Here is how Abfractions are caused by Obstructive Sleep Apnea.

This may be used as patient education in your web site or as a hand-out.

(Take the Quiz at the end.)

“Doctor, I always thought these notches are from brushing too hard. They are painful and I have them on my teeth on both sides. What causes them?” 

7-13-13 ABFRACTION

Here is a simplified explanation:

An abfraction occurs on the lower part of the crown of a tooth, near the gum line as shown in the picture above.

            The enamel covering the crown tapers down to its thinnest there. When the occlusion (bite) is not balanced, there will be uneven pressures on the biting surfaces of teeth. Those pressures cause a torque on the tooth which produces a slight bend at the center where the crown meets the root. As the tooth keeps bending, the thin enamel at the bottom of the crown, near the gum line, chips away. The sensitive “dentin” surface inside the enamel is now exposed. Vigorous, improper teeth brushing will then wear away the unprotected dentin and the notches will grow deeper and larger.

The dentin also becomes vulnerable to acid erosion from foods such as citrus.

3-22-15 ABFR DRAWING RODS

The uneven bite pressures also cause a loss of gum and bone attachment around the roots so the roots become progressively exposed adding to the acute sensitivity to touch and cold. Advanced effects can be fracture of the tooth at the crown-root junction, tooth mobility and serious gum disease. 

             Abfractions can resemble other conditions like decay or toothbrush abrasion, but the treatment is more specific. The treatment, after diagnosing the cause as a bite dysfunction, consists of balancing the bite to equally and properly distribute the pressures and then to restore the lost tooth structure. An occlusal guard may be required. About 25% of the population clench or grind their teeth at night (Nocturnal bruxism) and are completely unaware of it!. Obviously, the earlier this condition is discovered, the less damage to the teeth and bone will have occurred. In advanced cases crowns may need to be placed to protect the weakened teeth. There is a convincing connection to Obstructive Sleep Apnea. There are some cases where orthodontic treatment may be necessary. 

3-22-15 ABFR DRAWING

Abfractions are non-carious cervical lesions (NCCL) caused by flexural forces; the enamel, especially at the cementoenamel junction (CEJ), undergoes this pattern of destruction by separating and breaking the enamel rods.  

Abfractions are common in patients with OBSTRUCTIVE SLEEP APNEA. Nocturnal bruxism, which is indicative of OSA, plays a major roleThe effective solution requires treatment of the causes. I created this explanation to serve as an aid to educate patients on the need to understand the CAUSES of abfractions- and to treat those causes.

QUIZ

True/False

  1. Abfractions are usually caused by improper teeth brushing.                   (F)
  2. Abfractions are a specific type of dental decay.                                       (F)
  3. Correction of an abfraction requires more than just a cervical filling.       (T)
  4. Nutrition plays a role in worsening abfractions.                                         (T)

Multiple Choice

Which are correct?

  1. .Abfractions occur primarily on the facial surfaces of teeth.
  2. A porcelain veneer can have an abfraction.
  3. Abfractions occur only on maxillary teeth.
  4. An abfraction may be able to cause a separation fracture of a tooth crown.
  5. All the above.

The treatment options include all except one of the following:

  1. Orthodontics
  2. Nutritional adjustments
  3. Occlusal adjustment
  4. Periodontal Therapy
  5. Cervical restorations

Scary connection: Sleep Apnea and Acid Reflux

10-28-14 GHOST 1

How it happens:
During the cessations of breathing the body will increase its efforts to take in air.
Abdominal contractions are exaggerated and increase until breathing resumes.
The contractions squeeze the stomach and force acid up the esophagus.
The efforts to breathe also increase a negative pressure in the esophagus which also
 pull up acid.

Become a Sleep Medicine Dentist and help your patients that have these Sleep Apnea connected comorbidities and symptoms-
Diabetes, High Blood Pressure, GERD, headaches, nocturnal bruxism.

