Get the 411 on Porcelain Veneers

Posted on May 6, 2018 by HartrickDentistry

Royal Oak and Birmingham, MI

How would you like to improve the way your teeth look, but also how they function? Porcelain veneers can accomplish this double feat. The veneers used at Hartrick Dentistry represent the pinnacle of strength, flexibility, and aesthetics that currently is available in the world of cosmetic dentistry. In many cases, having porcelain veneers installed can resolve several cosmetic issues at the same time.

Here is some more information on porcelain veneers, and their potential benefits:

A dream smile: Advances in cosmetic dentistry have made it more attainable than ever to have a beautiful smile worthy of Hollywood. This means having brilliant white teeth that are all perfectly straight and long is achievable. Improving your smile will make you more likely to want to show it off, thus boosting your self-confidence. Studies even show that people with a gorgeous smile are more likely to get promotions at work, and get more dates!
Versatility: A porcelain veneer can resolve aesthetic concerns if your teeth are discolored, stained, chipped, misshapen, crooked or too small. Even a person who has multiple complaints with the look of their smile can have those aesthetic issues treated at the same time by receiving a veneer.
How they work: A veneer is an ultra-thin layer of ceramic that is custom-crafted to fit on the front of your natural teeth, covering the visible surface. Each of the veneers used by your Royal Oak cosmetic dentist at Hartrick Dentistry is constructed of beautiful, high-quality dental porcelain. This porcelain has the same light-reflecting quality as natural tooth enamel. Plus, the porcelain can be color-matched and shaped to look like your other teeth if only receiving a one or two veneers on your front teeth. However, if you desire a complete smile makeover, costmetic dentist Dr. Nancy Hartrick can help you choose a much lighter shade to give your smile a permenantly white look.
Durability: The word porcelain may conjure images of fragility, but the ceramic used to construct our high-quality dental porcelain represents the cutting edge of cosmetic dental technology. In addition to looking beautiful, this porcelain is powerful; it can withstand as much as 58,000 pounds of pressure per square inch.
Choose wisely: Make sure to seek out a dentist with the knowledge and the aesthetics to perform a porcelain veneer installation. Many dentists may claim to offer porcelain veneers, but that does not mean they can perform the procedure at a high level. It takes a unique blend of technical expertise and artistry to install a beautiful, fully functioning porcelain veneer. Common mistakes include errors when preparing your teeth to receive the veneers, which can affect their durability; or installing them without paying due diligence to your bite, causing a misalignment that can damage both your veneers and your healthy teeth.

Veneers in Royal Oak

At Hartrick Dentistry, we make sure to tailor each porcelain veneer installation to the needs and goals of every individual patient. We never take a “by the numbers” approach to a veneer or any dental procedure for that matter, making sure that each veneer patient leaves with a unique and flawless-looking smile.

To learn more about porcelain veneers, or any of the other cosmetic techniques and treatments at our disposal at Hartrick Dentistry, call our office at (248) 549-0950 to schedule a consultation today.

Hartrick Dentistry is proud to serve the oral health needs of patients in the areas of Royal Oak and Birmingham, Michigan.

Posted in Cosmetic Dentistry

Sedation Dentistry for Dental Anxiety

Posted on April 7, 2018 by HartrickDentistry

Royal Oak and Birmingham, MI

Gum disease affects nearly half of Americans who are over the age of 30. Meanwhile, it is estimated that one out of every three Americans is dissatisfied with the appearance of their smile. However, millions of individuals avoid going to the dentist out of fear.

What is a dental phobia?

This is a condition known as dental phobia, and it affects 30 to 40 million people in this country. This refers to patients who experience strong feelings of fear and anxiety. As a result of this behavior, many people with dental anxiety actually have the greatest need to receive professional oral care because they have neglected regular check-ups and cleanings, allowing significant problems to develop. A patient who suffers from dental anxiety may go several years—or even decades—without seeking the care of a dentist because of this phobia.

