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Common Dental Problems

Posted by on Thursday, February 4, 2010, 12:15
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Burning Mouth Syndrome

Burning mouth syndrome (BMS) is a chronic oral facial pain syndrome that affects more than one million American adults, mostly postmenopausal females. It is characterized by a burning sensation, dry mouth, thirst, altered taste perception, changes in eating habits, irritability, depression, and a decreased desire to socialize .

The most commonly affected areas are the lips, palate, and tongue. Symptoms vary widely and can go away unpredictably. Most troubling is the lack of any universally effective medication. A number of oral and systemic disorders may contribute to the problem. Poorly fitting full dentures can lead to irritation and BMS.

About 20 percent of BMS patients have measurably less saliva, a condition called xerostomia. The xerostomia is often due to medications, not to classic BMS.

Snoring and Sleep Apnea

Apnea is an interruption or cessation of breathing. It most often occurs during sleep. In the most common form, obstructive sleep apnea, an individual stops breathing as many as seventy times per hour. These short episodes can each last as long as thirty seconds and can deprive the person of needed oxygen and rest, leading to daytime sleepiness and altered cardiopulmonary function.

Sufferers from sleep apnea not only snore heavily but are chronically drowsy. They have trouble staying awake through a movie, play, or even a TV show, and can fall asleep while driving. It is estimated that 2 to 4 percent of middle aged adults are affected by this condition.

Most people who suffer from obstructive sleep apnea also snore, though not all people who snore have obstructive sleep apnea. Snoring is the result of vibration of the soft palate and the adjacent structures of the throat and is caused by narrowing and thickening of the upper airway tissues.

Snoring can be complicated by overweight, hypertension, cardiopulmonary problems, craniofacial abnormalities, tonsillar overgrowth, genetic factors, and aging because of loss of tissue tone. A fairly inexpensive intra oral device that is custom fitted by a dentist has been shown to be useful for the treatment of snoring and early sleep apnea.

The device opens the airway by keeping the lower jaw slightly open and forward. Most patients report substantial improvement at first, but some find the device to lose effectiveness after a period of time, ranging from months to three years, probably because of the thickening with age of the airway tissues. Surgery has been tried with lasers and other techniques, with inconsistent results. We feel that surgery should be tried only as a last resort.

The most effective treatment by far is the use of an air pump called a CPAP,  which forces air through the nose while you sleep The CPAP successfully deals with most cases of apnea and, as bonus, eliminates snoring. Many CPAP patients report that the are now wide awake; they claim that they no longer fall asleep the theater or at the wheel and have stopped snoring. CPAP should be prescribed and fitted only after a careful evaluation done by a physician specializing in sleep disorders.

Tobacco Related Diseases

Tobacco has special meaning to dentists not only smoke but also chew tobacco. Chewing tobacco known as smokeless tobacco (ST), has been strongly associated  with nicotine addiction and an increased risk of developing oral cancer.

More than five million Americans are estimated to use ST, resulting in a higher prevalence of precancerous lesions, gum loss, and loss of tooth structure next to the area of the cheek where the wad of tobacco is held.

Baseball players are famous for the wad of tobacco many carry around in their mouths. These athlete addicts have influenced many young people to copy their behavior and their addiction, often with the false belief that ST can enhance their athletic performance and that it’s safe.

Research has shown that ST has no effect on performance, and we’ve known for many years how immensely dangerous it is to keep a wad of tobacco pressed against your cheek. Fortunately, the use of ST has been banned by virtually all of the well known children’s baseball organizations, as well as all of the minor league clubs.

But as a recent article in the Journal of the American Dental Association said, “Even though dipping and chewing (of tobacco) is illegal on tens of thousands of diamonds across the country its presence on just 28 major league diamonds undermines all the efforts.”

As for smoking, we all are familiar with its dangers and how it greatly increases the risk of contracting cancer and heart disease. As if that isn’t enough, it is also associated with adult gum disease and early onset juvenile gum disease. The overwhelming conclusions of dental studies of smokers is that “the risk of smoking could greatly accelerate tooth loss.”

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