How to Cure Your Snoring Sunday, Jul 22 2012 

Snoring is a very common condition that has a tendency to get worse as we age. Men suffer from the problem more frequently than women, but it is very common in people who are overweight.  In most cases snoring is not much of a problem  , but more of a nuisance. However, if it is severe, it will disrupt the sleep patterns of those close to you, as well as your own sleep quality.

The cause of snoring is very straight forward: air flow through the mouth and nose is obstructed. Generally, obstructed nasal airways are one of the major causes of snoring. A deviated septum, nasal polyps or a sinus infection all can block air flow which will result in snoring.

Muscle tone in the throat and tongue, if it is not firm, will allow these muscles to relax too much and they will block the air way. This problem can be caused by deep sleep, alcohol consumption, use of certain sleeping pills and aging.  Throat tissue which is large and bulky, often a problem with overweight individuals, can result in snoring. Along this same line, children with large tonsils or adenoids will often snore. The combination of a long soft palate and a large uvula, will also cause snoring. The structures will vibrate and touch one another which closes the airway, and produces snoring.

In addition to the noise created by snoring, which is irritating, you might also suffer from excessive daytime sleepiness, a sore throat, restless sleep, gasping or choking at night. All of these are not good for you or your sleeping partner.

One of the great problems with snoring, is that over time it can become a health risk factor. In many cases ,obstructive sleep apnea developes from habitual snoring, and this is a serious health issue. Sleep apnea can cause high blood pressure, enlargement of the heart , which could cause heart attacks or strokes.

Snoring and some mild forms of sleep apnea can be treated with oral appliances made by a dentist . I am sure you know about many of the devices sold in pharmacies or discount stores. These are like mouth pieces, and in  most cases and can actually make additional problems for your teeth and jaw. The appliances made by the dentist all work by moving your lower jaw forward. This opens the airway in your mouth, keeping the airflow from being blocked. They are custom-made for your mouth and can be adjusted as necessary to help control your snoring. Some cases of mild sleep apnea can also be treated with these devices since an open airway also treats sleep apnea.

So, get some help with your snoring and make everyone in the house happy. Everyone will enjoy a better nights rest and feel better in the morning.

How to clean your dentures and partial dentures Wednesday, Nov 16 2011 

Taking proper care of your dentures is not as simple as some people think. In most cases the dentures are placed in a glass with water and a tablet of denture cleaner tossed in and left over night or for an hour or so. There are two major problems with this method.  First, you need to scrub your dentures with a soft tooth-brush or special denture brush which is soft and second, that denture cleaner tablet is doing a great job of etching and discoloring your dentures.

The brushing part is simple and very straight forward. You have to remove all of the food and other substances which accumulate on your dentures at least once a day. At night, before you go to bed is the best time to do this.  Brush your dentures, inside and out , with a soft brush and use either a special dentures tooth paste or dishwashing liquid–calgon works very well, but any will do. Why use a soap or special paste? Because regular tooth paste is abrasive and will actually leave scratches on your dentures and over time you can leave grooves in the surface of your dentures.

The commercial denture cleaning tablets do the same thing –they etch the surface of the dentures and make the acrylic dentures material and teeth become dull and rough. Actually any etching or rough surfaces on your dentures are great areas for bacteria to grow which can cause denture odor.  If you wear partial dentures which have metal surfaces or clasp for holding them in place, the commercial cleaners, over time, will destroy the metal surface. It becomes pitted and discolored.

Never soak your dentures in bleach. It’s true that bleach kills everything, but you pay a price. It will etch and corrode your dentures very quickly. If you want to soak your dentures in some sort of cleaner, you can use hydrogen peroxide or white vinegar.  Pour a 1/2 cup of 3 percent hydrogen peroxide in a glass or bowl. Add 1/2 cup of water and mix them together. Place your dentures in the bowl and let them soak for about 30 minutes. The vinegar technique is similar except use 1/3 cup of vinegar to 2/3 cup water. Always rinse your dentures off throughly after cleaning.

