Snoring and Sleep Apnea. You Could Die!

Sorry for the drama. But this is important.

One of the things many of the women patients in our practice tell me is that their husbands snore. Even some of the men tell us that about their wives. It really disturbs their sleep.

That's not good, but that’s not the most important thing.

Many of the snorers also stop breathing and than suddenly gasp for breath — sometimes dozens of times an hour!

This is called Obstructive Sleep Apnea, or OSA. It’s very dangerous.

Obstructive sleep apnea is a common disorder that affects more than 18 million people in the United States. In many of these people, the condition is undiagnosed. People with OSA literally stop breathing repeatedly during their sleep, often for a minute or longer and as many as hundreds of times during a single night.

Sleep apnea can be caused by either complete obstruction of the airway (obstructive apnea) or partial obstruction, both of which can wake one up. OSA occurs in approximately 2 percent of women and 4 percent of men over the age of 35.

It is important to emphasize that, often, the person who has obstructive sleep apnea does not remember the episodes of apnea during the night.

The main symptoms are usually associated with excessive daytime sleepiness due to poor sleep during the night. Often, family members, especially spouses, witness the periods of no breathing.

A person with obstructive sleep apnea usually snores heavily soon after falling asleep. The snoring continues at a regular pace for a period of time, often becoming louder, but is then interrupted by a long silent period during which there is no breathing. This is followed by a loud snort and gasp, and the snoring returns. This pattern repeats frequently throughout the night.

During the nonbreathing episodes, blood oxygen levels fall. Persistent low levels of oxygen may cause many of the daytime symptoms. If the condition is severe enough, pulmonary hypertension may develop, leading to right sided heart failure.

Symptoms that may be observed include:

Abnormal daytime sleepiness, including falling asleep at inappropriate times

Awakening unrefreshed in the morning

Depression (possibly)

Episodes of no breathing (apnea)

Lethargy

Loud snoring

Memory difficulties

Morning headaches

Personality changes

Poor concentration

Restless sleep

Abnormal heart rhythm (arrhythmia)

Excessive carbon dioxide levels in the blood

High Blood Pressure

Heart disease

Sleep deprivation

Stroke

So why is a dentist talking to you about this? Because dentists can be terrifically helpful with mild to moderate OSA.

Dentists with a special interest in this issue know how to make an oral appliance that advances the jaw in sleep and keeps the airway open. Sometimes this is all that is needed to stop the problem.

These appliances are easy to wear in sleep and the involvement in sleep quality, to say nothing about the improvement of the sleep for the partner, can be remarkable.

The alternatives are for the OSA person to use CPAP (continuous positive airway pressure) devices, which involve a mask that fits over the face and and a machine that pumps air under pressure to force breathing. And there are surgical procedures that may be able to help.

I personally favor the oral appliance called Somnodent, and my patients have found it to be comfortable and effective.

If you are told you snore loudly or stop breathing in sleep, or if your partner does this, please seek help. The diagnosis is usually made by having a sleep study at a sleep center, but some cases are just plain obvious.

But don't neglect OSA. It can kill you.

Call us if you want more information about this. 845-297-6206. Or write: DrSteveRoss@aol.com.

So You Think You Have Migraine? Maybe Not!

For years I've been telling patients who are taking medication (a polite name for drugs) for migraine headaches that they may not actually have migraine.

What, you say?

No, really.

This month, Redbook Magazine, the ultimate source for dental and medical information, had an article about the four most frequently misdiagnosed syndromes. Guess what number 2 was.

2. Headaches and/or ringing or aching ears, plus aching back, neck, and/or teeth.

The doctor says: It's migraines (or an ear disorder).

It could be: Temporomandibular joint syndrome. The temporomandibular joint (say it three times fast) are the two jaw joints in front of your ears.

When this joint, which connects your jaw and skull, becomes inflamed, the pain radiates and causes headaches and pain in your face. And sometimes TMJ problems are really chewing muscle problems, where the muscles that move your lower jaw get stressed out. This often happens when you clench or grind your teeth in your sleep.

It hurts! It makes you avoid chewing foods that are not soft or that take a lot of chewing to get down.

And it can give you headaches. Sometimes bad ones. And sometimes your M.D. will call it migraine and give you drugs.

TMJ is best treated by a dentist with training in this stuff. We have a special interest in this and have helped a ton of patients become comfortable. Without strong drugs. Without jaw joint surgery.

Maybe you are the one who fits this situation.

I hope this blog was helpful. We'd be glad to talk with you if you have questions or want to explore help.

Validation

Today I just want to share something really special.

Trust me. It will make you smile.

It's a short video. Watch it through.

Please. The link is right below.

Because you are great! You are amazing!

http://www.metacafe.com/watch/yt-Cbk980jV7Ao/validation/

Are You Throwing Away Dental Insurance Benefits?

As long as I'm on the subject of dental insurance (take a look at my last blog) it's time to talk about a big mistake that lots of people make with their dental insurance plan.

Because it's half way through August already and the time is flying by. Soon it will be Autumn and after that the year-end is getting near. Time really goes fast when you're having this much fun, right?

What's the mistake? Throwing away valuable dental insurance benefits! Why would you do that, you ask? I'll tell you.