Explanations like this are presented in upcoming Sleep Apnea seminars.
You can view the course outlines and register here:

Oct 2015

ATLANTA, GA –           10/16/2015 – 10/17/2015 Register Now! 
LOS ANGELES, CA – 10/16/2015 – 10/17/2015 Register Now! 
SEATTLE, WA –         10/23/2015 – 10/24/2015 Register Now! 

Nov 2015

PHILADELPHIA, PA –   11/06/2015 – 11/07/2015 Register Now! 
SALT LAKE CITY, UT – 11/06/2015 – 11/07/2015 Register Now! 
IRVINE, CA –                 11/13/2015 – 11/14/2015 Register Now! 
OKLAHOMA CITY, OK –11/13/2015 – 11/14/2015 Register Now! 
LAS VEGAS, NV –          11/20/2015 – 11/21/2015 Register Now! 
MEMPHIS, TN –              11/20/2015 – 11/21/2015 Register Now! 

Scary connection between Sleep Apnea and Acid Reflux

10-28-14 GHOST 1

Most Sleep Apnea sufferers have Acid Reflux…. and other comorbidities.

How it happens:
During the cessations of breathing the body will increase its efforts to take in air.
Abdominal contractions are exaggerated and increase until breathing resumes.
The contractions squeeze the stomach and force acid up the esophagus.
The efforts to breathe also increase a negative pressure in the esophagus which also pull up acid.

Become a Sleep Medicine Dentist and help your patients that have these Sleep Apnea connected comorbidities and symptoms-
Diabetes, High Blood Pressure, GERD, headaches, nocturnal bruxism.

Explanations like this are presented in the upcoming Sleep Apnea seminars.
You can view the course outlines and register here:

Oct 2015

ATLANTA, GA –           10/16/2015 – 10/17/2015 Register Now! 
LOS ANGELES, CA – 10/16/2015 – 10/17/2015 Register Now! 
SEATTLE, WA –         10/23/2015 – 10/24/2015 Register Now! 

Nov 2015

PHILADELPHIA, PA –   11/06/2015 – 11/07/2015 Register Now! 
SALT LAKE CITY, UT – 11/06/2015 – 11/07/2015 Register Now! 
IRVINE, CA –                 11/13/2015 – 11/14/2015 Register Now! 
OKLAHOMA CITY, OK –11/13/2015 – 11/14/2015 Register Now! 
LAS VEGAS, NV –          11/20/2015 – 11/21/2015 Register Now! 
MEMPHIS, TN –              11/20/2015 – 11/21/2015 Register Now! 

 

Here is how Abfractions are caused by Obstructive Sleep Apnea.

 

Abfractions are difficult to explain to patients. Here is a simplified explanation

“Doctor, I always thought these notches are from brushing too hard. They are painful and I have them on my teeth on both sides. What causes them?”  

7-13-13 ABFRACTION

Here is a simplified explanation:

An abfraction occurs on the lower part of the crown of a tooth, near the gum line.

            The enamel covering the crown tapers down to its thinnest there. When the occlusion (bite) is not balanced, there will be uneven pressures on the biting surfaces of teeth. Those pressures cause a torque on the tooth which produces a slight bend at the center where the crown meets the root. As the tooth keeps bending, the thin enamel at the bottom of the crown, near the gum line, chips away. The sensitive “dentin” surface inside the enamel is now exposed. Vigorous, improper teeth brushing will then wear away the unprotected dentin and the notches will grow deeper and larger.

The dentin also becomes vulnerable to acid erosion from foods such as citrus.

             The uneven bite pressures also cause a loss of gum and bone attachment around the roots so the roots become progressively exposed adding to the acute sensitivity to touch and cold. Advanced effects can be fracture of the tooth at the crown-root junction, tooth mobility and serious gum disease. 

            Abfractions can resemble other conditions like decay or toothbrush abrasion, but the treatment is more specific. The treatment, after diagnosing the cause as a bite dysfunction, consists of balancing the bite to equally and properly distribute the pressures and then to restore the lost tooth structure. An occlusal guard may be required. About 25% of the population clench or grind their teeth at night (and are completely unaware of it!). Obviously, the earlier this condition is discovered, the less damage to the teeth and bone will have occurred. In advanced cases crowns may need to be placed to protect the weakened teeth. There are some cases where orthodontic treatment may be necessary. 