I would not recommend putting your dentures in water and then microwaving them. The chances of heating them up too much and then having the acrylic warp or distort are very real. If the heat warps your dentures they might not fit you again.  This is true even for cleaning them with very hot water–be careful, let them cool before placing them back into your mouth.

Many people have a soft liner which is placed in their dentures for healing purposes. This liner is temporary, but needs to cleaned and maintained. Use a special cleaner like Stain Away Plus but use cool water for mixing. High heat and regular cleaners will damage the temporary liner. Don’t soak the dentures for more than 30 minutes each day. Clean them very gently with cotton balls or a very soft tooth-brush.  Always keep the dentures moist and soak them in water at night. If the liner drys it will distort and the dentures might not fit.

Soak the dentures in water at night in some sort of container. Leaving the dentures out at night is very important for the health of your gums. Also, remember to brush your gums –they need to be cleaned too. Lastly, don’t let the dog or cat get your dentures. They will think they have found the world’s greatest bone and chew them to pieces. Apparently, your saliva imparts some sort of smell or taste to the dentures which the animals find irresistible.

Tooth Development in Children Monday, Oct 31 2011 

The office receives a great number of questions about teeth in children and when they should first appear and what to do about certain problems children have with their teeth. So, in this blog, I will address some of those questions and concerns.

First, children have two sets of teeth, primary(baby) teeth, and permanent (adult) teeth. All teeth are important for speech, chewing and give the face structure. In addition, the primary teeth help children develop the muscles necessary for chewing and  also act as placeholders for the permanent teeth, which erupt later in life.

The first primary tooth will usually erupt around the age of 6 months. After that happens, the parents should brush the child’s teeth twice daily to prevent tooth decay. Generally, at 2 years of age, all 20 primary teeth will erupt. Parents should continue to brush the child’s teeth until he or she is able to avoid swallowing the toothpaste.

One common misconception of parents is that primary teeth do not require dental care since they are temporary and will eventually be replaced by permanent teeth. If a primary tooth is lost before the scheduled time of eruption of its permanent successor, it is likely the space will reduce in size, or even close due to drifting of near by teeth, which can cause the permanent tooth to grow in crooked. A baby tooth which has a large cavity which is not treated, can abscess. This infection can actually harm the permanent tooth which is developing under the baby tooth.

The primary teeth are lost between 7 and 12 years of age and are replaced with permanent teeth. This phase of development is typically referred to as the “mixed dentition” stage because children have both primary and permanent teeth.

There are a total of 32 permanent teeth; the additional 12 teeth will erupt behind the primary teeth and are called the molars. All permanent teeth erupt by the age of 14 with the exception of the “wisdom teeth” or third molars that erupt between the ages of 17 and 25.  Not everyone develops “wisdom teeth”, but those of us that do typically have them removed for one reason or another.  Usually because they are so far back in the mouth and are often difficult to properly clean.  This does not interfere with chewing as the “wisdom teeth” are not generally used for chewing.

That is a quick over view of the primary or “baby” tooth story. The most common question or concern that parents express is when the lower permanent front teeth begin to erupt. It can look strange, like the child is actually getting a second set of teeth behind the front baby teeth.  Actually, what you see are the two permanent teeth erupting behind the baby teeth. As the permanent teeth come in, they will move forward and actually “push” the baby teeth out.

The pictures should help with the “average” time-table of when baby and permanent teeth should appear in a child’s mouth. It can vary by months, so do not get too concerned if your child seems a bit slow with his tooth development. If you are worried, the dentist can take an x-ray and show you the permanent teeth developing in your child’s mouth.

House Call–A Story about Real Doctors Wednesday, Oct 19 2011 

A  long time ago, when I was seven or eight years old( this would have been in the mid 1950’s) I managed to convince my father and grandfather to let me accompany them to visit one of my grandfathers sick patients. Just a bit of back ground would be order at this time. My father was a physician -ObGyn, and my grandfather was a real country doctor. His father,  my great-grandfather was also a country doctor. They were  from eastern North Carolina and at this time my grandfather was practicing in Zebulon ,North Carolina.

