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Why Read Reviews? Because We Love To Hear From You!

Google Reviews

The business world is changing quickly as you all know!  Social Media has become a tool for marketing and consumer research!  In order to keep up with today’s world, online marketing is a must.  We have had fun setting up our Facebook page and sharing tidbits and pictures with our dental family:  https://www.facebook.com/sabledds/.

But what we have confirmed recently is that the most powerful marketing tool is doing great work!  We thank all of our patients who have taken the time to post a review about their dental experience.  We have been asking for reviews using a software program called Birdeye that emails or texts our patients after their appointments and asks for honest feedback.

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Guess what?  We LOVE hearing from you!  Your kind and thoughtful posts motivate us to be our best!  We read these posts in our morning “huddle” when we discuss what we need to do to improve our service for you!  And boy do these boost us up! If you have not seen any of these reviews, check them out: https://sabledds.com/testimonial.php

Happy “googling”!

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Do You Snore? There Is A Dental Connection!

Sable DDS Sleep Apnea

(Based on Blog by Holli Draper, RDH)

“Sleep is an investment in the energy you need to be effective tomorrow” -Tom Rath, author of Eat Move Sleep and Are You Fully Charged 

What is Obstructive Sleep Apnea?  
Obstructive Sleep Apnea (OSA) is a life-threatening condition that affects over 18 million Americans. This commonly undiagnosed syndrome involves the cessation of breathing during sleep. While sleeping, the upper airway muscles enter relaxation and may vibrate against each other (this vibration is what causes snoring). As sleep deepens, muscle relaxation increases and can occlude the airway. This severely decreases the amount of oxygen flowing to the lungs. The body responds to this lack of oxygen by sending a signal to your brain that you are suffocating. The brain compensates by lightening the phase of sleep in order to increase control and contraction of upper airway muscles, ultimately increasing oxygen flow to the lungs. This constant exchange between suffocation and arousal can occur several times throughout the night and many do not recall it happening upon fully awakening the next morning.

Is Treating OSA Important?
While studies estimate 1 in 4 Americans over the age of 18 (31% of men and 21% of women) are considered “high risk” for sleep apnea, 90% of those with sleep apnea have gone undiagnosed.1 If left untreated, sleep apnea can increase the risk of health issues, including cardiovascular disease (stroke, high blood pressure, and atrial fibrillation), diabetes, impotence, memory loss, and GERD. Excessive fatigue caused by OSA can affect your safety by increasing your risk of motor vehicle accidents and work-related accidents. Untreated severe OSA also increases your risk of death

According to Dental Sleep Solutions, fewer than 10% of those suffering with OSA have been accurately diagnosed and only 25% of those diagnosed have been successfully treated. This chart indicates the large percentage of Americans who have gone undiagnosed with this condition.1
Screening for Sleep Apnea (Common Signs and Symptoms)
During your appointments, your dentist and dental hygienist are examining much more than your teeth. During your head and neck exam and oral cancer screening, we are also analyzing your anatomy to determine your risk of OSA. These anatomical features include swollen tonsils, an enlarged tongue, inflamed sinus membranes, an anatomically small airway, malocclusion, and obesity (excess fatty deposits on the neck and chest)

Health professionals use the Mallampati Classification system to determine your risk of OSA:Patients with Class I and Class II Mallampati scores have lower risks of OSA since their airways are mostly patent (open). Patients who are in the Class III and IV range are at a much higher risk of OSA due to the obstruction of their soft palate.

There are also many symptoms of OSA that you may notice about you or your partner between dental appointments:

  • Snoring
  • Waking up due to gasping or choking
  • Excessive day time fatigue
  • Waking up feeling unrefreshed/Restless sleep
  • Waking up with xerostomia (dry mouth)
  • Morning headaches/migraines

As you hopefully know by now, we are here to support your total health – we are invested in you as our patient! If you notice any of these symptoms for yourself or your loved ones, please make an appointment for a consultation.  We will work with your physician to help with diagnosis and evaluation of treatment options.

I May Have Sleep Apnea – What Should I Do?
One of the first steps in diagnosing OSA is performing a sleep study. From the study, if OSA is diagnosed, there are several routes of treatment depending on a few specifics including the severity. The three common treatment options include a continuous positive airway pressure (CPAP), oral appliance therapy (OAT), and surgery.

  • CPAP Therapy is the most common treatment method for OSA. It involves wearing a face mask that connects to a machine via plastic tubing. The machine forces oxygen through the mask at a continuous rate, predetermined by your doctor, throughout the night. This was the gold standard for treatment of OSA until recently as it is highly effective in maintaining oxygen intake during sleep. However, its efficacy is often diminished by the lack of patient compliance. Patients often find that it is not comfortable and only wear it for an average of three hours per night.
    • Advantages: considered most effective treatment of all severities of OSA
    • Disadvantages: mask discomfort, not easy to travel with, nose/throat dryness
  • Oral Appliance Therapy has recently risen in popularity as a comfortable alternative to CPAP. It utilizes a custom device that fits similarly to a sports mouth guard or an orthodontic retainer and maintains an open airway by repositioning your lower jaw and tongue slightly forward. Studies have found that OAT and CPAP are both effective OSA treatments. The Journal of Clinical Sleep Medicine reported that patients prefer OAT over CPAP because it is quiet, portable, and comfortable.2
    • Advantages: least invasive, comfortable, quiet, portable, does not require electricity to work, easy and inexpensive to clean
    • Disadvantages: may not be as effective with severe cases of OSA
  • Surgical Options often involve soft tissue and/or jaw surgery to increase airway opening. While these surgeries have varying degrees of success, nonsurgical options are typically recommended prior to proceeding with this route.
    • Advantages: most surgeries are effective in long-term improvement of airway
    • Disadvantages: most invasive, requires post-operative recovery

