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.
7-14-12 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):

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?

7-14-12 SNORING

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

 

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

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.

https://adental.files.wordpress.com/2015/06/counting-sheep-a.jpg

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.

RECOMMENDATIONS FROM THE NATIONAL SLEEP FOUNDATION

Sleep protects our physical and mental health and insufficient sleep is the cause of some serious health problems including strokes, high blood pressure, overweight and obesity, diabetes, dementia and occular problems.

6-2-12 BRAIN

 

Obstructive Sleep Apnea is a killer. Imagine holding your breath for 10 to 30 seconds 30 times in one hour. How much sleep would you get? How much oxygen would be passing to your brain?

“Sleep is important for mental function, alertness, memory consolidation, mood regulation and physical health,” says Phyllis C. Zee, MD, PhD, professor of neurology and director of the Sleep Disorders Center at the Northwestern University Feinberg School of Medicine in Chicago.

The amount of sleep that a person needs to stay healthy, alert and active depends on their age and will vary from one person to another, but there are now some recognized guidelines.

The National Sleep Foundation (NSF) evaluated 300 studies and recently released an age-based sleep recommendation scale. 

SleepTimeRecommendations0126151-page-001_0

Newborns (0 to 3 months):     14 to 17 hours of sleep
Infants (4 to 11 months):          12 to 15 hours of sleep
Toddlers (1 to 2 years):            11 to 14 hours of sleep
Preschoolers (3 to 5 years):   10 to 13 hours of sleep
School-agers (6 to 13):               9 to 11 hours of sleep
Teenagers (14 to 17 years):      8 to 10 hours of sleep
Young adults (18 to 25 years): 7 to 9 hours of sleep
Adults (26 to 64 years):              7 to 9 hours of sleep
Older adults (65 years +):           7 to 8 hours of sleep

Gender Differences

Women often sleep more than men and their sleep is lighter and more easily disrupted. Pregnancy and hormonal changes related to menopause influence sleep health. Traditionally, tending to babies and children was “the woman’s job” but today the modern man shares those nocturnal duties.

Other Factors that Disrupt Sleep

Depression, stress, arthritis, fibromyalgia, muscle pain, epilepsy, heart disease and substance abuse. Restless Leg Syndrome is another sleep disrupter.

START THE NEW YEAR WITH A NEW (MUCH NEEDED) SERVICE

You know about Dental Sleep Medicine and you’ve heard how some dentists are so happy to be offering it to their patients. One out of every three patients who walk through your doors has symptoms of sleep dysfunction. ARE YOU PREPARED TO HELP THEM? 
An Introduction to Dental Sleep Medicine
Dr. Marty Lipsey is coming to the San Jose area to speak on treating patients for Sleep Disordered Breathing issues. Dr. Lipsey is recognized as the top expert in Medical Billing for Dentists.
LIP 5
    
Take advantage of this end-of-year special, offered at a 30% savings plus NO CHARGE for up to two staff members. Register with code: email695.
When:  December 18-19th
Where: Courtyard San Jose Airport
Time:    8am-5pm (both days)
CEU:     16 (AGD/PACE)
Tuition: 
$695 (includes 1 DDS and 2 Staff)
Promo code: email695
About 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 also a Sleep Group Solutions Instructor and teaches Dental Sleep Medicine from coast to coast.

Read the course content and register here 

http://join.sleepgroupsolutions.com/seminars/san-jose-ca-2/ SAN JOSE, CA 

Courtyard San Jose Airport

http://join.sleepgroupsolutions.com/seminars/san-jose-ca-2/

 

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! 

 

SLEEEP SOUNDLY this fall- don’t sleep WITH SOUND.

8-3-14 SAW WOOD  

 In denial, many people still ask, “What’s the big deal about snoring?” “Don’t most people snore?”

Snoring is disturbing and is a major cause of spousal alienation. Who can sleep with the sounds of a freight train two feet away from their ear? Spouses of snorers often have to move into separate bed rooms and sales are up of homes with two Master bed rooms. Snoring is, however, the most attention demanding WARNING SIGN of serious sleep dysfunction. 

It is the common denominator in the Sleep Apnea equation. Snoring, like pain, should sound an alert to us that there is something more serious to look for under the surface.

We continue to learn about more illnesses connected to Sleep Apnea–

Cancer

Researchers suggested a correlation between sleep apnea and increased cancer risk of any kind. A Cancer study of 1,240 participants who underwent colonoscopies found that those who slept fewer than six hours a night had a 50 percent spike in risk of colorectal adenomas, which can turn malignant over time. Another 2012 study identified a possible link between sleep and aggressive breast cancers. (Ref: 2010 American Cancer Society) 

Other serious ailments known to be tied to Sleep Apnea are:    Heart Disease. Strokes, Dementia, Depression, Diabetes Mellitus, High Blood Pressure, Chronic Daytime Fatigue, Motor Vehicle Accidents

With an assortment of health threats like these, all Sleep Apnea related, we need to show more respect to snoring.

3-24-14 SNORING

The word equinox means “equal night”; night and day are about the same length of time. This occurs two times each year: Vernal in late March and Autumnal in late September.

DENTISTS- ARE YOU READY FOR THIS?

It’s mid-September and there are just a few months left to get those CE credits.
Here’s how to do it and score even greater benefits:
Have your Dental Study Club or local Dental Association schedule a meeting for a Dental Sleep Medicine presentation. We will provide all licensed attendees with materials,CE credits and most importantly, with a valuable introduction to DSM.
9-27-14 MS SAN FRAN.FROM BACK.jA
Presentation Outline
These presentations include analysis of patients’ symptoms and how to screen for them, scripts for an effective patient interview, how to motivate the Dental team to engage their patient on the subject, the morphology of the airway, comorbidities to look out for, the effects on the systemic organs, the reimbursement strategy and insurance billing using dental and medical coding.
4-20-13 GELB 3
Dentists who attended our DSM presentations have gone on to make DSM an important element on their practices.
Email me at cskdoc@aol.com to check on available dates.

☆ SHINE WITH THE STARS IN CA AND DC ☆

  ☆ From coast to coast.  From Irvine, CA to Washington, DC. ☆
On Friday and Saturday, September 18,19, scores of dentists will become rising stars in the Dental Sleep Medicine universe.  In a two day training program, in both of these cities, the most comprehensive introduction to DSM will be presented. The nation’s most knowledgeable sleep authorities will present  a program with an interactive hands-on opportunity to work with sophisticated diagnostic equipment. 
One third of your patients suffer from sleep dysfunction. Are you prepared to help them?  Join the force. Your patients need you.
8-2-14 MATH FOR DUMMIEsS 8
This training course will make it easy for you to get started as a “sleep doctor”. It is two full days and offers 16 CE credits.  You can read the course outline, meet the presenters and register here for any of the courses:  http://join.sleepgroupsolutions.com/seminars/
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