If you or a member of your family suffers from dental anxiety, these feelings of fear no longer have to stand in the way of top-quality professional oral care thanks to sedation dentistry. This refers to the practice of using sedation to make a patient calm and comfortable, allowing dental care to take place.

Oral Sedation

Oral sedation, which is administered as a small pill, is the most common type of sedation. This sedation will make you relaxed and perhaps a bit drowsy, but will not put you to sleep. You still can respond to those speaking to you, but you will have less awareness of your surroundings.

Nitrous Oxide (Laughing Gas)

Nitrous oxide is another popular type of sedation used in dentistry. Also known as laughing gas, nitrous oxide has been used for decades in dentistry and makes a person very relaxed in a short period of time. Proven safe and effective, nitrous oxide is mixed with oxygen and administered in a mask that fits over the nose. Once a procedure is complete, the flow of the gas is cut off and replaced with pure oxygen, allowing a quick recovery from the effects of nitrous oxide.

Who should not undergo sedation dentistry?

Certain pre-existing conditions may preclude you from sedation dentistry. These conditions include pregnancy, glaucoma, and central nervous system depression. A qualified dentist should evaluate your medical history before beginning any procedure that involves sedation.

Visit the dentist without fear or anxiety

Sedation dentistry makes it possible to undergo even extremely lengthy or uncomfortable procedures. You can sit in comfort without feeling any pain. Sedation also can be a good option for patients who have difficulty sitting still or holding their jaws open for a prolonged period of time, as well as those who deal with an extremely sensitive gag reflex.

Sedation Dentistry in Royal Oak

Whatever the reason, if phobia or some other condition has kept you away from the dentist, then sedation dentistry could be right for you. At Hartrick Dentistry, we offer sedation in the form of both a pill and nitrous oxide. Which form of sedation is right for you will depend on your oral health, overall health, and the degree of your fear regarding seeing your Royal Oak sedation dentist. To learn more, contact our office at (248) 549-0950 to schedule a consultation.

Hartrick Dentistry is proud to serve the oral health needs of patients in the areas of Royal Oak and Birmingham, Michigan.

Posted in Anxietry-free Dentistry

Dangers of Mouth Breathing

Posted on March 10, 2018 by HartrickDentistry

Royal Oak and Birmingham, MI

Parents spend time and money to make sure their children are safe, but did you know that how your child breathes can have a major effect—good or bad—on his or her health? Children who engage in regular mouth breathing early in life can be more vulnerable to a variety of issues, ranging from skin diseases and GI issues to a sleep breathing disorder such as obstructive sleep apnea.

How you breathe matters. The ideal manner of breathing is by taking shallow breaths through the nose. Breathing in this way means you receive a higher quantity of oxygen. Nasal breathing also produces nitric oxide, which encourages vaso-dilation in the airway, arteries, and capillaries, and allowing more oxygen and carbon dioxide to pass through your bloodstream.

Mouth breathing, however, dries and constricts the airway. Less oxygen is filtered into the bloodstream. Regularly breathing through the mouth also encourages the growth of bacteria, which increases the vulnerability of sinusitis, and it can inflame the GI tract.

Sleep apnea is one of the greatest health risks associated with mouth breathing. After all, many mouth breathers also snore, and snoring is considered the biggest warning sign of a sleep breathing disorder like sleep apnea. A patient with sleep apnea experiences a collapse of the airway during sleep. These collapses can be partial or complete, disrupting your ability to breathe and jolting you out of the sleep cycle as your body gasps for air. A person with an advanced case of sleep apnea may experience these airway issues hundreds of times per night. It is no wonder you may wake up feeling tired even though you were in bed for eight hours or more.

What causes mouth breathing? The culprit could be allergies or having enlarged tonsils. In most cases, however, improper oral resting posture is the reason behind regular mouth breathing. This posture problem actually is quite common with today’s westernized diet, as it encourages narrow dental arches and can affect the proportions of the face.

By using a custom-made oral appliance, your Royal Oak sleep apnea dentist can guide your child back into the preferred oral resting posture: with lips together, teeth together, and the tongue resting gently against the roof of the mouth. Over time, using such an appliance widens the arches, allowing the permanent teeth to erupt in their optimum positions as well. This optimum oral resting posture also encourages a wide, well-functioning airway that is far less susceptible to the type of blockages that occur in sleep apnea.

