Category Archives: continuing education
MAY IS NATIONAL STROKE AWARENESS MONTH
WHAT IS MISSING IN YOUR COMPREHENSIVE DENTAL EXAM?
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. .

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.
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.
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?
Interested? Then check this out: www.sleepgs.com
NATIONAL SLEEP AWARENESS WEEK ends with DAYLIGHT SAVINGS TIME on March 13th.
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?
Are you keeping your partner awake?
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
02/19/2016 – 02/20/2016 |
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CHARLOTTE, NC
DoubleTree by Hilton Hotel Charlotte Airport
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02/19/2016 – 02/20/2016 | ![]() |
LAS VEGAS, NV
The Westin Las Vegas Hotel – Casino & Spa
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ARE YOU LOOKING FOR A WAY TO STAND OUT IN YOUR COMMUNITY?
Here is how you can gain respect as a thought leader, generate New Patients, and provide a great public service.
- 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.
- 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 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?”
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.
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.
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 role. The 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
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Abfractions are usually caused by improper teeth brushing. (F)
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Abfractions are a specific type of dental decay. (F)
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Correction of an abfraction requires more than just a cervical filling. (T)
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Nutrition plays a role in worsening abfractions. (T)
Multiple Choice
Which are correct?
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.Abfractions occur primarily on the facial surfaces of teeth.
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A porcelain veneer can have an abfraction.
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Abfractions occur only on maxillary teeth.
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An abfraction may be able to cause a separation fracture of a tooth crown.
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All the above.
The treatment options include all except one of the following:
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Orthodontics
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Nutritional adjustments
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Occlusal adjustment
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Periodontal Therapy
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Cervical restorations
☆ LEARN SLEEP WITH DR. FREYDBERG ☆
Sleep Group Solutions
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SATISFIED IS NOT ENOUGH !
WANT TO LOSE WEIGHT? THEN SLEEP BETTER
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.
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.
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.
- 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.