Obstructive sleep apnea is a condition created when a portion of the upper airway is blocked, causing breathing interruptions during sleep and low blood oxygen levels. As many as 20% of adults are affected by mild obstructive sleep apnea, while one in fifteen suffers from more severe apnea.
Symptoms of obstructive sleep apnea include snoring, extreme daytime drowsiness, restless sleep, high blood pressure, depression, problems with mental function, as well as a host of other mental and physical concerns. Left untreated, obstructive sleep apnea can lead to a long list of serious medical conditions, including hypertension, heart attack and stroke.
If you have been diagnosed with obstructive sleep apnea, your doctor may initially treat the condition with a CPAP device that you wear while sleeping. While a CPAP machine will reduce the obstruction to the airway, it is not a cure and will only be effective during use. Other non-surgical treatment recommendations may include the wearing of mouthguards to reposition the jaw, sleep position changes, or weight loss.
Tongue muscle advancement involves moving the bony attachment of the tongue muscles, and can be combined with palatal surgery to reduce excess tissues. This therapy may also include removing enlarged tonsils and nasal surgery. These treatments are most often used for milder cases of obstructive sleep apnea.
However, if these treatments do not work or for more severe cases of obstructive sleep apnea, oral surgery offers solutions to correct apnea. Maxillomandibular Advancement is a procedure that repositions the upper and lower jaw and chin to open the airway. This treatment is highly successful and offers the greatest chance of permanent correction in moderate to severe cases of obstructive sleep apnea.
For more information about how surgical therapies and treatments can be utilized to address your obstructive sleep apnea, consult with a qualified oral and maxillofacial surgeon.
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While minor gum recession can be treated by your dentist with deep cleaning and antibiotics, serious gum recession can only be treated with oral surgery. A loss of bone and gum pockets that are very deep require gum surgery to address the pain and damage left by acute gum recession.
Three treatments are used primarily in the treatment of serious gum recession, in order of invasiveness: pocket depth reduction, regeneration, and soft tissue graft. Pocket depth reduction involves a deep cleaning of the affected area. The periodontist folds the gum tissue back and utilizes tooth scaling and root planing to remove any tartar and plaque built up around the tooth. Once the gum pockets are clean, the surgeon pulls the gum tissue gently around the tooth, eliminating the deep pockets altogether or significantly reducing their depth.
Regeneration utilizes a similar treatment to pocket depth reduction, but it also addresses any bone loss that occurred due to acute gum recession. In this process, a regenerative agent such as graft tissue, membranes or tissue stimulating proteins is added to the affected area. The gum tissue is then tucked into place and stitched down. Over time, the regenerative agent will work to rebuild lost bone and tissue, leaving healthy and thriving tissue behind.
The most common soft tissue graft is taken from the patient’s own mouth, either by removing tissue from the roof of the mouth or from the gum tissue near the affected tooth. The healthy gum tissue is placed in the affected area, over the exposed tooth root, protecting it from infection and damage.
To prevent the need for oral surgery to address your receding gums, have good oral hygiene habits. Brush, floss and see your dentist twice a year for checkups and professional cleanings. Talk to your dentist if you have any other questions about how to reverse or prevent gum recession.
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You might think that the point of going to your general dentist is for cleanings and maybe an occasional filling. But you are wrong if you believe that’s all your dentist can offer you! A wide variety of treatments is available at a typical general dentist’s office.
Most visits to your general dentist include an initial consultation, thorough examination, and diagnostic tests if needed like dental x-rays. You’ll have the opportunity to express any problems or concerns you have, and your dentist will identify any issues that you might not be aware you have. You can also expect a meticulous professional cleaning to eliminate tartar buildup and stains that you may not have been able to get rid of at home.
You can expect these common procedures at many general dentistry practices:
- Fillings – to repair damage caused by tooth decay, often using composite resin material to provide a strong yet cosmetically appealing solution.
- Bonding – using composite resin to repair issues like cracks, chips, gaps or stains.
- Crowns – also called caps, these restorations are fitted over damaged or broken teeth to restore tooth structure and function, and to protect them from future damage.
- Bridges – to replace missing teeth, a bridge structure anchors an artificial tooth or teeth. Crowns fit over natural teeth on both sides of a gap, in which the artificial tooth replaces a missing tooth to provide a natural appearance and functional replacement.
- Dentures – if a number of teeth are missing, dentures are removable false teeth with the goal of functioning and looking like real teeth.
- Root canal treatment – when the interior pulp of a tooth is badly damaged or infected, this procedure removes the faulty portion and completely restores the tooth to avoid tooth loss.
- Teeth whitening – when teeth have become discolored with age, tobacco use, diet, or more, it can be very difficult to restore their white shade without the aid of professional whitening. General dentists may offer at-home kits or in-office whitening treatments.