A professional dental practice such as Hartrick Dentistry can prescribe an oral appliance that is far superior to the anti-snoring mouthpieces and other mouth guards available in stores. Each of these oral appliances from your Royal Oak dentist is one of a kind, made from impressions of the mouth of a patient to provide a snug, effective, comfortable fit.

Many times, children benefit from a course of myofunctional therapy, which trains muscles of the tongue and mouth to rest and function properly. This in turn will help facilitate nasal breathing and an open airway. Myofunctional therapy is offered at your Royal Oak dental office.

Parents can do their part to diminish the likelihood of mouth breathing in their children by providing a diet that includes a healthy assortment of raw and crunchy foods. Consuming these foods encourages jaw development, which is crucial as strong jaws make it easier to maintain the ideal oral resting posture.

Myofunctional therapy and sleep apnea treatment in Royal Oak

Have you noticed your child breathing regularly through the mouth or snoring loudly at night? If so, Hartrick Dentistry can help. Contact (248) 549-0950 to schedule an appointment today.

Hartrick Dentistry provides the finest level of dental care to people in the areas of Royal Oak and Birmingham, Michigan.

Posted in Pediatric

How to get rid of those Embarrassing White Spots on your Teeth

Posted on February 5, 2018 by HartrickDentistry

Royal Oak and Birmingham, MI

For generations, dentists have been using fluoride to help patients in their fight against cavities and tooth decay. However, did you know too much fluoride could be a bad thing?

What are all of these white spots?

Too much fluoride exposure, especially when your teeth still are developing, can affect the formation of tooth enamel – the outermost structure of your teeth. This can result in cosmetic issues, such as white spots that form on the surface of teeth—a condition that is referred to clinically as fluorosis.

Is fluoride good for my teeth?

Generally speaking, fluoride is a good thing for your teeth. It actually serves as a catalyst that affects how quickly tooth enamel forms. An excess amount of fluoride, however, means the enamel forms before all the supporting minerals in a tooth can establish themselves.

What is fluorosis?

If you have these small white spots on your tooth, this is considered a low grade of fluorosis. More severe stages of fluorosis can manifest as opaque areas on teeth, all the way to the most advanced cases of fluorosis where your teeth appear darkly stained, corroded or pitted.

Teeth whitening to treat fluorosis

Many people with just mild cases of fluorosis are dissatisfied with how their smile looks because of the white spots. Certain cases of cosmetic fluorosis will respond to teeth whitening procedures, especially the professional deep bleaching treatments that whiten the rest of the tooth to match the shade of the lesions. However, receiving a whitening treatment also may whiten the lesions as well, making them continue to stand out. You should seek the care of a qualified cosmetic dentist for any whitening procedure, as a professional whitening treatment will yield better results and cause less tooth sensitivity than the whitening kits that are available for purchase over the counter in stores.

Veneers to hide white spots

The most consistent treatment for cosmetic fluorosis is to receive a veneer. These ultra thin porcelain shells cover the existing defects in your tooth enamel, concealing the lesions and creating the appearance of smooth, natural, healthy tooth enamel. Advancements in cosmetic dentistry mean that the dental porcelain used by your Royal Oak cosmetic dentist to fabricate each veneer is of the highest quality, and even has the same light-reflecting appearance as natural tooth enamel.

Save severely damaged teeth with a dental crown

Advanced cases of fluorosis can do structural damage to teeth, leaving them vulnerable to decay because of the damaged enamel. If you have extensive decay in a tooth, a dental crown can possibly save it. In these cases, your Royal Oak dentist can install a dental crown to protect and restore your tooth. Made of the same top-quality dental porcelain as veneers, these crowns replace the exterior of the tooth, protecting the interior structure and preventing potential tooth loss.

