Oral appliance therapy - your dentist may save your life!!

What is oral appliance therapy and can my dentist really save my life?

Obstructive sleep apnea is a sleep related breathing disorder that involves a decrease or complete stop in airflow despite an ongoing effort to breath.  It occurs when the muscles relax during sleep, causing  soft tissues at the back of the throat to collapse and block the upper airway.

Well let's think about it, air flow stop, that sounds like suffocation.  For people with OSA this can happen a few times an hour to 40, 50, 60, or more times an hour while you sleep and it can be pretty serious.

If left untreated will have impact on your cardiovascular system, increase chance of motor vehicle accidents, psychiatric and behavioral issues, quality of life and productivity issues, endocrine and and neurocognitive issues.

A cpap (continuous positive airway pressure) machine can treat this but this machine is strapped onto you and the compliance is not great, perhaps around 50%.  If you can wear this machine then  your success is close to 100%.  If you can't get used to wearing this then you need to find another solution.

This brings us to the dentist, your dentist can fabricate an appliance (mandibular advancement device) for you that stops your tongue and jaw from falling backwards as you sleep and opens your airway to help you breath.  Many people can tolerate this much better and it again lets you breath while you sleep and perhaps saves your life.

Any questions you have don't hesitate to leave a reply on the blog.

Regards and all the best

Dr. Ron Barzilay

Hamilton Ontario Canada

www.rondentist.com

My Insurance! My Insurance! My Insurance! - Do you know anything about your insurance?

This is a true story.
A patient of ours was in the other day.  We had just made  new dentures for him and his wife.
We said we would send it to his insurance company to see if they would pay but he right away knew that they would not pay since he didn't have coverage for dentures.  Of course, shortly after that we heard from the insurance company that he has no coverage for dentures (major coverage).
He did tell us that he pays $170 dollars a month for only dental insurance for himself and his wife.
$2040 dollars a year for him and his wife and there was no major coverage.
My staff were flabbergasted.  They almost never have fillings to do and their cleanings amount to about 2 months of their premiums
So they pay their premiums faithfully every month but never get value.  In other words, in their case, it is not worth it to get insurance. Pay your dental bills out of pocket and they would be left with a larger sum of money in their pockets.
   Is this the case for everyone?  Of course not but it was the case for them.  Many people when they come to see me, say that they haven't been to the dentist for years because they didn't have dental insurance so they couldn't afford it.  I always explain to them that dental insurance costs money and that if they put that same money aside to go to the dentist they would be surprised by what value they get.
    The morals of the story?
 1. Check what you are actually getting when you buy dental insurance.  How much does it cost and is it really worth it.
2.  You can still go to the dentist even if you don't have insurance.

All the best

Dr. Ron Barzilay

Having fun practising dentistry in Hamilton Ontario Canada

www.rondentist.com

PS. If you have any questions just send a reply to the post.

How to make your Dentist HAPPY!

Dentists are just ordinary people and like ordinary people something's make them sad and something's make them happy.  Something's make them angry and something's make them smile.
Why is it important to make your dentist happy?  Well I guess I could tell you that he is the guy holding the needle so it is not a bad idea to make him happy (just kidding) but that is not true.  Your dentist is a professional and even if he is angry he will never hurt you and he will always act for you benefit.  Then why even worry about whether you dentist is happy or not.  I guess it is the same reason we try to make anyone happy.  Because it is the right thing to do!!  But here is a little secret that many people don't know.  If you treat people well then they will treat you well.  If you are nice to your dentist he will be nice to you.  If you don't miss appointments or cancel at the last second he will be more inclined to stay late for your emergency.  If you are just plain nice then the whole office will always bend over backwards for you in just about everything.  No this is not a secret but for some reason (and it is so simple) most people don't know this. 

So what makes a dentist happy you may ask?  Well here are a few things:

Remember your appointments especially if you just booked it yesterday.  Don't be a habitual appointment no show.
Remember to shut off your cellphone when going into treatment.  Nothing worse than the cell phone buzzing throughout treatment.
Brush your teeth!  Next time your dentist asks you why you are not brushing don't say "It's a time thing!"  We know that anyone can find two minutes in the morning and two minutes in the evening, which is much less time than you spend watching TV or checking your Facebook everyday.
Remember to do the treatment that has to get done.  Nothing worse than you showing up a year later with a toothache and now we have to extract the tooth which we told you then was just a small filling.
Nothing is worse than this happening to your child because you didn't book the appointment, better it should happen to you.
Remind your children we have coloring books for coloring and the reception carpet is not part of the coloring book.  Yes we do love children and see so many of them but we just ask them and you to respect our home as you would respect your own.
Oh yes, remember to pay your bill. 

There are more things but I think you get the general idea.
"Remember to treat your dentist, or anyone, as you would like to be treated yourself."

Having fun doing Dentistry in Hamilton Ontario
All the best to everyone.
Dr. Ron Barzilay
www.rondentist.com

If you have a comment let me know and you are more than welcome to follow this blog.

