Is Sleep Apnea a Dental Emergency?

Apr 26th, 2010
Easton Dentists Mar 1st, 2017

We’ve all heard about the dangers of sleep apnea: excessive daytime sleepiness, increased risk of accidents while driving, as well as cognitive effects. If left untreated, sleep apnea can even be fatal, which is why it is crucial to be properly fitted for oral appliances to correct the situation. Fear not, your emergency dentist in Columbus and New Albany can help!

One of the most common treatments for sleep apnea is a procedure called Continuous Positive Airway Pressure (CPAP).  In this procedure, a device is attached to a mask worn by the sufferer as they sleep.  While it is shown to be effective for many people, it is uncomfortable and awkward.

The American Academy of Sleep Medicine recommends dental devices for patients with mild-to-moderate obstructive sleep apnea who are not appropriate candidates for CPAP or who have not been helped by it. Several different dental devices are available:

· Mandibular Advancement Devices are the most widely used dental devices for sleep apnea. They look very much like a sports mouth guard, forcing the lower jaw forward and down slightly, and keeping the airway open.

· Tongue Retraining Devices are splints that hold the tongue in place to keep the airway as open as possible. Patients fitted with one should have a check-up early on to see if it is working, as it may need to be adjusted or replaced periodically.

Dental devices seem to offer several benefits over CPAP:

· Significant reduction in apneas for those with mild-to-moderate apnea, particularly if patients sleep either on their backs or stomachs.
· Improvement in sleep in many patients.
· Improvement and reduction in the frequency of snoring and loudness of snoring in most patients.
· Better long-term control of sleep apnea when compared to uvulopalatopharyngoplasty, which is the standard surgical treatment. There are also few complications with a dental device.

Of course, dental devices also come with some disadvantages:

· Dental devices are not as effective as CPAP therapy.
· The cost of these devices tends to be high.
· Side effects associated with dental devices include:
o Nighttime pain, dry lips, tooth discomfort, and excessive salivation. Over the long-term, these side effects tend cause nearly half of patients to stop using dental devices.
o Permanent changes in the position of the teeth or jaw have occurred in some cases of long-term use. Patients should have regular visits with a health professional to check the devices and make adjustments.
o In a small percentage of patients, the treatment may worsen apnea.

An orthodontic treatment called rapid maxillary expansion, in which a screw device is temporarily applied to the upper teeth and tightened regularly, may also help patients with sleep apnea and a narrow upper jaw. This nonsurgical procedure helps to reduce nasal pressure and improve breathing.  Your emergency dentist at The Dental Center can assist you in selecting the right solution for you.

Pulling Wisdom Teeth – Post Operative Care

Apr 19th, 2010
Easton Dentists Mar 1st, 2017

Having your wisdom teeth removed takes some recovery time and complications are unfortunately common. You are trying to heal an area of the body that stays moist and is bombarded with foreign substances like food particles and bacteria. Unlike a surgical incision elsewhere on the body, the incisions made in the mouth cannot be easily bandaged and protected during the healing process. Your emergency dentist in Columbus, Ohio or your oral surgeon can give you specific instructions.

Immediately after the surgery, you have to let the affects of the anesthetic wear off. That means rest. Avoid physical exertion for the rest of the day and maybe for several days after. There are great variations in the amount of rest you will need until you heal depending on your age, the amount of bone that was removed, and your own individuality.

Watch for bleeding. You will have blood-tinged saliva for the first 48 hours or so. This is normal. But if there are dark red clots of blood in your mouth, that isn’t normal. If you have gauze, bite on it while you lie still for about forty-five minutes or so. If you don’t have gauze, use a folded up paper towel—anything to put pressure on the surgical site. If the bleeding persists, call your emergency dentist in Columbus, Ohio.

If you have been prescribed pain medication, take only as needed to control the pain. If you find the pain medication inadequate to control the pain in the dosage prescribed, call your dentist.

Eat soft foods and drink plenty of liquids the day of the surgery and for a few days after. Don’t rush getting back to solid foods. Continue to eat soft foods until you can chew without pain. Make sure your diet includes protein and vitamin C. Ice cream and milk are good sources of nutrients for healing.

Keep the surgical site clean as much as you can. Start by rinsing with salt water several times a day. A teaspoon of salt in a cup of water is about the right mixture. Brush your teeth, but use a soft brush. After a couple of days, begin to brush the teeth furthest back, being sure not to disturb any loose tissue that has been sutured into place.

A common healing complication is dry socket. This occurs in 10% to 15% of patients, and is much more prevalent in the lower jaw. With dry socket, healing progresses normally for about three days, and then there is a dramatic increase in pain coming from the socket and radiating to the ear. If this happens to you, call your emergency dentist.

The roots of lower wisdom teeth may lie near the main nerve to the lower jaw, and their crowns may be near the nerve to the tongue. During the surgery, these nerves could be damaged. This happens in 1% to 2% of cases. The result is numbness in the lips, chin, and teeth on the side affected, or in the side of the tongue. This is rarely permanent, but it is annoying for several weeks up to several months. Movement would not be affected—only sensation. If this happens to you, your emergency dentist in Columbus, Ohio will be able to determine the actual cause. It may be that the nerves were not touched during the surgery, but there is swelling pressing on the nerve, causing it to go numb. In this case, a prescription of anti-inflammatory medication can ease the swelling and make recovery quicker.

