★★ Learn from the Stars ★★

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                                                                                                                                                                                                                                                                       Dr. Damian Blum, a renown trainer and a star in Dental Sleep Medicine, will present a comprehensive “A to Z” introduction course to dentists and their teams in Hollywood, Florida.
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You can join the battle to combat this serious diseaseSleep Apnea..
Get trained and prepared to help the 40 million victims of sleep apnea. Many of them are already your patients.
Be a shining light and stand out as a doctor who literally saves lives.
9-11-14 UNIQUE BULB
Register with code: DBK916 and receive huge ($1130.) savings on tuition:
Only 655. with 2 auxiliaries at no charge.
(Available only by responding with this code.)
Review the course outline and register here:
 

 

MAY IS NATIONAL STROKE AWARENESS MONTH

Be aware that untreated Sleep Apnea is a major risk factor of strokes. One out of 15 adults has moderate to severe sleep apnea and men with moderate to severe sleep apnea are 4 times more likely to have a stroke.
A 2014 study published in the Journal of Clinical Sleep Medicine showed that people with moderate to severe obstructive sleep apnea were four times more likely to have a stroke even when results were adjusted for factors like obesity, cholesterol levels, hypertension, and smoking.
                                                               **************
How?  Simply stated, when there are repeated cessations in breathing, as in Obstructive Sleep Apnea, adequate oxygen is not carried to the brain.
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The National Stroke Foundation explains that “sleep apnea can be an after effect of stroke, but can also be the cause of a first time or recurrent stroke. The condition causes low oxygen levels and high blood pressure, both of which can increase the risk of a future stroke.”
Isn’t this another good reason for you to get a sleep test?
5-16-16 tip of iceberg
 Read the signs and symptoms from the Center of Disease Control (CDC):

WHAT IS MISSING IN YOUR COMPREHENSIVE DENTAL EXAM?

A truly professional comprehensive dental exam examination (D0150 or D0180) should include much more than what the CDT codes delineate.
What is essential?
Beyond the obvious FMX, the charting of existing and needed dental and periodontal conditions, and an oral cancer screening, there are many other useful evaluations which are directly related to our services and are within our range of authority and responsibility. 
The Comprehensive Exam should also include measurement of vitals such as blood pressure, a sleep dysfunction (Obstructive Sleep Apnea) screening such as the Epworth Sleepiness Scale, a nutritional analysis and a careful discussion of any notable items (alerts) in the patient’s med history. These things don’t need to be spelled out in the CDT code. They come with our desire to do what we know is right. .
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  TMJ exam, facial muscle palpation, Mallampati classification (of the airway entrance) and 
an oxygen saturation test will provide critical information.  Any dentist/hygienist will chose how extensive they wish their dental exams to be and what should be included.
Would we be “spending too much time” in a dental exam visit?

Not if we care about our patient’s total well being, about our conscience, and about our dental license.

And is this nearly always accepted by patients as hugely valuable and with appreciation?     YES, it is, where the dental team shows their patients how much passion, care and skill they have. I see it in many dental offices.    The really successful ones.

5-20-12 HUMAN PYR

A Hygienist is in a uniquely key position.
Here’s your opportunity to increase your service to your community, to create your “niche”, and  to stand out in your community as a complete care-giver.
It is reported that 34% of the population has Sleep Apnea symptoms. 
One of the next three patients that walk thru your doors is a Sleep Apnea victim. Are you able to help them?
Does your New Patient Exam include a screening for Sleep Apnea?
1-21-13 LOGO DENTAL PROS SHARING

Interested? Then check this out:   www.sleepgs.com

NATIONAL SLEEP AWARENESS WEEK ends with DAYLIGHT SAVINGS TIME on March 13th.

 

3-6-12 SPRING FORWARD

We “Spring forward” at 2 AM Sunday night, March 13 and lose an hour of sleep.

Are you planing to get to bed one hour earlier? In order to fulfill the essential number of regenerating sleep cycles an adult requires 7-8 hours of healthy sleep.

Do you sleep soundly or sleep with sound?

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Are you keeping your partner awake?

