Josh Bernstein, DDS, Cosmetic Dentist
San Francisco's Cosmetic Dentistry
Thursday, December 17, 2009
The television trailer for "Up in the Air" depicts this fine film as a comedy, but the writer clearly points out the emptiness of a life without human connection. There are a number of funny scenes to be sure, however, the stark reality of George Clooney's dispassionate character--a professional job terminator--leaves one shocked and saddened by the consequences of his work, and the lonely life he leads. Rather than showcasing a Hollywood ending, or a Hollywood life, the characters in this film are real people, living real life, with its joy, tragedy, disconnection and the ultimate pain of George Clooney's character's failure to have built a life with real human involvement. "Up in the Air" provides outstanding writing, acting and directing for those who appreciate quality cinema. Just don't expect to leave feeling uplifted. Josh Bernstein, DDS Founder and President, Dental Comfort Academy http://www.allnewsmiles.com http://www.sanfranciscosedationdentist.com http://www.comfortacademy.org
Every year, countless dollars are spent on over-the-counter headache medications such as Advil, Tylenol, Alleve, and Excedrin, not to mention the prescription medications such as Imitrex and others. Tension headaches are from tension in the muscles of the head and neck. So what makes these muscles tense?
One common cause is an unbalanced bite. The muscles in the head and neck operate the jaw. Since the teeth dictate the jaw's posture, if the jaw posture puts chronic excess tension on the temporalis muscles on the side of the head, patients can get persistent headaches.
This is why dental "orthotics" frequently solve headache pain. Properly trained dentists can find ideal jaw position, then record that position and make an orthotic to allow the patient to rest in that position. There are many other dental treatments to solve headache pain since headache pain is so closely related to the teeth and jaws. Bite adjustments, orthodontics, new dental restorations, and sometimes jaw surgery can help.
To find out more about the technology used to find the ideal bite and ideal jaw position, go to http://www.myotronics.com. And please feel free to call our office at 510-601-7645 if headaches are a problem for you--and your doctor has ruled out anything serious. Josh Bernstein, DDS Founder and President, Dental Comfort Academy http://www.allnewsmiles.com http://www.sanfranciscosedationdentist.com http://www.comfortacademy.org
In nearly every case of TMJ I have seen, there is some form of airway obstruction. Either a narrow airway in the throat, enlarged tonsils or adenoids, allergies, sinus problems, deviated septum or small mouth with limited tongue space. Many researchers believe that airway obstruction in one form or another is the underlying cause of TMD/TMJ. Why?
If the airway is compromised, the patient naturally alters their oral posture to ensure proper air flow for survival, usually by mouth breathing with the tongue and jaw forward. Ideal resting oral posture is for the lips to be together and for the tongue to be resting gently just behind the upper two front teeth. When the tongue is forward and the mouth is open on an ongoing basis, the tongue pushes the teeth forward, and the cheeks collapse inward, narrowing the jaw. In effect, the tongue and cheeks act as orthodontic appliances, moving the teeth to a position far from ideal. With the teeth out of proper alignment, the bite can become unbalanced, placing unbalanced force on the biting muscles, causing headaches, jaw pain, and other symptoms of TMD/TMJ.
What causes airway obstruction? According to Weston Price, it is our modern society's foods which, to many people, are allergens. The most common food allergens are wheat, dairy and chocolate--the things we all love to eat! Compounding the problem, when young patients get crowded teeth from this syndrome of mouth breathing and forward tongue posture, the orthodontic solution is often to extract the first bicuspid teeth to make more room. From a strictly orthodontic standpoint, this works nicely as the teeth can be moved so that they don't look crowded anymore. And if the patient wears their retainers, the teeth will stay that way. But what about the airway?
The tongue becomes more crowded with fewer teeth in a properly formed dental arch. The tongue then moves forward between the teeth, which can cause an open bite at the skeletal level, putting severe pressure on the rear-most teeth. Alternatively, the tongue is restricted by the retained teeth to the back in the throat, which can cause sleep apnea, a condition where the patient stops breathing many times during a night's sleep.
Obstructive Sleep Apnea (OSA) is often accompanied by snoring and is very common in modern civilization. OSA can cause death and is closely associated with an increase in cardiovascular disease, hypertension, and an average 20% decrease in lifespan. Many OSA experts believe that Tim Russert of "Meet the Press" and Billy Mays, TV pitchman, died because they had OSA. Not surprisingly, OSA patients commonly grind their teeth and have an un-ideal bite.
So what can be done for prevention and treatment of TMD/TMJ? Aside from raising your children in the Australian Outback where Weston Price found no patients with this problem, there are some solutions. Awareness of the nature of the problem is most important. Everyone should be able to breath freely through their nose. If that is not happening, look into the problem as early as possible with an ENT Physician.
If you are considering orthodontics for crowding, in my opinion, I would request the orthodontist to expand the jaws, rather than remove teeth, decreasing the intraoral volume for the tongue. Many orthodontists will say that this is not possible after a certain age, but it is being done by those orthodontists and dentists that know how to do it. Once a patient is in a TMD/TMJ syndrome, orthodontics is often an option but it becomes even more important to follow principles that support an increase in airway. Sometimes, orthodontists work in concert with oral surgeons to solve these problems permanently.
While these solutions may sound drastic, TMD/TMJ treatment is often as simple as making a small adjustment to a new filling or making an orthotic/nightguard that places the jaw into a relaxed position for the jaw muscles. If the teeth are severely worn or damaged, dental work can be made to allow the jaw to relax in the physiologically most restful posture for the muscles.
Most importantly, seek the services of an experienced professional to guide you in prevention and treatment of TMD/TMJ. If we can help, please call our office at 510-601-7645. Josh Bernstein, DDS Founder and President, Dental Comfort Academy http://www.allnewsmiles.com http://www.sanfranciscosedationdentist.com http://www.comfortacademy.org
Wednesday, December 16, 2009
Snoring is common but not normal. Snoring is often associated with Obstructive Sleep Apnea (OSA), a condition where the patient stops breathing many times during a typical night of sleep. Many sleep apnea patients do not snore and are known as "silent" apnea patients. Here in our Piedmont office, we see a lot of patients with severely worn teeth from night time grinding. Sleep apnea patients are more likely to grind their teeth. Sleep Apnea is dangerous for the obvious reason that you must breathe to live. What is less well known is that people who have untreated sleep apnea have a 20% shorter life span on average than those who breathe normally during sleep. OSA patients typically have a higher incidence of cardiovascular disease and hypertension (high blood pressure). Until recently, the only effective treatment for sleep apnea was to wear a CPAP machine that is essentially night time life support. A CPAP forces air into the lungs through a mask worn on the nose or mouth. In the recent past, dental technology came up with so-called "snore guards," dental appliances that positioned the jaw to decrease or eliminate snoring. With research, innovative clinicians improved these "snore guards" to open the airway for sleep apnea patients. One of the best sleep apnea appliances is the Somnodent, made by Somnomed. If you (or you partner) are suffering from snoring or sleep apnea, or if you cannot tolerate your CPAP machine, there is help for you. Ask about a custom made Somnodent appliance here at our Piedmont office. Josh Bernstein, DDS Founder and President, Dental Comfort Academy http://www.allnewsmiles.com http://www.sanfranciscosedationdentist.com http://www.comfortacademy.org
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