Obstructive Sleep Apnea

Can’t Wear a CPAP mask? Your dentist may help..


Obstructive sleep apnea (OSA) is a chronic condition when it causes disturbances in sleep three or more nights a week. It occurs in males twice as often as in females. As we age, we lose muscle tonus in many areas of the body, including the mouth and throat. And just as you may be a little flabby in your belly, you also become flabby in the muscles controlling your airway. The usual scenario is this: You fall asleep on your back. Your tongue falls back toward your throat. Your soft palate and your pharynx also collapse a bit. You start to snore as the air that you inhale goes through the airway that is now narrowed because of the muscle collapse. What happens if those airway muscles completely collapse? You stop breathing. Of course, you won’t let your body do this for too long, so you wake up just enough to tighten the muscles in your airway and start breathing again.

This process can occur several times per hour. The more you are awakened out of a deep sleep, the more tired you’re likely to be the next day. But is doesn’t stop there. OSA increases the risk for high blood pressure, heart attack, stroke, obesity, and diabetes.

The first-line treatment for OSA is CPAP (Continuous Positive Airway Pressure), a nasal and/or oral mask connected by hose to a machine that gently blows air into your airway to keep it from collapsing. Despite its effectiveness, many with OSA, particularly in its mild or moderate form, find the CPAP to be a nuisance and don’t use it.

An increasingly popular alternative to CPAP for those who cannot use it is an oral appliance. This device, worn on top of the teeth, opens your jaw and moves it forward, thus opening your airway.

You can try it yourself. Take a deep breath and feel the air going through the airway. Now thrust your lower jaw forward and take another deep breath. Do you feel a difference? You’ve just opened your airway. The oral appliance opens the airway in the same fashion, stopping snoring and alleviating obstructive sleep apnea for many. And for those who don’t like CPAP, it seems to be better accepted.

There are many oral appliances available for OSA. There are simple snoring appliances. There are also adjustable appliances that you or your dentist can adjust to put your jaw in the most ideal position to open your airway. The use of such an appliance may not just make you a less noisy bed partner, it may save you from daytime fatigue as well as reduce your risk of some serious diseases.

Lee N. Sheldon, DMD

NUTRITION and Periodontal Disease

NUTRITION and Periodontal Disease

The area that doctors and researchers are studying very carefully is chronic inflammation. In fact, chronic inflammation may very well be the common link to all of the chronic degenerative diseases—arthritis, heart disease, some forms of cancer, and periodontal disease to name just a few. I mention periodontal disease, because as a periodontist, that is what I see on a frequent basis.

Periodontal disease is that disease which causes a loss of the supporting bone for the teeth. Also known as pyorrhea and gum disease, periodontal disease robs the person of his or her teeth, resulting in loss of mouth function, loss of support of the facial tissues, and discomfort in eating.

So why bring this up in this column. The facts are changing in regard to this disease. For years, we have emphasized controlling plaque. You know—Floss your teeth, brush your teeth. “But you showed me how to floss my teeth last time!! “ Well, get even more used to the lecture, because we have even more information that links gum disease to overall disease. Your body’s immune response to plaque in your mouth results in chronic inflammation. That chronic inflammation not only destroys the bone supporting your teeth, it also destroys tissues all over the body. Yes, that’s right, all over the body.

But if you think that’s all, just hang on here a little longer. While plaque is necessary in the start of periodontal disease, there are other factors that will worsen it and worsen the chronic inflammation in the rest of your body. What is that, pray tell? NUTRITION !!! In fact, nutrition can play a positive or a negative role depending on how positively or negatively you eat. You already know what the bad things are, highly processed food, fast food. Have you ever seen what a McDonald’s hamburger looks like 4 years after it’s cooked. I have one. It looks exactly the same as when I bought it, bun included. I’ll show you. How good is that for you?

The American Heart Association recommends 4-5 servings a day of fresh vegetables and 4-5 servings a day of fresh fruits on a 2000 calorie diet. Yes, that means 8-10 servings (a serving is usually a half cup of a dense fruit or vegetable or a full cup of a leafy vegetable) of delicious fruits and vegetables. That will reduce your risk of heart disease, and it will also reduce your risk of other degenerative diseases, including periodontal disease.

“But I take my vitamins,” you say. Sorry. Vitamins don’t cut it. A multivitamin has generously 50-75 nutrients in it. A whole fruit or vegetable—over 12,000 nutrients that have been identified already. Some studies on vitamins A, C, and E were stopped because those people taking the vitamins were doing worse than those who weren’t.