We drove out in the country around Zebulon to a small house surrounded by fields. The wife of the farmer was ill and my grandfather wanted a second opinion about her situation. As I recall, the situation was not good and there was some concern about how to treat her. When we drove up, everyone came out from the house except the mother. I was instructed to remain by the car while they tended to the patient. Their equipment was a real “doctors black bag”–blood pressure cuff, stethoscope, few other odds and ends and a watch with a second-hand. Very primitive by the standards of today, but the two of them were not concerned. They had their hands, eyes, and a wealth of diagnostic skills built up with time.

There was no doubt the family was poor–tenant farmer, share cropper, I am not sure what the family did. There were a number of children, various ages and we stared at each other as children will do when confronted with a new situation. I have seen many houses like the one they lived in over the years. Most derelicts falling down and covered with vines and weeds. The house was built up off the ground with some brick pilings  and made from rough finished timber which was agedto  a sort of black brown and had never see any paint.  I don’t remember the windows having any curtains or even screens.

After a period of time, father and grandfather walked out of the front door and spoke with the husband. As I remember, they walked back to the car and had a discussion of sorts. It dealt with the womans situation and my father was not optimistic. Grandfather concurred and there was bit more discussion. I believe that he went back to the house and had a brief talk with the husband.

This was all on a Sunday afternoon, as Sunday was generally the day we visited my grandfather. It was a beautiful day, lots of sunshine and late summer. Not much was said on the ride back although I am sure that I made attempts at talking, but was  encouraged  to be quiet,as everyone was not in a talkative mood.

I have no idea what happened to the woman and her family. Obviously, the event impressed me as I can remember most of what happened. But I never asked my father or grandfather about it and they never spoke of it, at least not when I was around. But I was witness to an event that no longer exist–doctors making a house call to visit a sick patient. No fancy machines and lab test, only their knowledge and diagnostic abilities backed up by their examination with hands and eyes. This is still the way many doctors make their diagnosis, but it is rendered in an office or hospital instead of a farm-house miles from any city. I think that I find myself reflecting on this event more and more, with the discussion of the vast changes that have occurred in health care, and the potential changes that are coming. It was a simple time with simple yet time-tested techniques. Money was not much of an issue; the man had little if any and probably paid my grandfather with something from the farm. He received a high-powered specialist consultation from my father, who asked for nothing–he was helping his father and another physician with a difficult case. I feel lucky to have been present for this small vignette of medical history. A real country doctor at work.

The Case for Dental Implants Wednesday, Oct 19 2011 

If you have lost teeth and have gaps in your smile, or just don’t seem to be able to chew very well due to missing teeth, you might want to consider replacing those teeth with implants. It is one of the best and most reliable methods to restore your mouth and provide you with a great smile and a good bite for chewing food.

Implants have been around for a long time and the technology has gotten better. You can actually have a tooth pulled and place an implant in the vacant tooth socket all at the same visit. If you are missing a tooth or teeth, the process is only different in that the dentist will have to drill a very specific sized conical-shaped hole in the bone. The implant is then fitted to this space and screwed into the bone. It might sound bad, but it is really less painful and traumatic than having a tooth pulled. There is no pushing and shoving or “pulling”, only slight pressure from the drill and then the placement of the implant .

After the implant is placed it has to heal which involves the implant actually fusing or joining to the bone. In the top of your mouth (maxilla) this can take anywhere from 4 to 6 months whereas in the bottom of  your mouth it only takes 2 or 3 months to heal. Once it has healed, the implant is uncovered and an abutment is screwed into the implant. In most cases you don’t even have to be numb to have this done. The abutment is checked for how it fits in your mouth and if necessary is adjusted (outside of your mouth) and prepared for an impression. This part is actually just like you had a regular tooth and were having it fixed for a crown. Once everything is correct with the abutment, an impression is made of it. Then a temporary crown is made for the abutment. When the permanent crown comes back from the dental laboratory, it is fitted, checked and permanently cemented into place. You are now ready to get down to some serious chewing.

