Posts for: December, 2014
Jillian Michaels, personal trainer and star of television's The Biggest Loser isn't afraid of a tough situation — like a heart-pumping exercise routine that mixes kickboxing with a general cardio workout. But inside, she told an interviewer from Dear Doctor magazine, she's really a softie, with “a drive to be one of the good guys.” In her hit TV shows, she tries to help overweight people get back to a healthy body mass. And in doing so, she comes face-to-face with the difficult issue of sleep apnea.
“When I encounter sleep apnea it is obviously weight related. It's incredibly common and affects millions of people,” she says. Would it surprise you to know that it's a problem dentists encounter as well?
Sleep apnea is a type of sleep-related breathing disorder (SRBD) that's associated with being overweight, among other things. Chronic loud snoring is one symptom of this condition. A person with sleep apnea may wake 50 or more times per hour and have no memory of it. These awakenings last just long enough to allow an individual to breathe — but don't allow a deep and restful sleep. They may also lead to other serious problems, and even complications such as brain damage from lack of oxygen.
What's the dental connection? Sleep apnea can sometimes be effectively treated with an oral appliance that's available here at the dental office. The appliance, worn at night, repositions the jaw to reduce the possibility of the tongue obstructing the throat and closing the airway. If you are suffering from sleep apnea, an oral appliance may be recommended — it's a conservative treatment that's backed by substantial scientific evidence.
As Michaels says, “I tell people that [sleep apnea] is not a life sentence... It will get better with hard work and a clean diet.” So listen to the trainer! If you would like more information about sleep-related breathing disorders, please contact us for a consultation. You can learn more in the Dear Doctor magazine article “Sleep Disorders and Dentistry.”
Many people have questions about the proper use of antibiotics — especially today, as the overuse of these medications has become a concern. It isn’t necessary for most people to take antibiotics before having a dental procedure. But for a few — notably, those with particular heart conditions and, in some cases, joint replacements — pre-medication is advisable. The question may be even more confusing now, because the standard recommendations have recently changed — so let’s try and sort things out.
First, why would anyone need antibiotics before dental treatment? Essentially, it’s because of the chance that an open wound could allow bacteria from the mouth to enter the bloodstream. For people in good health, the body is capable of quickly containing and neutralizing the bacterial exposure. But people with some types of heart disease, heart transplants, and/or total joint replacements have a greater likelihood of developing a bacterial infection, which can be dangerous — or even life-threatening. The same may be true of people whose immune systems are compromised.
At one time, people with a broad range of heart problems and artificial joints were advised to pre-medicate; today, new research indicates that fewer people need to take this step. Antibiotics are currently recommended before dental procedures if you have:
- An artificial heart valve, or a heart valve repaired with artificial material
- A history of endocarditis
- A heart transplant with abnormal heart valve function
- Cyanotic congenital heart disease (a birth defect where blood oxygen levels are lower than normal) that hasn’t been fully repaired — including children with surgical shunts and conduits
- A congenital heart defect that has been completely repaired with artificial material or with a device — but only for the first six months after the repair procedure
- Repaired congenital heart disease with residual defects, such as leakage or abnormal flow
In addition, not everyone who has an artificial joint needs antibiotic premedication. Instead, your health care providers will rely on your individual medical history to determine whether this step is required in your situation. However, having a compromised immune system (due to diabetes, cancer, arthritis, chemotherapy and other factors) is still an indication that antibiotics may be needed.
The question of whether or not to pre-medicate is an important one — so it’s vital that you share all relevant medical information with your doctors and dentists, and make sure everyone is in the loop. That way, the best decisions can be made regarding your treatment.
Maria Menounos, an independent filmmaker, actress, and co-host of daily entertainment news program Extra, learned at an early age about the importance of maintaining good general and dental health when her father, Constantinos, a Greek immigrant, was diagnosed with type 1 diabetes. As a result, her parents made sure the family consumed a diet filled with fresh fruits and vegetables, many of which they produced themselves. Maria and her family also consumed little-to-no junk food.
Menounos is still committed to helping those with diabetes. In fact, because she saw first hand the power of communication in the lives of diabetes patients and their families, Menounos is an avid ambassador for the American Diabetes Association.
Maria's experience with diabetes is one that she shares with millions of people worldwide. And if you or someone you care about is suffering from this disease, it's important to be aware of the connection between diabetes and oral health. Recent research has shown a link between two chronic inflammatory conditions: periodontal (gum) disease and diabetes. Evidence consistently reveals that diabetes is a risk factor for increased severity of periodontal disease and conversely, periodontitis is a risk factor for worsening blood glucose control in patients with diabetes and may also increase the risk of diabetic complications. Periodontal inflammation is also associated with an elevated systemic (general body) inflammatory state and an increased risk of major cardiovascular (“cardio” – heart; “vascular” – blood vessel) events such as heart attack, stroke, adverse pregnancy outcomes (e.g., low birth weight and preterm births) and altered blood sugar control in people with diabetes.
If you are interested in learning more about periodontal disease, you can continue reading the Dear Doctor magazine article “Diabetes & Periodontal Disease.” Or, if you are diabetic and fear you may have periodontal disease, you can contact us today to schedule an appointment so that we can conduct a thorough examination. During this private consultation, we will also discuss any questions you have as well as what treatment options will be best for you. And to read the entire interview with Maria, please see the Dear Doctor magazine article “Maria Menounos.”