Cosmetic Dentistry in Royal Oak

If you have noticed these white spots developing on your teeth, seek the care of a qualified, experienced cosmetic dentist to resolve those aesthetic issues and prevent the fluorosis from advancing to more serious stages that can damage the structure of your teeth. The office of Hartrick Dentistry can treat fluorosis in any stage. Call our office today at (248) 549-0950 to schedule a consultation.

Hartrick Dentistry is proud to serve the oral health needs of patients in the areas of Royal Oak and Birmingham, Michigan.

Posted in General Dentistry

Why Lying to Dentist is bad for your Oral Health

Posted on January 8, 2018 by HartrickDentistry

Royal Oak and Birmingham, MI

“Have you been flossing?” It is a question that you should hear asked every time you visit your dentist for a cleaning. When asked this question, or anything else regarding your oral hygiene habits at home, it is important to be completely honest. Embellishing, fibbing or outright lying to your dental provider makes it more difficult for you to receive the top level of oral health care. Lying about or oral health routine simply doesn’t do you any favors! Plus, spoiler alert – we know when you are not telling the truth about how often you brush or floss.

Lying about your personal oral hygiene, such as the frequency of flossing, will not work inside the dental office. An expertly trained dentist or dental hygienist can recognize the sign of oral health issues immediately, just by observing indicators such as the accumulation of tartar between the teeth and under the gums. Also, when your gums bleed easily it is usually a good indicator that you do not floss regularly or even at all. Trying to make up for missed time brushing or flossing by performing personal hygiene vigorously for a few days before a dental visit also does not work. In short, there is no substitute to disguise the results achieved from a long-term regimen of comprehensive personal oral hygiene.

Being completely honest with your dentist also allows you both to remain on the same page at all times. If your dentist has all the valid information—the good and the bad—he or she can come up with an optimal regimen of oral home health care that will be customized to your specific lifestyle and needs. Having full knowledge of your real brushing and flossing habits also allows your dentist and dental hygienist to provide the most effective treatments possible during a dental visit.
Plus, it will save you money in the long run.

Even the best dental work by an exceptional dentist will only go so far if the patient does not comply with good oral hygiene efforts. If you spend a significant amount of money on cosmetic dentistry, yet still do not brush and floss regularly, your results simply may not last as long as it could. This means you may end up paying to redo treatment much earlier than you should have, had you kept up with your oral health.

While there are certainly unforeseen circumstances or pre-existing conditions that may contribute to the condition of your oral health, it is important to also discuss your medical history with the dentist. Certain conditions such as pregnancy or diabetes can really take a toll on your oral health, and it may effect how we ultimately treat you for your oral care needs.

So, remember, when your dentist asks questions about your oral hygiene, honesty is always the best policy.

A lifetime of good oral health only can be achieved when you and your dentist work together to obtain the best possible results. If you want to learn more about Hartrick Dentistry and the services that we offer, call our office at (248) 549-0950.

Hartrick Dentistry is proud to serve the oral health needs of patients in the areas of Royal Oak and Birmingham, MI.

Posted in Oral Health

Make Your Smile Sparkle for the Holidays

Posted on December 6, 2017 by HartrickDentistry

Royal Oak and Birmingham, MI

Office parties and family gatherings will soon set off the holidays. But, how confident will you feel walking into that room full of co-workers of family members? If your smile is not as bright as you want it to be, there is still time to make your smile sparkle for the holidays!

Why are my teeth dingy and yellow?

Our teeth naturally become yellow and dingy from the foods we eat, specifically by drinking coffee or wine, and by using tobacco products. But, sometimes you can do your best to avoid these things, but end up with a less than perfect smile still. What gives? Well, you can thank Father Time, since teeth naturally discolor as we age. Also, if you do not practice good oral hygiene, you are likely to experience discolored or stained teeth.

How can I brighten my teeth for the holidays?

A simple and inexpensive method of brightening your teeth is with teeth whitening. You have probably seen many teeth whitening kits available over-the-counter at your local drug store, but keep your money in your pocket! These whitening kits can only do so much as far as whitening your teeth, and may not be as effective and safe as professional whitening treatments available at your Royal Oak dentist.