"Roar"

Sleep Awareness Week, which takes place this year March 6-13, is an annual public education and awareness campaign to promote the importance of sleep. The week begins by the announcement of the National Sleep Foundation’s Sleep in America and ends with the clock change to Daylight Saving Time, where Americans lose one hour of sleep. This week, focus on sleep education and Sleep Dysfunction screening.

If you are a Dentist consider helping the 34% of your patients that have a sleep breathing disorder. Learn how: www.sleepgs.com

 

LEARNING DSM TO BUILD A REWARDING PRACTICE

Dr. Barry Freydberg, a nationally recognized authority on the treatment of sleep disorders shared his unique perspective on his very successful Dental Sleep Medicine practice at a training course in Florida on Feb. 12,13.  This was an awesome learning experience.
 FREYDBERG 001
Next up in the DSM training seminars is Charlotte with Dr. George Jones and Las Vegas with Dr. Marty Lipsey.   Both seminars are held on Friday and Saturday, Feb. 19-20.
Included in these A to Z presentations is Medical Insurance billing, Codes, Fees and Procedures.  And you will receive 16 CE credits to jump start your new year.
GENIUS
You will be prepared to do far more as a comprehensive care-giver for your patients and the new ones who seek your services.
Review the course outlines and register here:

02/19/2016 – 02/20/2016
CHARLOTTE, NC CHARLOTTE, NC 

DoubleTree by Hilton Hotel Charlotte Airport

02/19/2016 – 02/20/2016 LAS VEGAS, NV LAS VEGAS, NV 

The Westin Las Vegas Hotel – Casino & Spa

ARE YOU LOOKING FOR A WAY TO STAND OUT IN YOUR COMMUNITY?

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Here is how you can gain respect as a thought leader, generate New Patients, and provide a great public service.

Select a topic that will draw an audience. The “hottest” topic today is Sleep Apnea. Just google into the internet and you will see the widespread interest in Obstructive Sleep Apnea. People are becoming very aware of the dangers caused by the stoppage of breathing while they are asleep. They are looking for answers and very few Dentists are prepared to help them. Take a training course or a seminar, become knowledgeable in the signs and symptoms, the risk factors, and in the various treatment options. Sharpen your expertise.
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Here’s how you do it:
Present a free seminar in your Reception Room. Select a date at least one month out so you and your invitees will be able to get it into your schedules.
How to Announce and Promote it:
  • Have a “sign-up sheet in your office
  • Send out email announcements to patients of record; ask them to assure their place by return email.
  • Let each invitee know they may invite two friends or relatives.
  • Place a large colorful poster in your Reception Room.
  • Distribute flyers to local businesses and professional offices.
  • Place a small display ad in your local newspaper.

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Some Tips for your Seminar
  • Present it in the largest room in your office- usually the Reception Room
  • Prevent any interruptions – turn off phone ringers, etc.
  • Have a “Welcome Table” with some juices and other beverages (sugarless, of course).
  • Have your flyers, brochures, and business cards on the “Welcome Table”.
  • Prepare a power point presentation with video.
  • Subjects like Sleep Apnea are serious, but to keep the audience entertained, infuse some humor.
  • Encourage interactive participation. Invite questions from the audience.
  • Prepare some hand-outs for the participants to take home.
  • These are just a few ideas. I am sure you will think of a lot more.

Objectives and Outcomes

You will be respected as a Leader and Educator.

You will generate New Patient leads.

You will provide a needed and valuable public service.

If you want some help with any of this you may email me: cskdoc@ aol.com

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

☆ LEARN SLEEP WITH DR. FREYDBERG ☆

Dr. Barry Freydberg is a nationally recognized authority on the treatment of sleep disorders. He will share his unique perspective on his very successful Dental Sleep Medicine practice. “Be like Barry.” 
Included in this A to Z presentation is Medical Insurance billing, Codes, Fees and Procedures.  And you will receive 16 CE credits to jump start your new year.
Send us an email cskdoc@aol.com and let us know what you’d like Dr. Freydberg to add to the two day course. 
Getting tired yet of the freezing weather?  Join Dr. Freydberg in Fort Lauderdale on Friday and Satuday, February 12 and 13.  The warmest part of the continental U.S. has been here in south Florida. Enjoy Abraham Lincoln’s birthday weekend in sunny Florida.
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You will be prepared to do far more as a comprehensive care-giver for your patients and the new ones who seek your services.
Review the course outline and register here:
     FT. LAUDERDALE, FL
Sleep Group Solutions

 

SATISFIED IS NOT ENOUGH !