If the roots of your upper wisdom teeth lie close enough to the wall of one of your nasal sinuses, your sinus wall could be perforated during the operation. If that happens, you would notice bleeding through your nose after the surgery. Call your dentist, who can advise you on how to care for it until it heals. Your dentist may want to perform a minor post-operative surgical procedure to close the hole. In rare cases, the wall between the tooth and the sinus can be so delicate that attempts at extraction cause the tooth or a piece of the tooth to be displaced into the sinus. If this happens, the piece or tooth should be surgically removed to prevent later sinus infections.

Pulling Wisdom Teeth – The Surgery

Apr 12th, 2010
Easton Dentists Mar 1st, 2017

Wisdom teeth, or third molars, are a source of dental problems for many people. As an emergency dentist in Columbus Ohio, we see our fair share of patients in pain because of their wisdom teeth.

The wisdom teeth are the last four teeth to erupt in the mouth, usually in the teenage years. The biggest problem with wisdom teeth is that many people do not have enough room on the tooth arches for the wisdom teeth to erupt normally. Because they are cramped for room, many wisdom teeth will try to come up at an angle or sideways. When this occurs, it is known as impacted wisdom teeth.

Most dentists recommend that the wisdom teeth be removed as soon as it is evident that they will not come in straight on their own. Because of expense or fear of pain, many people will choose to leave them alone if they are not hurting. This is not always wise. For one, the risk for complications from wisdom tooth extraction surgery greatly increases as the patient ages, especially if the older patient is on medications for other ailments. Secondly, when a wisdom tooth starts to hurt, it usually means that an infection has set in, making the surgery that much more dangerous. And finally, people in their late teens or early twenties heal much, much faster than older patients. The recovery time is much longer in older patients, which can lead to more opportunity for infections and complications.

Wisdom teeth are removed in a surgical operation, usually in the office of a dental surgeon or sometimes even at a hospital. If only one wisdom tooth is being removed, the dentist will apply a local anesthetic to numb the area. If several or all of the wisdom teeth are being removed, a general anesthetic may be administered. This will cause the patient to sleep through the entire procedure. You will typically not eat or drink anything the night before your surgery.

To remove the wisdom teeth, the dentist will cut open the gum tissue and remove any bone surrounding the tooth. He or she will then remove the tooth from any connecting tissue. Sometimes, the tooth has to be broken into small pieces to be more easily removed, especially if it is deeply impacted.

Once the tooth is completely removed, including the roots, the dentist will stitch the area, usually with a dissolving stitch. The area is then packed with cotton gauze to stop the bleeding and the patient is moved to a recovery area. While in recovery, the patient is monitored to make sure the anesthetic is wearing off and there are no obvious complications. The patient will be sent home with instructions on diet, oral care, and medications.

Next week, we will look at the recovery process and the common complications that arise after wisdom tooth extractions.

When Do You Need an Emergency Dentist?

Apr 5th, 2010
Easton Dentists Mar 1st, 2017

Emergency dental services are needed for a wide variety of reasons. Here’s a list of common dental emergencies that should send you seeking an emergency dentist.

Knocked Out Tooth – Any sort of blow to the face or jaw that completely knocks out a tooth or multiple teeth is cause for an emergency dentist. If possible, save the tooth and hold it in place in the socket. If that’s not possible, gently rinse off the knocked out tooth without removing any attached tissue and then put the tooth in a glass of milk. Treatment for a knocked out tooth should not wait until morning. The sooner you get to an emergency dentist, the greater the likelihood that the tooth might be able to be re-attached.

Broken Tooth – If you are involved in an accident where a tooth is broken, try to save any pieces of the broken tooth that you can and rinse your mouth out with warm water. Again, put the broken pieces in some milk if possible. To decrease the swelling and pain, apply a cold compress to the area. Get to your emergency dentist as soon as possible.

Dental Abscess — If you notice a painful, pimple-like swelling on your gums, rinse with warm salt water and immediately contact an emergency dentist. Dental abscesses can lead to serious infections if not treated promptly.

Broken Jaw — Apply a cold compress to limit swelling and go immediately to a hospital emergency room or to an emergency dental clinic. If you suspect your jaw is broken, do not wait to seek help.

Object Stuck in Teeth — Carefully try to dislodge the object with dental floss. Do not try to use a sharp instrument. If you’re unable to dislodge the object with dental floss, contact your dentist.

Severe Toothache — Rinse your mouth out with warm water. Then use dental floss to make sure there isn’t any food or other debris causing the pain. If the pain is severe and persists more than a few hours, seek emergency dental care.

Lost Dental Filling or Dental Crown — For dental fillings, cover the area with a piece of sugarless gum or over-the-counter dental cement. If a dental crown has come loose, try to put it back in place with dental cement. If that doesn’t work, bring it with you to the dentist.

Here at The Dental Center, we are the emergency dentist in Columbus Ohio for the northeastern side of Franklin County. We are open extended hours to be available for most emergencies. If you find yourself in one of these situations, please call or come to our offices. We are here to help you.