This implant procedure can be done for bridges, multiple crowns or in most places where you are missing teeth. The implants can even be fixed to have a small bar made that is screwed into the implant. Then a denture (top or bottom or both) can be fitted to the bar. This makes the dentures fit tightly and it will not come loose when you are chewing or talking.

There are even mini implants which can be used to help keep dentures in place. The small implants are placed in the upper or lower jaw then the dentures is fitted with female attachments which fit into the mini implants. This technique holds the dentures in place very well and is not as expensive as the full size implants.

So implants can be used in most places of your mouth to repair or replace teeth which you are missing. They can be made as a single tooth or several teeth or fitted with different parts to help hold your dentures in place. The variations and possible combinations numerous. This make the implants one of the most flexible methods of replacing your teeth.

Xylitol–The Silver Bullet for Tooth Decay? Thursday, Oct 6 2011 

Recently, the natural sweetener xylitol, has been getting a great deal of attention from the dental world and the nutrition and health food worlds as well. Xylitol, is a natural sweetener found in fibers of many fruits and vegetables and can also be found in oats, mushrooms and corn husks. Xylitol was discovered by German and French chemists in the late 19th century and has been used in Europe primarily as a sugar alternative for diabetics.

In the early 1970’s,researchers in Finland discovered the dental benefits of xylitol, since that time many more studies have been conducted.  These studies have linked xylitol to a reduction in the bacteria that can lead to cavity formation.   The way xylitol works is quite interesting.  The bacteria in your mouth mistake xylitol for their favorite food, fructose. The bacteria transport xylitol through their cellular walls to metabolize it as a food.  Xylitol is a five carbon sugar alcohol, which during this process of transportation is changed into xylitol phosphate. The bacteria are not able use this substance as a food. Over time, the xylitol phosphate accumulates inside the bacteria, creating a toxic effect.  The bacteria become starved, and may eventually die.  This results in a reduction of the number of cavity causing bacteria in your mouth.  However, the long-term presence of xylitol in the oral cavity can lead to an increase number of xylitol-resistant bacteria. This is actually a good thing since these bacteria are not as strong as their cousins and are not as capable of producing tooth decay. They also lack the ability to produce the necessary acid to adhere to your teeth. This means there will be less plaque on your teeth. 

There is some evidence that suggests the use of xylitol  can aid in the repair of damaged tooth structure by creating bacterial changes; creating an ideal environment for remineralization to occur.  Remineralization is the natural process of restoring minerals to a tooth that have been damaged by the acidic activity of bacteria.  Think of it as replacing the missing rungs in an old rickety ladder, making it strong and stable again.   While nothing can replace brushing and flossing xylitol use can be another means of combating tooth decay.

Research suggests you need to consume between four and twelve grams of xylitol a day to experience the positive effects.  Xylitol can be purchased in many different forms, such as chewing gum, various candies, sweetener packets for your coffee or tea, or in bags just like sugar. It is not difficult to find, most health food stores carry it, as well as a number of internet sites.  It can be a little pricey, but if you have high rates of tooth decay it can help with the problem.

Mustard Fried Cube Steak Monday, Sep 19 2011 

Another cooking/frying article just to keep things interesting. This recipe can be used with venison if you are a hunter just as easily as with the beef version of cube steak.  It is easier to work with the cube steak if it is still a little frozen. You will need to cut it into bite size pieces, about one inch square to one and a half inches.

Take your steak pieces and place them in a pan or bowl. You will need to mix sour cream (it can be low-fat) and some brand of spicy mustard with the meat. It has to be completely covered by the sour cream/mustard mixture so somewhere between a half pint to maybe a pint of sour cream and then one to two average size bottles of the spicy mustard. I normally use Grey Poupon mustard so you can substitute something similar.  Cover the meat and marinade with wax paper or saran style wrap and refrigerate for 12 to 24 hours. One other thought about the sour cream and mustard for the marinade–  I add about a teaspoonful of Cumin to the mixture. This adds a nice subtle flavor, but you can leave this out if you want.