Most insurance plans have an annual maximum benefit payment limit that usually expires at the end of the year. This means that if you don't use this year's benefits, you lose them! Unused benefits do not roll over at the end of the year. The dollars that your insurance company will pay you toward dental treatment that were not paid out at year's end, are lost dollars. They're just gone, and you can't get them back.

This is a big bonus for the insurance company, because they get the premium no matter whether they pay out benefits you could have gotten or not. They get richer and you get nothing for it.

If you have dental insurance, get your dental treatment done before December 31st! Or start some of your treatment NOW and continue treatment in January to possibly DOUBLE your benefits! This way you use double your yearly maximum in a two month period (December and January).

You or your company pay good money to get these benefits. Don’t put off treatment and lose your yearly allowance. Avoid the holiday rush and schedule today!

A Smart Patient doesn't sit around and throw away help. If there is care you need or care you just plain want, but have not gotten around to it, now is the time to get moving. Make an appointment. As Ben Franklin said, "Any job, once begin, is half done."

Be smart. Don't waste your benefits. Call your dentist!

Dental Insurance: Storm Clouds on the Horizon

If you are a dental patient with dental insurance, change is coming and you may not like it!

When I was beginning in dental practice there was no dental insurance. Imagine that! No insurance. Everyone had dentistry anyway: crowns, bridges, root canals, fillings, checkups - the whole thing.

Then dental insurance came along and that made things a lot easier for people. They had help with the cost of care and their employer or union paid for the insurance plan.

But. As the years past, employers and unions began to feel the weight of the dental insurance (and health insurance generally) on their bottom lines and they began to cut back.

In 1970 the maximum benefits you could use in one year was about $1000, and that bought quite a lot of dentistry at 1970 fees. Almost 40 years later in 2009 the maximum benefits you could use in a year is still $1000 to $1500 for most plans. That buys much less dentistry at today's fees.

And now most people have to pay part of the cost of their dental insurance through payroll deductions and co-pays. So the value of your insurance is getting smaller and smaller.

And to make it worse, many businesses - especially small businesses - are discontinuing health insurance completely because the cost is killing their business.

To add to the burden, most people who lose their job or change jobs lose their insurance. Ow!

Feel bad enough? Wait - there's more. We have noticed something that some employers and their dental insurance carriers are beginning to do. They are reducing the benefits for specific services.

Here's an actual example and it happens every day. A patient whose fee of $133 and was benefited in full last year and who had the same service last month now is getting only $126.39 for that same service. The benefit has been lowered and it's only the beginning.

Another thing that is happening is that waiting periods for replacement of dentistry are getting longer. For example, most insurances plans will pay a benefit for a new crown if the old one breaks after 5 years in the mouth. But now we are beginning to see 10 year wait periods.

It's the same for things like x-rays. A good standard of care in dentistry is for a patient in good dental health to have diagnostic x-rays every three years. This is good preventive practice, like mammograms or colonoscopy in medicine. But now we are seeing insurance plans that will not pay the benefit until 5 years have passed. Waiting that long is dangerous and leads to undiscovered problems that are much worse when they are found.

But employers do not care much about that when they are struggling to keep the business going in the face of rising health insurance premiums.

Why is this important to you? Because if you wait until next year to have recommended dental treatment, you may be paying more out of pocket for it, due to this new trend. The insurance company saves money at your expense, because some people will not use their full annual maximum and those people help offset the insurance company's annual outlay of benefits.

The employer saves money at your expense because they can purchase a lower-cost policy for each of their employees. There is only one loser with this trend: You.

So what can you do?

Your dental health is important. If you lose it you will suffer. Things will get difficult. But you can do a few things:

1. Have regular evaluations. Do not skimp on the schedule. We establish an interval with our patients based on their individual situation. Those evaluations and professional cleanings have a powerful effect on our patients' dental health. Not only do they make sure things are not overlooked but they are, let's face it, motivating. That matters.

2. Personal oral hygiene is critical. Our patients know how we always talk with them about the bacterial biofilm called plaque and how we work with them to be sure they have great tools and techniques for reducing it. It works. It's in your hands and you have the power.

3. Don't put things off. If you need dental treatment, move to get it done before you find that you are now receiving less help from your insurance carrier. Or even that you have no insurance at all. If we have suggested or recommended care for you, try to stop talking yourself out if it. Three of the most powerful words in getting what you want are these: Just do it!

4. Share your economic situation with the office. Like most dental offices, we have payment plans and we can help. Sometimes things can be staged. There is usually a way. But it all starts with you saying “YES!”

5. Stay positive. Earl Nightingale wrote a famous book about what he called “The Strangest Secret”. It is this: You become what you think about. If your thinking is negative, negative will come into your life. Zig Ziglar, famous motivational speaker, calls that “stinkin' thinkin'. Colin Powell, distinguished General and former Secretary of State, says, “Do not let fear be your only counsellor.” And I like the well known acronym for FEAR. Here it is: False Evidence Appearing Real.

6. Be smart. Understand the situation and act to protect yourself. Dental insurance is uncertain, even though we have become used to it. The world is changing and we can't stop it. But we can still win by being a Smart Patient.

If you have questions or want to talk with us about anything just call or send e-mail. We are a dental office that cares and we can help.