“Satisfied” doesn’t do much for you.  Make them leave you ENTHUSIASTIC and eager to tell the first person they see about their great experience.
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Make them want to tell their friends and families that you are caring and professional. Caring enough to be concerned about treating the entire person, not just their teeth, and professional enough to know how the conditions in the oral cavity effect the other systemic organs.
6-4-12 CLIENT IS KING
Dentists who perform services like a sleep disorder screening and are able to offer solutions like an intra-oral appliance will “wow” their patients and encourage them to be enthusiastic ambassadors. It’s easy, economical and powerful to develop your patients into a marketing team like that. Simply take a course and learn Dental Sleep Medicine. 
The objective is to have every patient leave the office ENTHUSIASTIC and eager to tell the first person they see about their great dental office experiences. The side benefit of adding Dental Sleep Medicine to your practice is that you will be filling a underserved need and helping a lot of suffering patients.

WANT TO LOSE WEIGHT? THEN SLEEP BETTER

Lack of sleep is causally connected to many physical problems. We know that from numerous reliable studies.
Obstructive Sleep Apnea (OSA) is a major cause of sleep loss and one of the common symptoms of (OSA) is being overweight. Sleeping less than six hours — or more than nine hours — a night appears to increase the likelihood of weight gain. So then, how does OSA effect weight gain?
 FAT GUY SLEEPING
There are three hormones that factor in the equation of lack of sleep contributing to weight gain.  

1. Ghrelin: the Hunger Hormone

Lack of sleep increases ghrelin, and decreases leptin, both effects producing increased hunger and obesity. Ghrelin is produced in the gastrointestinal tract and functions as a neurotransmitter. When the circadian rhythm is interrupted by exposure to light at night, gherlin is released.

 2.  Leptin: the Anti-hunger Hormone
Leptin is the satiety hormone that has opposite effects from ghrelin.  The receptor for leptin is found on the same cells in the brain as the receptor for ghrelin.
3.  Melatonin:

Melatonin maintains the body’s circadian rhythm by regulating the other hormones. The circadian rhythm is an internal 24-hour “clock” that plays a critical role in when we fall asleep and when we wake up. When it is dark, your body produces more melatonin. When it is light, the production of melatonin drops. Being exposed to bright lights in the evening, or too little light during the day, can disrupt the body’s normal melatonin cycles. For example, jet lag, shift work, and poor vision can disrupt melatonin cycles.

Melatonin supplements can be helpful for those who are sleep disadvantaged but adherence to directions is recommended.

melatonin 5-6-15

The Process

An inverse relationship between the hours of sleep and blood concentrations of ghrelin exists: as the hours of sleep increase, ghrelin levels trend lower and obesity is less likely.  Short sleep duration is associated with high levels of ghrelin and obesity.

When the stomach is empty, ghrelin is secreted. When we eat something the stomach is stretched and ghrelin secretion stops. Ghrelin acts to increase hunger and to increase gastric acid secretion and gastrointestinal motility to prepare the body for food intake.

What else does Ghrelin do to effect weight gain?
Beyond regulating hunger, ghrelin also plays a significant role in other systemic functions. Ghrelin influences body composition, it stimulates the release of growth hormone and regulates the distribution and rate of use of energy.
Conclusion
This is just another convincing reason to get adequate healthy sleep…. at the right time. Light is the circadian rhythm disrupter. Avoid light disturbances during sleep: have no lights in the bed room, pull the shades down to block any outside light, wear an eye mask.

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Resources
WebMD
Wikipedia
Zarouna SWozniak, G, Papachristou, Stalo Zarouna,
Psychology Department, University of Cyprus, Nicosia 1678, Cyprus.
  • Department of Cell Biology, Physiology and Immunology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), and CIBER Fisiopatología de la Obesidad y Nutrición, 14004 Córdoba, Spain.
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