After you have marinated the meat and you are ready to fry, you will need to coat the meat in flour. Now from a previous post, you know that I am a big fan of House of Autry flour especially the fish breader either mild or hot. You can use regular flour which you add some salt and pepper to, but House of Autry is already seasoned. 

Take the pieces of meat and coat them with flour with whatever method you like. You can use a bowl with the flour in it and sort of dredge the pieces through it , or shake them in a paper bag or use the Bill Dance fish breader.

Make sure your peanut oil is 375 degrees and fry until golden brown. Watch the oil temperature as it will drop as you fry. Remove the meat and let in drain on a rack or paper towels and if you want you can season them with a bit of sea salt.  Let them cool and enjoy.

Why are my teeth so Sensitive? Wednesday, Aug 31 2011 

Tooth sensitivity is one of the most common of all dental complaints. In fact one in five adults suffer from sensitive teeth.  As long as you have adequate enamel and gum tissue around your teeth, sensitivity will not be much of an issue. However, once the gum begins to recede or shrink from around  your tooth for some reason, things change. This situation allows the dentin which is under the enamel to become exposed to the oral environment. This is the start of the problem.

At the center of the dentin is the nerve of the tooth. From the nerve, millions of tiny nerves travel through microscopic tubules to the surface of the dentin. These tubules are filled with fluid which protects the nerve fibers. But when you drink something really cold or hot, or sweet for that matter, the fluid in the tubules is stimulated and moves the fluid. This movement travels to the inside of the nerve chamber and results in pain.

Other things can cause the fluid to move and create pain. Some of these are dehydration of the tooth, which can be caused by tooth whitening chemicals. Decay at the gum line, a cracked or broken tooth, acidic foods like lemons, and grinding or clenching of the teeth can  combine with aggressive tooth brushing to create a sensitivity problem. In short anything that exposes the tooth surface (dentin) to the oral environment , can result in sensitivity.

Most treatments for this problem involve an effort to close or seal the microscopic dentin tubules. With the tubules closed, nothing can bother the small nerves and make the fluid move around in the tubules creating pain.  One method of treatment is using a tooth paste which contains potassium nitrate or a prescription strength fluoride rinse. So, you must clean and brush all parts of your teeth and use floss to keep the tubules sealed. Plaque on your teeth is another cause of tooth sensitivity. The bacteria create an acid that dissolves the dentin enough to open the tubules. Make sure your tooth-brush is soft since it will clean efficiently and  is gentle to your gums. Hard and medium tooth brushes can actually brush the gum from around your teeth.

If you are clenching and grinding your teeth you will need to use a night guard. Now, dental procedures can also cause sensitivity. Tooth cleanings, gum treatments, fillings and cementation or preparation of teeth for crowns can all result in sensitivity issues. These can be addressed by your dentist or will resolve by themselves.  For a quick fix, the dentist can apply desensitizing agents and make you feel better. But this is just a band aid. The real solution is proper brushing and flossing and maintaining your teeth. These two things combined with regular use of sensitivity tooth paste or fluoride rise will make you feel better and correct the problem.

How to fry Pheasant Tenders Monday, Aug 29 2011 

I realize that the name of this blog refers more to teeth and dentistry and airplanes, but from time to time it might be nice to discuss something else just to keep the interest up. So, I chose to provide a recipe of how to prepare pheasant.

Pheasants are great game birds and common throughout the mid west of America. They fly but are great runners which provides the chef with some problems when preparing them for a meal. The legs have many little bones, probably tendons, but they are difficult to eat due to this anatomical variation. Having attempted to cook pheasant many times, I have not met with great culinary success. My wife came up with a  good recipe for baking them with sweet potatoes and onions, but those legs are still an issue. I have grilled them, used the beer trick on the grill also, and even found a french version of pot a feu which was interesting, but all were still plagued by those legs and difficulty keeping the meat moist and tender.

In frustration, I decided to try frying them with some variations taken from some other recipes I will discuss in the future. Your pheasant should be clean and have no skin. Cut the breast from the bird staying as close to the bone as possible and keeping the meat whole. Once you have all of the breast from the pheasant or pheasants cut them into slices. You should be able to get three to four tenders per breast. Clean them and pat them dry and then add them to your marinade.