Dr. why do I have to fill out all of these Questions?

Many times a new patient will come to the office and start filling out our medical questionnaire and half way through get angry and flustered.  They then come to the front desk and ask:  What do all these questions have to do with my teeth?

Well that is really a great question and the answer goes something like this.

Most people will never have a problem in the dental office but we in the dental office have to be prepared in case of emergency and we have to make sure that we don't do anything that will cause a medical emergency in the dental office.  This starts with a thorough medical history of our patients.  We want to know that our patients are not allergic to any antibiotic that we may need to give them, we want to know that they have not had a bad reaction to the local anaethetic that we need to put the tooth to sleep.  We need to know that our patients are not allergic to our gloves etc.  We want to know if our patients are taking any medications for an underlying condition as our anaethetics could react adversely with those medications or a medication that we may prescribe could act adversely with a medication that they are taking.  We want to know if they have an underlying condition so that we can determine if they are suitable for treatment in a dental office or may require referral for treatment in a hospital setting.  We would want to know regarding underlying conditions so that in case of emergency we are better suited to help them.  The different possibilities are endless but knowing as much as possible about our patients medical history will help us avoid any unfortold medical emergencies and if they arise will help us better deal with them.  In our office we take blood pressure readings for all new patients and at recall appointments for our existing patients.  15% of the population walks around with undiagnosed hypertension and we have literally come across a number of those patients.  Incidentally we have had patients whose family phycicians have told them that their dentist saved their life.  We also take blood glucose for our diabetic patients to see how controlled their diabetes is.  The examples and their importance are endless.  I hope you got the picture!

What do all these questions have to do with your teeth?  They have so much to do with your teeth and your overall well being!  Thit is a great question, thank you for asking so we could have the opportunity to explain this to you!

All the best
Dr. Ron Barzilay

having fun doing dentistry in Hamilton Ontario

follow my blog

www.rondentist.com

I AM TOO SCARED TO GO TO THE DENTIST

I am too scared to visit the dentist!!

How many times have I heard this? 

Too many times to remember.
Well of course the patient is now sitting in my chair and telling me this.  I guess something overcame the fear.  That something was the PAIN!
I always get a little chuckle out of this momemt because it is inevitable and it just repeats itself over and over again.  I always tell these patients that it had to happen.  They may not like to come to the dentist but one way or another they are coming.  The difference being that either they will be walking through the door or they will be crawling through the door.  BUT THEY ARE COMING!

Unfortunately now, there is a lot of damage that needs fixing and they will be coming for many more sessions than if they had come earlier.

We as dentists are experts at pain and anxiety control.  We really can give freezing almost completely pain free.  If regardless of the freezing the patient is still nervous, we have many methods to alleviate that anxiety.  From laughing gas to oral sedation, to IV sedation, to general anesthetic, we do have solutions.
Please let your dentist try to help you when the work is miniscule as opposed to your mouth falling apart.
Remember, one way or another you are going to visit your dentist.

All the best

Dr. Ron Barzilay

Having fun in Hamilton, Ontario

My Tooth Hurts But My Dentist Can't Find the Problem- Good Chance It is a Cracked Tooth

A patient comes into the office and says that he is having discomfort on one side. He has hasn't eaten on that side for months if not years.  The culprit tooth has a small filling in it or no filling at all.  In the x-ray the tooth looks perfectly normal.

I am most definetly starting to think CRACKED TOOTH!!

I place pressure on each cusp separately.  On one of the cusps, as the patient opens from pressing, then the tooth starts to hurt.  Yes it is a cracked tooth.

Can you see it on the x-ray?  No you can't since the tooth is fractured and not broken.  When it is fractured the two sides are close together and an X-ray will not pick up the fracture.

Why is it hurting if the sides are still together?  This is because, as you bite down on the tooth, the sides of the tooth are flexing.  At that point fluid moves in and out of the tooth causing pain.

So how do you fix it?  This is the easy or hard part.  It all depends where and how far down the root the tooth is fractured.  To fix this problem you need a crown on the tooth.  By shaving the tooth down and then covering it with a crown (or cap) all the forces of biting will be directed internally and the fractured parts will be held together thus stopping the pain.  To test this, we place a temporary crown on the tooth first.  If the symptoms disappear then we can go ahead with the permanent crown and have reasonable confidence in the outcome.  If the fracture goes further down the root and beyond the crown then the symptoms may persist.  We may need to do a root canal and the symptoms may then disappear.  But overall the prognosis is now guarded.  When the crown does not encompass the entire fracture the tooth may still be flexing and the long term prognosis is questionable.

Does this happen a lot?  Actually it happens quite a bit, even teeth that have never had a filling in them get fractures.  This is called wear and tear.  If you never use your teeth this will never happen to you.  Since most people use their teeth quite a bit and of course many of us also grind our teeth which makes this worse, quite a few of us will experience this throughout our lifetimes.

If you have any questions, you can always send me a note.

All the best

Dr. Ron Barzilay
Hamilton Ontario

Don't forget, you can become a follower of this blog!