My Blog

By Dr. Mark C. Pothitakis
December 18, 2021
Category: Oral Health
Tags: sleep apnea  
YourDentistMayBeAbleToProvideYouWithaSleepApneaSolution

Morning tiredness, brain fog and snoring are just some of the indicators of a medical condition known as sleep apnea. And, it's worse than waking up on the wrong side of the bed—over time, sleep apnea could increase your risk for heart disease or other life-threatening conditions.

Sleep apnea occurs when air flow becomes restricted during sleep, usually by the tongue blocking the airway. As oxygen levels begin to fall, the brain signals the body to wake up to "fix" the air flow problem.

As this arousal may only last a second or two, you may not remember it when you awaken in the morning. But it can happen numerous times a night, depriving you of the deep sleep your body needs for rest and repair.

Fortunately, there are ways to treat sleep apnea. In extreme instances, you may need surgery to correct anatomical defects causing the condition. For most cases, though, the most common treatment is continuous positive airway pressure (CPAP) therapy, which consists of a portable pump delivering pressurized air through a face mask that keeps the throat open while you sleep.

Used by millions of patients, CPAP can be quite effective. Some patients, though, feel uncomfortable using a CPAP machine for various reasons. If you're one of those unhappy CPAP campers or you would like to consider a possible alternative, your dentist might have the answer: oral appliance therapy (OAT).

An OAT device is worn in the mouth during sleep to prevent the tongue from falling back against the back of the throat and blocking the airway. There are various forms of OAT appliances, but they're all custom-made by a dentist to fit an individual patient's mouth. They work best for mild to moderate sleep apnea in which the tongue is the primary culprit in airway blockage.

If you suspect you may have sleep apnea, you should undergo a complete examination by a doctor or dentist to confirm it. If you've been diagnosed with mild to moderate sleep apnea, talk to your dentist about an OAT device. You may find OAT can provide you the relief you need for a better night's sleep.

If you would like more information on oral treatments for sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “If You Snore, You Must Read More!

By Dr. Mark C. Pothitakis
December 13, 2021
Category: Oral Health
Tags: oral hygiene  
5TipsForKeepingYourToothEnamelHealthy

You know what people say: "Protect your tooth enamel, and it will protect your teeth." Then again, maybe you've never heard anyone say that—but it's still true. Super strong enamel protects teeth from oral threats that have the potential to do them in.

Unfortunately, holding the title of "Hardest substance in the human body" doesn't make enamel indestructible. It's especially threatened by oral acid, which can soften its mineral content and lead to erosion.

That doesn't have to happen. Here are 5 things you can do to protect your enamel—and your teeth.

Don't brush too often. Brushing is essential for removing bacterial plaque, the main cause for dental disease. But more isn't always good—brushing too frequently can wear down enamel (and damage your gums, too). So, limit daily brushing to no more than twice a day.

Don't brush too soon. Oral acid normally peaks at mealtime, which can put your enamel into a softer than normal state. No worries, though, because saliva neutralizes acid within about an hour. But brushing before saliva finishes rebuffering could cause tiny bits of softened enamel to flake off—so, wait an hour after eating to brush.

Stop eating—right before turning in for the night, that is. Because saliva flow drops significantly during sleep, the decreased saliva may struggle to buffer acid from that late night snack. To avoid this situation, end your eating or snacking at least an hour before bedtime.

Increase your calcium. This essential mineral that helps us maintain strong bones and teeth can also help our enamel remineralize faster after acid contact. Be sure, then, to include calcium-rich foods and calcium-fortified beverages in your diet.

Limit acidic beverages. Many sodas, sports and energy drinks are high in acid, which can skew your mouth's normal pH. Go with low-acidic beverages like milk or water, or limit acidic drinks to mealtimes when saliva flows more freely. Also, consider using a straw while drinking acidic beverages to lessen their contact with teeth.

Remember, enamel isn't a renewable resource—once it's gone, it's gone. Take care of your enamel, then, so it will continue to take care of you!

If you would like more information on caring for your tooth enamel, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “6 Tips to Help Prevent the Erosion of Tooth Enamel.”

By Dr. Mark C. Pothitakis
December 08, 2021
Category: Dental Procedures
Tags: veneers  
VeneersMayNotBeaGoodOptionforaTeenager

People love dental veneers—those thin, porcelain shells bonded to teeth to mask stains and blemishes. For a relatively modest price, they can vastly improve a smile.

But what if it's your teenager who needs a smile upgrade? Teens also experience dental flaws like adults—which, at their age especially, disrupt their self-image and social confidence.

So, can veneers work for teens? Technically, yes, but there's a possible snag, depending on the maturity level of their teeth.

The potential problem relates to the tooth preparation that precedes the bonding of the veneers. One option is no-prep veneers and they are a nice solution depending on the size and shape of the existing teeth. If the teeth are slight in size, no preparation is necessary. If the teeth are large, even though veneers are thin, they can still look unnaturally bulky when bonded to unprepared teeth. A dentist may need to remove some of the tooth's surface enamel before applying the veneers.

