Posts for: November, 2014

By John G. Rutland & Kenneth L. Vandervoort, Jr Family & Cosmetic Dentistry
November 26, 2014
Category: Oral Health
FitnessExpertJillianMichaelsHelpsKickSleepApnea

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.”


By John G. Rutland & Kenneth L. Vandervoort, Jr Family & Cosmetic Dentistry
November 11, 2014
Category: Oral Health
Tags: medication  
NewGuidelinesIssuedforAdministeringAntibioticsBeforeaDentalProcedure

One of the possible side effects of dental work is the introduction of oral bacteria into the bloodstream, a condition known as bacteremia. Although not unusual — it can also occur when you eat or brush your teeth — bacteremia could trigger a dangerous infection for some patients.

For many years, we in the dental profession have taken extra precautions with two such categories of patients: those with congenital (“at birth”) heart conditions who are more susceptible to infective endocarditis, a life-threatening infection of the heart lining or heart valves; and patients who’ve undergone joint replacements and are at a higher risk of developing blood-borne infections at the replacement site. It’s been a standard practice for many years to administer antibiotics to patients in these two categories sometime before they undergo a dental procedure as a way of curtailing the effects of any resulting bacteremia.

Recently, however, the guidelines for antibiotic pretreatment for dental work have changed as two major medical associations have revised their recommendations on the procedure. The American Heart Association (AHA) now recommends dentists administer antibiotic pretreatment only to heart patients with a history of endocarditis, artificial valves or repairs with artificial material, heart transplants with abnormal heart valve function and other similar conditions.

Likewise after a series of joint studies with the American Dental Association on infections in dental patients with orthopedic implants, the American Academy of Orthopedic Surgeons no longer recommends pretreatment for artificial joint patients. It’s now left to the dentist and patient to determine whether antibiotics before a procedure is appropriate based on the patient’s medical history. For example, premedication may still be prudent for joint replacement patients with compromised immune systems caused by systemic illnesses like cancer or diabetes.

Although the guidelines have narrowed, it’s still important for you tell us about any heart condition you may have, or if you’ve undergone any type of joint replacement therapy. It’s also advisable for you to discuss with your primary doctor how your condition might be impacted by any proposed or scheduled dental procedure. Our aim is to always minimize any risk to your overall health as we treat your dental needs.

If you would like more information on antibiotic treatment before dental procedures, please contact us or schedule an appointment for a consultation.