Teeth Whitening with ZOOM!

To get your smile ready for the holidays, Dr. Nancy Hartrick offers ZOOM! teeth whitening in Royal Oak. ZOOM! whitening is available only by prescription at your dentist’s office and can be applied in-office or for use with customized bleaching trays that you can take home and use for treatments. This professional grade of teeth whitening is available in six different concentrations, which means your dentist can choose the best solution for you.

Why Choose ZOOM!

Since ZOOM! is prescribed by your dentist, the right concentration can be selected for you, which helps provide the best results and with reduced sensitivity, unlike with those one-size-fits-all whitening products sold in stores. Over-the-counter whitening agents are designed for everyone, which means they generally are a much weaker solution than what you will find offered at Hartrick Dentistry.

How does ZOOM! work?

When you arrive at our office in Royal Oak, you will have a whitening consultation with Dr. Hartrick as she assesses your oral health, as well as consider your desires for a brighter smile. Then, she will determine which ZOOM! concentration is best for you. The entire whitening process should take no more than 30-45 minutes so you can literally get whiter teeth on your lunch break!

If you prefer to whiten your teeth at home, Dr. Hartrick will custom design whitening trays for you, and provide a whitening solution for you to take home. She will also instruct you on how to whiten your teeth, how often, and for how long.

Teeth Whitening in Royal Oak

If you desire a brighter smile for the holidays, ZOOM! whitening may be right for you! To learn more about teeth whitening, or any of the other cosmetic techniques and treatments at Hartrick Dentistry, call our office at (248) 549-0950 to schedule a consultation today.

Hartrick Dentistry is proud to serve the oral health needs of patients in the areas of Royal Oak and Birmingham, Michigan.

Posted in Cosmetic Dentistry

How what you eat Impacts your Teeth

Posted on November 11, 2017 by HartrickDentistry

Royal Oak and Birmingham, MI

The first thing that comes to mind when thinking of oral health is the basics: flossing, brushing, and routine cleanings. But, did you know what you eat can impact oral health too? Of course, your dentist wants you to stick to the basics, as well. “Have you flossed today?” Just kidding, we’re not here to nag you, but simply inform! As a culture, dieting and clean eating are becoming more prominent ways of getting that ideal body, but did you know that you can also protect your gums from the same practices?

By incorporating immune boosting foods, you could improve your oral health. According to an article by knowyourteeth.com, “Research shows a link between oral health and systemic conditions, such as diabetes and cardiovascular disease. So eating a variety of foods as part of a well-balanced diet may not only improve your dental health, but increasing fiber and vitamin intake may also reduce the risk of other diseases.” Foods rich in Vitamin C such as oranges, red peppers, kale, and brussel sprouts can help strengthen blood vessels, produce collagen to help fight periodontal disease, and can reduce inflammation. A few surprising, yet delicious immune boosting foods include garlic, shellfish, and sunflower seeds.

When you think of Vitamin C, is fruit the first thing to come to mind? It’s for sure the first thing to pop in our minds, but it is important to be cautious of how you are consuming those vitamin-packed, delicious fruits. Although a seemingly healthy option, steer clear of dried fruit. The sugar count is normally high and can often hurt your oral health. Also, canned fruit is a no go. Yes, it is easier and cheaper, but the sugar from the syrup tends to be too much for those pearly whites, increasing your risk of tooth decay. Fresh fruit is always the way to go, it’s delicious, juicy, and benefits your total health.

Adding more fresh fruits and veggies into your diet can be easier than you realize. Fresh fruit smoothies are simple, refreshing, and healthy for your mouth and body. You can even add a handful of your favorite greens for an added punch of antioxidants and vitamins. You might be surprised that your kids may also enjoy this delicious treat. Plus, it is a simple, fuss-free way of getting them to eat more fresh fruit.

Creating a well-balanced diet is one step toward a healthier mouth and body but don’t forget the most important part of oral health – routine check-ups and cleanings. To begin your journey of complete oral health, reach out to Hamilton Dental Care today!