3-22-15 ABFR DRAWING

 

Abfractions are non-carious cervical lesions (NCCL) caused by flexural forces, usually from cyclic loading; the enamel, especially at the cementoenamel junction (CEJ), undergoes this pattern of destruction by separating the enamel  rods.  Studies show that within the same patient, teeth with abfractions presented more gingival attachment loss than those without abfractions. However, associations were not demonstrated between premature contacts in centric relation (PCCR) and the presence of abfractions or increased attachment loss.

Abfractions are common in patients with Obstructive Sleep Apnea. Nocturnal bruxism plays a major role.

12-15-13 Sleep-Bruxism

 QUIZ

True/False

  1. Abfractions are usually caused by improper teeth brushing.                   (F)
  2. Abfractions are a specific type of dental decay.                                       (F)
  3. Correction of an abfraction requires more than just a cervical filling.       (T)
  4. Nutrition plays a role in worsening abfractions.                                         (T)

Multiple Choice

Which are correct?

  1. .Abfractions occur primarily on the facial surfaces of teeth.
  2. A porcelain veneer can have an abfraction.
  3. Abfractions occur only on maxillary teeth.
  4. An abfraction may be able to cause a separation fracture of a tooth crown.
  5. All the above.

The treatment options include all except one of the following:

  1. Orthodontics
  2. Nutritional adjustments
  3. Occlusal adjustment
  4. Periodontal Therapy
  5. Cervical restorations

Scary that most Sleep Apnea victims have Acid Reflux…. and other comorbidities.

10-28-14 GHOST 1

The Causes:
During the cessations of breathing the body will increase its efforts to take in air.
Abdominal contractions are exaggerated and increase until breathing resumes.
The contractions squeeze the stomach and force acid up the esophagus.
The efforts to breathe also increase a negative pressure in the esophagus which also pull up acid.

Become a Sleep Medicine Dentist and help your patients that have these Sleep Apnea connected comorbidities and symptoms-
Diabetes, High Blood Pressure GERD, headaches, nocturnal bruxism.

Explanations like this are presented in the upcoming Sleep Apnea seminars:
Oklahoma City    Dr.Damian Blum
Atlanta                 Dr. Marty Lipsey
Hollywood, FL     Dr. Dan Tache’
Boston                
Dr Barry Freydberg
Indianapolis        Dr. George Jones
Orlando               Dr Anjoo Ely
Miami                 
Dr Barry Freydberg
Houston              
Dr.Damian Blum
Scottsdale           Dr. Marty Lipsey

You can view the dates and course outlines and register here:
http://sleepgroupsolutions.com/2.0/modules/piCal/index.php?smode=&op=&cid=2

6-16-12 BUTTON #2

HOW TO BENEFIT FROM THE END OF DST


The days are getting shorter. Darkness arrives earlier.in the evening. Daylight Saving Time ends on November 2nd and we turn our clocks back one hour. When we wake up Sunday morning it will be a little darker than yesterday morning. We’ll have one extra hour for sleep.
10-29-13 fall-back 3
In order to fulfill the essential number of regenerating sleep cycles the average adult needs 7-8 hours. A five stage sleep cycle repeats consistently throughout the night. One complete sleep cycle lasts about 90 minutes. So during an average night’s sleep (8 hours), an adult will experience about four or five cycles of sleep.


A Little History of Daylight Saving Time
The concept of setting the clocks ahead in the spring in order to make better use of natural daylight was first introduced in the US by inventor Benjamin Franklin in 1784.

