baptist Hospital East.

To treat her sleep apnea, Purlee, a patient at Baptist's Sleep Disorders Center, was told to begin using a continuous positive airway pressure machine, which requires patients to wear a mask while they sleep. The machine, referred to as CPAP, uses mild air pressure to keep the patient's airway open.

"Getting the diagnosis and getting on, at that time, CPAP was like a miracle in my life," said Purlee, who was diagnosed in 2002. "The CPAP machine has allowed me to get a full night's rest, without severe snoring and waking up gasping for air."

CPAP is just one of the treatments available to people who suffer from sleep apnea, which is one of the most common sleep disorders in the country.

An estimated 12 million to 18 million U.S. adults have sleep apnea, according to the sleep guide. Children can develop it, too, but may appear hyper rather than sleepy, Lacy said.

"Identifying obstructive sleep apnea in kids is very important," said Lacy, who said treatments for children include tonsillectomy and CPAP.

Identifying type

Most people who are diagnosed with sleep apnea have the type called obstructive sleep apnea.

"Your airway narrows more than it should and then your brain sort of senses this reduction in airflow and says, 'OK, I need air,' " so you will have multiple awakenings, said Lacy, who specializes in pulmonary and sleep medicine as well as critical care.

To diagnose sleep apnea, people are often asked to stay overnight at a sleep center to be studied. Various things are measured, such as heart rate, oxygen saturation, brainwaves, arousals and breathing movements, Lacy said.

With sleep apnea, there's "decreased flow of air but with continued or even increased effort in your chest and belly, so you're trying to breathe, and we can see that, but your airway is closed off or narrowed," Lacy said.

Of treatments included in a recent review for the Agency for Healthcare Research and Quality, CPAP had the strongest evidence to support its effectiveness for treatment of adults with obstructive sleep apnea. "It's absolutely the gold standard," because it's reliable and effective, Lacy said. "Your snoring goes away, all these arousals and interruptions of your sleep go away, you're able to fall into those deeper stages of sleep naturally, and generally, you wake up feeling refreshed and ready to go."

Other treatments

Alternatives include a mouthpiece called a mandibular advancement device, which can be very effective, according to the AHRQ report. Weight loss and surgical treatment also may help, but the evidence for them isn't as strong, the report notes.

"If you're heavy, weight loss should be part of your treatment no matter what treatment you get," Lacy said, but it may not end the problem. "Rarely will I see the person lose weight and get off their treatment; it's just so hard to do."

Purlee, a former occupational therapist, has an enlarged tongue that contributes to her sleep apnea. She also has multiple health problems, including a rare immune deficiency disorder that adds to her fatigue and daytime sleepiness.

After using CPAP for a while, she switched to a BiPAP (bilevel positive airway pressure) machine for extra help. BiPAP makes it more comfortable for patients to exhale, Anderson said.

Purlee also uses a bite guard, which she obtained from a dentist, to help her breathe better, and she takes medicine to treat daytime sleepiness.

Paul Markwell, 49, of Louisville was diagnosed with sleep apnea in May. The loan officer used to get up many times during the night to use the bathroom and relied heavily on caffeine and naps for energy. But he's noticed a big improvement in his symptoms since starting CPAP treatment.

Now, "I'm not waking up every two hours to go to the bathroom," said Markwell, who is one of Lacy's patients. "I don't need nearly as much coffee in the morning. I used to have to have a 15-minute nap every day when I came home. I don't need that anymore. €1/8 Now, I can stay up and watch Monday Night Football.

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Great video on what sodas do to your teeth and body

5/7/2015

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Just a little Sleep Apnea humor

5/7/2015

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SLEEP APNEA does NOT just affect adults! Awesome video!!!

5/7/2015

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Check out this great article about Sleep Apnea

5/5/2015

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Sleep Apnea By the NumbersPosted on March 9, 2015 by Megan Kelly


Many people understand that snoring or tiredness can be attributed to sleep apnea, but the disease can actually result in many other issues that affect every aspect of a person’s life. Sleep apnea is also a wildly under-diagnosed condition that leaves millions of people at risk every day, both because people do not think to get sleep tested, and because doctors do not prescribe sleep tests as often as they should.

  • If you’ve been diagnosed with diabetes, your likelihood of having sleep apnea is 50% higher than someone without diabetes. If you’re both obese and diabetic, you’re 77% more likely to have sleep apnea. And if you fit both of those categories and your diabetes is Type II, you’re 87% more likely to have sleep apnea.
  • Untreated apnea patients are three times more likely to die in a car crash than someone without sleep apnea.
  • 90% of people with sleep apnea don’t know they have it – and neither do their doctors.
Sleep apnea is a treatable disease. If you are concerned about sleep apnea, contact a physician or other licensed healthcare professional.

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