Whole foods is the answer. And there are also whole foods supplements that you may take to help.

So, just before you brush and floss, have an apple, eat some grapes, dip some carrots in peanut butter (unprocessed). Eat the good foods. They may save more than your teeth.



Lee N. Sheldon, DMD

What to do about the loose lower denture

Lower dentures are famous for being loose and difficult to retain in the mouth. Lower dentures are where most of the dental adhesives are used. If you have a lower denture that is loose and floppy, that lower denture may be able to be converted to a dental implant supported denture. Very often your existing denture can be used and a new denture does not have to be constructed. By the placement of as few as two implants in the jaw, snaps can be placed on the inside of your denture to allow you to snap your dentures in place. Imagine your denture just being clicked into place. No adhesives, no worry about a denture suddenly moving out of your mouth. Walk in, have the dental implants placed in about a forty minute procedure, wait a month, then readapt your denture to the dental implants in about one hour, and voila! In less than two hours you have a denture that is snapped in place.

Remember, we have a Charitable Giving Campaign, and that is for a donation of $50 to charity Drs. Sheldon and Amir and his staff can tell you whether you are a candidate for this efficient, comfortable, and cost-effective procedure. Procedures can also be done to allow your existing denture to be screwed in to dental implants so that it doesn’t move at all. Such a procedure, with the appropriate planning, could be done all in one day. Dr. Sheldon and Dr. Amir can place the implants and on the very same day your denture can be adapted to the dental implants and literally screwed in place. The dental implants are then allowed to heal in place and about four to six months later you will have a new, permanent, implant-supported prosthesis made.

Osstell Radiofrequency Analysis Device

We now have the Osstell Radiofrequency Analysis Device, a device which accurately tells us when your implants are ready for restoration. The Osstell Radiofrequency Analysis Device determines by sonic waves when your dental implant is firmly attached to the bone. It looks like an iPod. By placing a wand close to your dental implant, the Osstell sends out radiofrequency waves to the implant. The implant, itself, then vibrates very much like a tuning fork. The amount of vibration of the dental implant then is measured by the Osstell device and a numerical readout instantly shows up on the machine. The numbers on the readout accurately determine when your implant is ready for restoration. This will greatly speed up restoration, as within a matter of moments, we will know how firmly embedded your implant is to the bone. The Osstell technology, combined with our new Cone-Beam CT scan, brings the latest in technology to our office to improve predictability for you.

Please Pardon Our Dust!

In anticipation of Dr. Jamie Amir’s arrival on July 6th, and the arrival of our new dental Con-Beam CT scan, our office is undergoing rejuvenation. Here are all of the things that are going to occur over the next few months.
• One additional treatment room.
• One additional consultation room.
• A room for our new Cone-Beam CT scan.
• Complete dental laboratory
• Ostell radiofrequency analysis unit to predict the suitability of your bone for dental implants.
• Installation of BTI platelet derived growth factor system
New staff are being trained now to implement all these changes. The same old faces will be here, and there will new smiling faces to improve our delivery of the best dental implant and periodontal services that we can provide.

Welcome, Dr. Jamie Amir!

The office is making substantial changes in anticipation of welcoming our new associate, Dr. Jamie Amir. Dr. Amir just finished up his training at the University of Florida. He will come to us with a diverse and comprehensive background. His original training in dentistry was in England. He then came to the United States for all of his advanced dental training. Dr. Amir brings to us a two year residency in dental implants and a three year residency in periodontics. Five years of post-graduate education in the specialties that we deal in, plus four years of dental school training means nine years of post-graduate training. This is unique and very special in our field. Dr. Sheldon has had the opportunity of teaching Dr. Amir over the past three years and observing Dr. Amir’s work. We are thrilled to have Dr. Amir with us. Dr. Amir’s diverse training will allow us to open new services to our patients and to our referring doctors. Dr. Amir’s scheduled start date is July 6th.

Office Update!

We are happy to have a new addition to our staff. Michelle, our new sterilization technician, joined our team last week. Michelle is an experienced dental assistant who has additional schooling in dental hygiene. She says what she likes so far about our office is “everybody’s willingness to help each other out in a team environment.”

I am hosting another free dental implant lecture this Wednesday, March 18th at 1:00 p.m. This lecture is designed for anyone who wants to learn more about dental implants or Teeth-In-an-Hour. It lasts about an hour and we do provide a light lunch. If you would like to attend, please give us a call at (321) 259-9980.