12-30-11 Benjamin_Franklin_1767During his time as an American envoy to France, Ben Franklin publisher of the old English proverb, “Early to bed, and early to rise, makes a man healthy, wealthy and wise” anonymously published a letter suggesting that Parisians economize on candles by rising earlier to use morning sunlight. This 1784 satire proposed taxing shutters, rationing candles, and waking the public by ringing church bells and firing cannons at sunrise.
US President Franklin D. Roosevelt instituted year-round DST in the United States, called “War Time” during World War II from February 9, 1942 to September 30, 1945. The change was implemented 40 days after the bombing of Pearl Harbor and during this time, the U.S. time zones were called “Eastern War Time”, “Central War Time”, and “Pacific War Time”. After the surrender of Japan in mid-August 1945, the time zones were relabeled “Peace Time”.
Congress decided to end the confusion and establish the Uniform Time Act of 1966 that stated DST would begin on the last Sunday of April and end on the last Sunday of October. However, states still had the ability to be exempt from DST by passing a local ordinance.
Healthy nights of sleep are essential to recharge our human organs and maintain good health and longevity. 

 This fall, dentists have the opportunity to spring forward with Dental Sleep Medicine and help the millions of their Sleep Apnea victims. 

Upcoming training seminars by DSM experts are available in the following cities:


Oklahoma City    Dr.Damian Blum
Atlanta                Dr. Marty Lipsey
Hollywood, FL     Dr. Dan Tache’
Boston               Dr Barry Freydberg
Indianapolis        Dr. George Jones
Orlando              Dr Anjoo Ely
LIP 8
You can view the dates and course outlines and register here:
http://sleepgroupsolutions.com/2.0/modules/piCal/index.php?smode=&op=&cid=2

 

DENTISTS STRIKE GOLD IN SAN FRANCISCO

 

10-5-14 GOLD RUSH 6Attending the Sleep Group Solutions training seminar on Sleep Dysfunctions in San Fransisco, a new team of dentists prospected for gold and found it there.
Dr. Marty Lipsey presented a two day comprehensive course which included:

  •  The science of sleep,
  •  Identifying the 34% of their patients who were Sleep Apnea victims,
  •  Patient Education,
  •  Case Presentation and Treatment Acceptance,
  •  Understanding and handling the comorbidities,
  •  Hands-on working with the popular Oral Appliances including TAP, Respire, EMA, Silent Night and others,
  •  Sleep Apnea Medical Insurance Codes, Fees, Billing Procedures.

9-27-14 MS  SAN FRAN.FROM BACK.jA

These lucky dentists who struck it rich are now able to begin screening and treating their patients who desperately need their help.

Next up in Dental Sleep Medicine courses (16 CEU) :

          Pick your expert or city:

10th October 2014 Friday
11th October 2014 Saturday
Charleston, SC – Dr. Jeffrey Horowitz
17th October 2014 Friday
18th October 2014 Saturday
Washington, D.C. – Dr.George Jones
17th October 2014 Friday
18th October 2014 Saturday
Portland, OR – Dr. Barry Freydberg
24th October 2014 Friday
25th October 2014 Saturday
Philadelphia, PA – Dr. Damian Blum
24th October 2014 Friday
25th October 2014 Saturday
Dallas, TX –     Dr. Marty Lipsey
7th November 2014 Friday
8th November 2014 Saturday
Oklahoma City, OK – Dr. Damian Blum
7th November 2014 Friday
8th November 2014 Saturday
Atlanta, GA –    Dr. Marty Lipsey
14th November 2014 Friday
15th November 2014 Saturday
Hollywood, FL – ADVANCED Dr. Dan Tache’
14th November 2014 Friday
15th November 2014 Saturday
Boston, MA – Dr. Barry Freydberg

Read the course outline, see the speakers and register here to get your gold:    http://sleepgroupsolutions.com/2.0/modules/piCal/index.php?smode=&op=&cid=2

10-5-14 GOLD RUSH 1

What would make YOU stand out and be sought out as a Dentist?