Hamilton Dental Care helps create beautiful smiles that fit the needs of every patient in Bloomsburg, PA and surrounding areas including Danville and Lewisburg. All restorative treatments provided by Dr. Joel Hamilton and Dr. David Hamilton is not only functional but focus on cosmetics as well. With Hamilton Dental Care, you are part of the family. You can schedule your next consultation by calling 570-387-0533.

Posted in Oral Health

Link Between Sleep Apnea & Type II Diabetes

Posted on October 8, 2017 by HartrickDentistry

Royal Oak and Birmingham, MI

Scientific research continues to show a link between obstructive sleep apnea and Type II diabetes.

The International Diabetes Federation (IDF) now recommends that any patient with one of the two conditions be screened for the other. As published in the Sleep Medicine journal, the IDF states that approximately 13 percent of men and 6 percent of women in America suffer from moderate to severe sleep apnea that has gone undiagnosed. Sleep apnea is referred to as the “silent killer,” and could be putting your life on the line!

A separate study by the University of Wisconsin School of Medicine and Public Health showed that obesity increases the risk factor for both sleep apnea and diabetes.

Sleep apnea is a sleep breathing disorder. A patient with the disorder experiences a partial or complete collapse of his or her airway during sleep. This diminishes or cuts off the flow of oxygen, causing breathing to become intermittent and disrupting the sleep cycle. In a patient with severe sleep apnea, these collapses may occur hundreds of times during the night, leaving a person feeling fatigued and irritable. Sleep apnea increases the risk of other chronic health ailments such as cardiac disease, high blood pressure, anxiety, depression, obesity, and—yes—diabetes.

The World Health Organization estimates that one out of every 10 adults has diabetes. Most diabetic patients have Type II diabetes, meaning they cannot make or process enough insulin, a hormone that helps regulate blood sugar.

This new research emphasizes the need for preventive screenings for sleep apnea in people who are overweight or physically inactive—two factors that significantly increase the likelihood of developing diabetes. A sleep study is considered the standard diagnostic tool for determining sleep apnea, but a sleep apnea dentist also can perform an airway evaluation.

Ignoring sleep apnea can bear unsurpassable health risks including an increased risk of stroke, diabetes, and heart attack. Diabetes alone is enough to battle, but throw in these other health risks to the mix and you are really setting yourself up for some major health issues! Thankfully, a sleep apnea dentist such as Hartrick Dentistry can easily treat sleep apnea. Treatment is easier, and more convenient than you may think.

A sleep apnea dentist can both diagnose and treat the sleep breathing disorder, prescribing an adjustable oral appliance that addresses the cause of sleep apnea—the airway issue. This oral appliance is worn during sleep and keeps the lower jaw in the ideal forward resting position, maintaining an open airway, and the flow of oxygen to get you the rest that you need.

Do you or a member of your family have sleep apnea? Do you exhibit any of the symptoms of the disorder such as loud snoring or excessive daytime fatigue? If the answer to any of these questions is yes, or you already have been diagnosed with diabetes, then you should be screened for sleep apnea at your earliest convenience. Call the office of Hartrick Dentistry at (248) 549-0950 to schedule an evaluation today.

Hartrick Dentistry is proud to serve the oral health needs of patients in the areas of Royal Oak and Birmingham, Michigan.

Posted in Sleep Apnea

The Truth Behind Dental Checkups and Cleanings

Posted on September 12, 2017 by HartrickDentistry

Royal Oak and Birmingham, MI

Many people just assume that if their teeth seem healthy, then why bother going to the dentist? That line of thought is to the contrary, as prevention is the key to optimal oral health. There is a lot that could be going on with your teeth and gums that do not show many symptoms until your teeth are in need of repair or irreversible damage has been done.

Here are the reasons why you should go to the dentist for regular checkups and cleanings instead of just waiting until you feel pain or something goes wrong.