Although this alteration has little effect on an adult tooth (other than requiring a veneer or restoration from that time on), it could damage a less mature tooth and stunt its development. A younger tooth can have a larger pulp—the central tooth chamber containing blood vessels and nerves—that's closer to the enamel surface than an adult tooth.

Because of the pulp's proximity to the surface of an immature tooth, there's a risk of damaging it during the tooth preparation phase for veneers. If that happens, the tooth may need additional treatment to save it.

We don't depend on a teen's calendar age to determine whether or not it's safe to install veneers. Instead, we examine the teeth and measure how close the pulp may be to the surface, as well as the thickness of the middle layer of dentin. Veneers could be acceptable if it appears the teeth have reached a healthy level of maturity.

If not, though, we may need to consider less invasive ways to improve a teen's smile. For stains or other outer discolorations, whitening with a bleaching solution significantly brightens teeth. We can repair chips by bonding and sculpting color-matching dental material to the teeth. And, these or similar cosmetic measures won't endanger an immature tooth like a veneer application.

Once a young patient's teeth have matured, we can revisit the subject of veneers. That may take time, but the more attractive smile that results will be worth the wait.

If you would like more information on dental care for adolescents, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Veneers for Teenagers.”

By Dr. Mark C. Pothitakis
December 03, 2021
Category: Dental Procedures
ImplantsStreamlineDentalWorkUpgradesforGradualToothLoss

One day, you lose one… followed by another…and then another. And then, after years of dental disease, you finally lose all your remaining teeth.

But between the first tooth lost and the last, years or even decades could pass. Individuals in the past caught in this downward spiral often decided the cost of continually upgrading their restorations with each lost tooth was simply too much. Instead, they opted at some point to have their remaining teeth extracted, even relatively healthy ones, to make way for full dentures.

That's still an option you might one day want to consider. Today, though, you have another alternative: With the help of dental implants, you can easily update your restorations with gradual tooth loss and keep more of your natural teeth longer. And keeping them longer is often the best scenario for maintaining optimum oral health.

Most people are familiar with dental implants as single replacements for individual teeth. It's a straightforward application. A dentist imbeds a titanium metal post into the jawbone at the missing tooth site, to which they later attach a life-like crown.  Over time, the titanium post attracts new bone growth, resulting in enhanced durability for the implant, while also helping to reduce the bone loss that typically occurs after losing teeth.

But implants can also be used to support more traditional restorations like bridges or partial dentures. When used in that manner you only need a small number to support a restoration for multiple teeth, a much more affordable method than an individual implant for each tooth. And with planning and forethought, earlier installed implants could be incorporated into the next phase of restoration.

This helps make the process of updating restorations more manageable and affordable, while also prolonging the life of your remaining teeth. And should the time come when you lose all your teeth, implants can support a full fixed bridge or a removable denture. Including dental implants in your ongoing treatment strategy can pay dividends toward maintaining your best oral health.

If you would like more information on the many applications for dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Replacing All Teeth But Not All at Once.”

By Dr. Mark C. Pothitakis
November 28, 2021
Category: Dental Procedures
RemovingaToothCouldHelpCorrectThisParticularBiteProblem

Dentists extract millions of teeth each year, mostly because of disease. But sometimes a healthy tooth is removed to gain a more favorable, long-term dental health outcome.

An example of this is extracting teeth for the sake of orthodontic treatment. This is often beneficial when treating bite problems caused by crowding, a condition in which not enough space on the jaw exists to accommodate all of the teeth coming in. When this happens, the limited space can force teeth out of their proper alignment.

Crowding also complicates correcting the bite problem with braces: As with the eruption phase, there's no available room for orthodontic movement. One solution that may arise after a detailed examination is to open up space on the jaw by removing some of the teeth.

Planning this kind of tooth extrication requires careful forethought with the end in mind—ultimately, the dental providers involved want the resulting appearance after braces to look as natural as possible. For that reason, dentists usually choose teeth for extraction that are outside of the "smile zone" (the teeth visible while smiling) like premolars and molars.

Additionally, dentists are concerned about bone loss after extracting the teeth. Bone often diminishes around empty tooth sockets, especially if those sockets were damaged during extraction. This loss in bone can weaken the jaw structure and cause significant problems while moving teeth with braces.

To avoid this, dentists take great care during tooth removal not to damage the socket. Additionally, they may place a bone graft within the socket immediately after removing the tooth, especially if the space will remain vacant for a significant period of time. A bone graft serves as a scaffold upon which new bone cells can form and accumulate.

After the extractions, the orthodontist may then proceed with correcting the bite. Patients may also need some form of prosthetic teeth to fill in the spaces while wearing braces. Often prosthetic teeth can be incorporated with the braces for a more natural look. After braces, any remaining gaps may require further restoration, either with dentures, bridges or, later in adulthood, dental implants.

Complex bite problems like crowding pose unique challenges in correcting them. But using techniques like tooth extraction can help achieve a successful and satisfactory outcome.

If you would like more information on treatments for bite problems, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Removal for Orthodontic Reasons.”





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