I’m sure you understand that now, more than ever, you need to stand out and be able to offer not only EXCELLENCE, but also DIFFERENCE. In this sluggish economy, where there is a perception of “financial doom”, (I personally don’t believe in that.), dental consumers have a tight hold on their wallets and reports of dental service acceptance show a concerning drop.
11-30-11 WALLET
What would make YOU stand out and be sought out?
WHAT ‘UNIQUENESS” ARE PATIENTS LOOKING FOR TODAY?
9-11-14 How_to_create_your_Uniqueness_in_the_Market_Place_1
What are YOU doing now to offer a unique service? Your First Class Service and Patient Engagement are expected as basic “givens”. But what is your clinical niche?
Are YOU the dental practice they must go to? Are you the only practice around that offers “invisible” braces, or mini-implant dentures or Nutritional Analysis ?  Are you the “Holistic Dentist”, the “Soft Tissue Management Dentist”, the “Snooze Dentist”,  the “Snore Dentist”? Are you the “Sleep Dysfunction Dentist”?
EVOLUTION OF DENTAL DEMAND
Remember how it was about 20 years ago when teeth whitening (aka “bleaching”) was the “new kid on the block”- THE “HOT BUTTON”? If you had an “in-office” Bright Smile or Zoom machine, you could schedule an operatory all day long with patients from near and far. After that we had the “porcelain age of dentistry”, when the media made patients very image-conscious for “smile enhancements” at any cost while the public was more confident in the future of the economy . Teeth whitening is now offered in nearly every practice, and in most as a discounted loss leader. Cosmetic crowns and veneers are now a lower patient priority.
Implants were the next rage in dental attractions. Today most dental practices are offering implants.
SO, WHERE ARE WE NOW?
What would make YOU stand out and be sought out?
 9-11-14 UNIQUE BULB
Dental Sleep Medicine is where Teeth Whitening was 20 years ago.
It is the “hot button” where Implant Dentistry was 10 years ago.
Strike while the iron is hot.
DSM can be your uniqueness to serve the needs of 34% of your existing patients and attract many new patients.    Take the training and stand out as the “go-to” dentist in your area.
9-11-14 UNIQUE ON PEDESTAL

IS 13 YOUR LUCKY NUMBER?

On Sept. 12th and 13th you are given the chance to win big in
Hartford, CT or in Las Vegas, NV

9-6-14 DICE

On Fri. and Sat., September 12, 13, you can pick your training by either of these two most respected Dental Sleep Medicine educators in the nation.

Sleep Group Solutions presents:

Dr. Anjoo Ely in Hartford

Dr. Marty Lipsey in Las Vegas

The choice is yours; either way, next week YOU WIN!

 

8-3-14 SAW WOODThe current need and “buzz” is in discovering and treating sleep apnea.  Patients are asking their Dentists about sleep apnea. How comfortable are YOU with the answers? It is reported that less than 4% of practicing Dentists are able to assist the more than 50 million people who suffer from sleep apnea. There is a growing public awareness of the hazards that come from a nocturnal stoppage of breathing. Your patients are becoming increasingly more concerned about the blockage of oxygen to the brain and other organs. Strokes. Heart attacks. Diabetes. As a Care Giver, think of how you can serve.  Serve an unfilled need.

These 2 day courses are designed to provide you with the knowledge to confidently return to your practice and immediately begin implementing new screening and treatment protocols.

1-21-13 LOGO DENTAL PROS SHARING

You can learn more about the courses and register for one here:  http://sleepgroupsolutions.com/2.0/modules/piCal/index.php?smode=&op=&cid=2

Dr. Marty Lipsey

Dr. Marty Lipsey Dr. Marty Lipsey, received his DDS degree from UCLA and a Master of Science from Northwestern University Dental School. Dr. Lipsey is the founder of Dental Sleep Med Systems, offering dental teams assistance in implementing and/or improving their dental sleep medicine practices, including electronic medical billing and successful insurance coding and processing. Dr. Lipsey is a Sleep Group Solutions Instructor, and teaches Dental Sleep Medicine regularly.

 Dr. Anjoo ElyDr. Anjoo Ely
Dr. Ely  is a graduate of the University of Michigan Dental School 1997, and is a Member of the American Dental Association, Michigan Dental Association, and American Academy of Dental Sleep Medicine. Dr. Ely’s passion for Dental Sleep Medicine stems from her loss of her father at a young age due to suspected undiagnosed sleep apnea. Her passion is not just treating sleep apnea patients but also educating more dentists to be able to treat their sleep affected patients.

 

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