The marinade is simple. Depending on the number tenders you have, take a pint or quart of butter milk(you can use low fat or regular) and pour it into a large bowl (I don’t use metal bowls) and add some hot sauce. Texas Pete works well but use whatever your favorite is. Put a 1/2 cup to a full cup in with the butter milk (you can add more if you want). Add the tenders and work them and the marinade around until it is thoroughly mixed. Cover the bowl and put in the fridge overnight or at least six hours.

When you are ready to fry, take House of Autry fish breader (regular, medium or hot all work) and coat the tenders with any method you desire. I use a plastic Bill Dance Fish Breader, but paper bags, plates or other bowls all work just as well. Place in the hot oil and start frying.

When they are nice and golden brown remove and place on a draining pan or paper towels. When they cool they are ready to eat. I don’t think they need any salt or pepper as the breader is well seasoned.  Dipping condiments are optional, as I think the tenders hold their own quite well.

As for the rest of the bird; you can boil it and make stock and take any of the meat and make Pheasant salad as opposed to Chicken salad. Be careful of those little bones though.

To Veneer or Not to Veneer Tuesday, Jun 21 2011 

Veneers for teeth are hot right now. Their popularity was enhanced by some of the extreme make over shows and a great ad/marketing campaign by one of the manufactures of the Veneers used on that show. Since most veneers are porcelain, the effort to promote one type over another was amusing to most dentist. Porcelain is used to make most crowns or veneers and the material has fairly consistent properties. Some materials are harder and stronger than others, but the ultimate appearance of the porcelain veneer is the same. In other words it is going to match the shade or color the dentist selected with the patient’s input as to what color they wanted their teeth to be. Colors or shades, to the dentist, can be “tweaked” at cementation by the dentist.

Veneers are a versatile means to improve the appearance of many teeth. The shape, color and arrangement can be changed with veneers. In fact one of the most versatile things about veneers is that in some situations they can be placed on teeth without  drilling on the teeth at all.  This process does use a special porcelain and a high pressure pressing technique. The result can produce a very thin veneer–0.3mm in thickness, which is not much at all. The final color of a veneer can be adjusted by the dentist at cementation using different color cements. This can enhance the existing color of the teeth, or mask more serious discoloration in certain cases.

But not all teeth can be veneered. In some situations, the bite or occlusion on a tooth or teeth can make the veneer weak, or likely to pop off the tooth due to the chewing forces exerted on it.  It is important to keep in mind, that unlike a crown, the veneer is bonded onto the tooth. It does not rely on any mechanical retention, or friction to hold in it place– only the wonders of chemistry. Prior to cementation, the tooth is treated with chemicals to aid in the bonding process. The veneer itself must also be treated with some of the same chemicals including silane–another amazing product from the space program. Silane bonds inorganic substances to organic substances–for example the ceramic titles used to dissipate heat on the surface of a  space shuttle. For teeth this means a porcelain veneer to the surface of the tooth.

Another situation which might present some problems are badly discolored teeth. Teeth that suffer from enamel damaged by excess fluoride or other chemical discoloration from drugs like tetracycline might present some challenges for the veneer process. Another type of staining that can be a problem is teeth that suffer from discoloration due to a patient who had a high fever as a young child.  Depending on the severity of the process, a veneer may or may not work. In those difficult situation, a full coverage crown would be indicated.

When discussing veneers with your dentist, it is best to be very specific about what results you are looking for . Many times a diagnostic wax up is indicated. This utilizes a stone cast of your teeth, which the dental laboratory waxes up teeth to look like what can done with veneers to change the appearance of your natural teeth. This way you can see the results before anything is done and you have the flexibility to make changes prior to starting work on your teeth.

Veneers are another option in improving your smile or restoring broken down and decayed teeth.They can be used with conventional crowns, or removable partials to provide you with a versatile part of the puzzle piece to put things back in order so you have a better bite and a dazzling new smile

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