- Maxillofacial treatments – mouth, jaw, or facial procedures are sometimes offered, including options like TMJ treatment or dental implants.
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Gum disease is a serious problem. You should treat it as soon as possible following the recommendations of your dentist. Also known as periodontal disease, it has several treatments, depending on the severity of the issue.
Your first course of action is to completely revamp your oral hygiene habits. Daily flossing and brushing following meals are essential habits to develop. You must have a clean mouth before you go to bed. If you smoke, you should stop. Your mouth’s health depends on it.
If you haven’t been keeping up with your professional checkups and cleanings, you need to start again. Long-term gum health is greatly impacted by the plaque, tartar, food debris and bacteria left on teeth. Hardened calculus, or calcified plaque, can be removed using a process called scaling. This process may require local anesthesia.
Your progress will be evaluated by your dentist to see if your gum tissue is recovering. With enough progress and response to treatment, your gum disease treatment may not progress beyond these initial steps; however, for more severe cases of gum disease, you may require oral surgery.
Surgical procedures are available that can regenerate and repair the soft gum tissue in the mouth, as well as hard tissues such as bone or teeth. Your oral surgeon will want to reduce or completely eliminate gum pockets, or open areas beneath the gum line, improving and renewing gum to tooth attachment. Normal oral functions and aesthetic appearances are aimed to be restored.
There are many sedation dentistry options available to patients treating their gum disease with oral surgery. These include local anesthesia and IV or conscious oral sedation. Talk to your oral surgeon to see what’s appropriate for your specific needs.
Don’t wait to treat your gum disease. Do what you need to do to ensure a lifetime of better oral hygiene and gum health.
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If oral surgery is in your future, you might be worried about what’s to come. The way to relieve that worry is to talk to your oral surgeon. Your oral surgeon has the experience and knowledge necessary to guide you through whatever concerns or questions you may have. Here is a guide to some of those questions and answers:
How will I handle pain following surgery?
- In many cases, you will have been prescribed narcotic pain relievers. If you are taking narcotics, take them only as recommended and do not mix them with over-the-counter pain relievers or alcohol. Driving while on narcotics is dangerous and can have serious consequences for you personally and for others. If you weren’t prescribed any medication, use anti-inflammatory analgesics such as ibuprofen or naproxen sodium.
What will happen to my stitches in the days following surgery?
- Some stitches will be designed to dissolve over time and will not need to be removed. Others will not come out on their own and will need to be removed at a subsequent appointment. In many cases, losing a single stitch or two in the days following surgery isn’t serious; however, for bone-graft treatments, it is problematic and you should contact your surgeon immediately.
Can I eat normally after surgery?
- Immediately after surgery when you’re still experiencing any mouth or tongue numbness, don’t eat anything. You could mistake the soft tissues of your mouth for food and do serious damage to your mouth without realizing it. After your numbness subsides, consume soft foods of tepid temperatures for several days to allow for healing. Talk to your surgeon to learn when you can resume normal eating patterns as dictated by your particular surgery.
What other tips do you have?
- Stay hydrated and rest as much as possible to facilitate complete and quick healing. Call your surgeon if you have excessive bleeding or pain that doesn’t lessen with time. Be aware of signs of infection (swelling, redness, odorous or sour discharge) at the surgical site and seek professional care when needed.
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Oral surgery to correct problems with the jaw is known as orthognathic surgery. Jaw issues can result from birth defects, changes due to growth, or injury or trauma to the face. While orthodontics can correct bite problems when only the teeth are involved, oral surgery may be required when repositioning of the jaw is necessary to correct the issue. If you suffer from any of the following concerns, orthognathic surgery may be a consideration:
- Difficulty chewing, biting or swallowing
- Problems with opening and closing your mouth, or with speaking
- Persistent jaw or temporomandibular joint pain
- Clenching or grinding of teeth causing excessive wear to the teeth
- Inability to make the lips meet without straining
- Un-proportional facial appearance or protruding jaw
- Malocclusion, open, or incorrect bite
- Recessive lower jaw and chin
- Sleep apnea and breathing problems
Most jaw surgeries are performed completely in the mouth, so no facial scars are visible. The oral surgeon makes cuts in the jawbone and then moves them to the correct position. Once the jaw is correctly aligned, screws and bone plates are placed to secure the jaw into the new position. Sometimes it may be necessary to add extra bone to the jaw from your hip, leg, or rib.
Orthognathic surgery is performed by an oral and maxillofacial surgeon usually in a hospital setting. Recovery time from jaw surgery takes three to six weeks. Your general or family dentist should be able to refer you to a skilled oral surgeon for a consultation and examination to determine a treatment plan. Jaw surgery can improve not only your facial appearance, but also chewing, speaking and breathing functions.
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