Bite Correction

Sure, your chompers have been chewing food for years but is your bite properly aligned for optimal support and function? Alternatively, maybe your crooked teeth do not bother you, but you would be surprised to know that misaligned teeth can have negative consequences on your oral health. An optimal bite can not only make you feel confident about your smile, but also relieves tension headaches, mouth, jaw, and neck pain. If you are suffering from bruxism, a condition that leads to clenching and grinding of the teeth, a customized mouth guard is ideal for protecting your teeth from being ground down.

Dental Cleaning

We all get tartar buildup around our teeth and gums, no matter how well you take care of your teeth. Tartar is a hard substance that harbors bacteria that causes tooth decay (cavities), gum disease, infection, and tooth loss. Even with your best efforts of brushing and flossing at home, you simply cannot remove tartar buildup once it has formed. You can save yourself some trouble by having your teeth cleaned regularly at the dentist’s office twice a year. Plus, you will enjoy healthy teeth much longer than if you ignore these checkups.

Prevention and Disease Control

During your checkups at the dentist, your oral health is documented so that problems are apparent, should any changes occur. Also, small issues can be nipped in the bud, instead of waiting until a dental problem is much more serious, requiring invasive treatment. A simple filling is less invasive, and much easier on the wallet, than compared to the cost of a root canal or even replacing a missing tooth due to extensive decay and damage. Remember the old saying that an ounce of prevention is worth more than a pound of cure!

That is not all the dentist can do. Establishing good oral health is essential to your overall well-being. The dentist can work together with you to derive a treatment plan and oral health regimen that fits your needs. Plus, when you take good care of your teeth, you are lowering your risk of systemic diseases such as heart disease, stroke, and diabetes.

To schedule an appointment, contact Hartrick Dentistry today at (248) 549-0950. We welcome patients of all ages and look forward to helping you begin or continue a journey of optimal oral health.

Hartrick Dentistry is proud to serve the oral health needs of patients in the areas of Royal Oak and Birmingham, Michigan.

Posted in General Dentistry

Treatment and Prevention of Sleep Apnea: Dentistry Plays a Key Role

Posted on August 10, 2017 by HartrickDentistry

Royal Oak and Birmingham, MI

Health and wellness are important interests and concerns among the public. The dental profession plays a significant role in this area with the increasing awareness of the relationship between oral and systemic health. The primary responsibility of dental practitioners is to educate and treat patients in a manner that enables them to make the best choices to improve the quality of their lives.

There has been much discussion in the public domain about sleep apnea. This has been brought more into mainstream media the past few years following the local fatal rail accidents that occurred on both the Metro North (2013) and in the Hoboken Terminal (2016). The common detail in each of the accidents is that the engineers of the trains suffered from obstructive sleep apnea (OSA). Excessive daytime sleepiness (EDS), is one of the common comorbid conditions in OSA.

Obstructive sleep apnea occurs when the airway closes off during sleep and breathing ceases until the brain detects a drop in blood oxygen and rise in carbon dioxide levels. This condition triggers the sympathetic nervous system to signal for an arousal, which allows breathing to begin again but disturbs the normal cycles of sleep. This protection is the body’s way to get us to our next breath, not to support an equilibrium where we can be healthy. The sympathetic nervous system stimulation is accompanied by an increase in cortisol levels via the hypothalamic-pituitary axis. Cortisol causes increased stress on the heart and other systems, which also increases levels of inflammation in the body. Heightened cortisol levels increase heart attack and stroke risk, as well as potentially a host of other comorbid conditions including erectile dysfunction, cardiac arrhythmias, hypertension, nocturnal bruxism, attention deficit hyperactivity disorder (ADHD), anxiety and depression.

Dentists are in a unique position to help people of all ages, from screening for airway issues in adult patients, to aiding in the development of normal airways for growing children. Healthy breathing is necessary both in sleep and in our daily awake lives. Focus on airway and breathing must be centered on structure, function, and behavior. The use of functional appliances, in combination with myofunctional therapy, can be used to guide the growth of the maxilla and mandible to create healthy and properly functioning airways that may not develop into OSA. Long before the airway collapses in OSA, a patient goes through a period where it becomes too small, collapses or there is turbulent airflow, making breathing and proper exchange of oxygen and carbon dioxide difficult. It should be the focus of dental professionals to know how to screen for breathing and airway issues in adults and children, as well as how to properly treat pediatric patients so they can experience normal breathing and airway development. It is our responsibility to screen, diagnose and treat airways and breathing. We have access to great technology to assist us in proper diagnosis and management.

The introduction of High Resolution Pulse Oximetry and cone beam CT scans provides us with great tools to assist our patients in screening and diagnosis of airway issues.

Although diagnosis from a physician is necessary in sleep apnea, dentists can be trained to manage structural and function issues. This includes screening and managing these areas of care. We must take the lead in actively creating a network of health care professionals to treat and manage this large and growing public health concern. Dental health professionals should be in the forefront as they are uniquely trained to assess the oral, perioral and facial structures, as well as recognize and treat airway issues before the total collapse of airway obstructive sleep apnea occurs.

There is considerable literature to support the fact that many of the cases and symptoms of ADHD are associated with breathing and airway issues in children. Treatment as well as proper development and function of the airway can often eliminate the symptoms of ADHD. Children must be able to nasal breathe, seal their lips at rest and have proper tongue position and function. Nasal breathing stimulates production of nitric oxide. This chemical is produced in the paranasal sinuses and only during nasal breathing. It is a stimulant to the parasympathetic nervous system, which is essential for proper function of both the cardiovascular and central nervous systems. In addition to being a potent vasodilator, it also has antimicrobial properties. Constant mouth breathing causes inflammation to tonsils, adenoids and oral tissues due to lack of nasal filtration of air. The nose is the filter for the air we breathe as it helps eliminate the passage of viruses, bacteria, fungi and environmental irritants into our airway.

The proper rest position of the tongue from infancy is on the palate as it is the force that leads to proper development of the maxilla.

CBCT for look at sinuses, nasal passages and airway. Keys to upper airway resistance

Constant light forces of the tongue on the palate allow for formation of a wide and properly contoured maxilla. The maxilla is the scaffold for the facial structures along with the width of the nasal passages. Proper development is integral to proper airway formation. The mandible has a higher probability of proper development if the maxillary develops normally.

In clinical screening for airway and breathing, a red flag to normal airway development is the presence of a high palatal vault from tongue positioning. This can result when the tongue rests too low in the mouth which may be due to a tongue tie (ankyloglossia) or enlarged tonsils and adenoids. Open mouth posture, dry mouth, chapped lips, nasal congestion and snoring in children are all additional red flags to proper breathing and airway development.

A network of health professionals who have full understanding of airway and breathing is necessary to help minimize potential diseases and conditions that can result from improper breathing. It is believed that over 40 million Americans suffer from breathing and airway related issues and over 35 million are undiagnosed.

The network of health professionals that can help our community of patients with breathing and airway issues include the following:

Restorative dentists
Pediatric dentists
Pediatric ENTs
Adult ENTs
Myofunctional therapists
Respiratory physiologists
Pediatricians
Sleep physicians
Primary care physicians
Orthodontists
Craniosacral therapists

The goal of these networks and dental practices is to have an algorithm for the diagnosis, control and desired resolution of breathing and airway issues for patients. This is a multidisciplinary approach that involves individualized care. In many cases, the restorative dentist and pediatric dentist are in the unique positions of being the first health care professionals to see and evaluate patients for breathing and airway related issues. The message for the dental profession in 2017 is the fact that this health problem goes way beyond treating sleep apnea. This is a health concern whose vast ramifications are just now becoming well understood.

It is a life changing issue for many patients in our communities. The dental profession has the ability to make a great impact on the health and wellness of our communities and our country.

Dr. Steven Acker has been in clinical practice in Staten Island at his practice, NY Elite Dental of Staten Island, since 1989. He has been an attending at Brookdale University Hospital Medical Center since 1982. He is also a clinical instructor at the Kois Center.

Dr. Nancy Hartrick is in clinical practice at Hartrick Family Dentistry in Royal Oak, MI. She is also a clinical instructor at the Kois Center.

Posted in News and Updates