Summary:

  • OSA is a life-threatening condition that is grossly undiagnosed in the United States.
  • Treatment options for OSA include: CPAP, OAT, and surgery.
  • While CPAP has been deemed the “gold standard” for OSA treatment, its effectiveness is compromised by patient intolerance and unwillingness to wear it. Patients who have tried CPAP and (1) did not have good results or (2) were not able to tolerate it should consider trying OAT.
  • If you or someone you know may have OSA, contact us today!

References

  1. What You Need To Know If You Snore Or Have Trouble Sleeping Blog posted by Holli Draper, RDH http://www.mdsmiles.com/blog/Snoring-Sleep-Apnea/What-You-Need-To-Know-if-You-Snore-or-Have-Trouble-Sleeping/6354
  2. 1Dental Sleep Solutions. “What is OSA Syndrome?” 2014. Web. 21 Feb. 2017.
  3. 2Ramar, K. “Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015.” AASM. American Academy of Sleep Medicine, 2015. Web. 21 Feb. 2017.
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For Heart Healthy Month, Get To The Dentist????? YES!

Sable DDS Heart Healthy

Heart disease is the leading cause of death in the United States. The month of February is dedicated to raising awareness about heart disease and increasing knowledge about prevention.

We are dedicated to educating our patients about the mouth/body connection. An increasing number of researchers are finding that there’s a link between common health conditions—like heart disease—and oral health. It’s becoming clear that the body can affect the health of your mouth and vice versa.

So, how is heart disease related to your mouth?

Several studies exist to explain the link between periodontal (gum) disease and heart disease

  1.  Oral bacteria can affect the heart via the blood stream and then attaching to fatty plaques in the coronary arteries (heart blood vessels) and contributing to clot formation.
  2. Another possibility is that the inflammation caused by periodontal (gum) disease increases plaque buildup, which may contribute to swelling of the arteries.

More Heart Disease/Gum Disease Connections 

  • The number one cause of death is inflammation.
  • The number one cause of inflammation is gum disease.
  • Researchers have found that people with gum disease are almost twice as likely to suffer from coronary artery disease.
  • One study has shown that gum disease, cavities and missing teeth are as good at predicting heart disease as cholesterol levels.
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Do I Really Have to Get Dental X-rays…Again? Why? Are They Risky?

Sable DDS Xray

Dental radiographs (x-rays) allow us to monitor bone levels and rule out any disease processes that might be occurring. Radiographs allow us to see structures that are not visible to the naked eye – the spaces between teeth, under the soft tissue, and inside the bone.  All of this really, really helps us work with you on your oral health, especially to diagnosis any potential “danger zones!” In fact, without x-rays, we cannot detect:

  • Cavities
  • Periodontal Disease
  • Infections and Abscesses
  • Cysts
  • Tumors
  • Cancer

In fact, one of the most important uses of radiographs is to allow us to compare a current x-ray to a previous one.  This comparison, side-by-side, helps identify any changes from the previous period.  The comparison is important, because it tells us not only what is going on with the teeth on that day, but also the rate of change from the previous period.  A slow rate of change, even if not in a positive direction, may allow us to be more conservative in treatment.  A faster rate of change may indicate a need to treat in a more aggressive manner.

The American Dental Association recommends that bite-wing oral radiographs are updated annually, and panoramic radiograph (or full mouth intraoral series) updated every three years, to provide for optimal oral care and accurate diagnosis.  However, for patients with any risk factors or significant dental work, we may recommend panoramic x-rays to be done annually.

So, even with all that, you may be thinking right now “What about the radiation?”  Are you subjecting me to unnecessary or excessive radiation with dental x-rays?

The clear and definitive answer is NO.

If you have wondered about this or expressed this to us in the last few years, you are not alone.  We want to let you know that we take your concerns seriously.  We are also hearing new and erroneous theories on radiation exposure from dental x-rays.  So, to help get you up to (x-ray) speed, we want to share a quick science lesson:

Radiation dosage is measured in units called millirems (mrem).  According to the US Nuclear Regulatory Commission (USNRC) U.S. residents, on average, receive 620 mrem every year, with approximately one-half coming from background sources like outer space, radioactive materials in the earth, small amounts of radioactive material in foods and products that we use, etc.  The other half come from exposure to mrem in medical procedures. In general, according to the USNRC, a yearly dose of 620 millirem from all radiation sources has not been shown to cause humans any harm.

A typical digital dental x-ray (the kind we take) exposes a patient to less than 0.5 mrem.  This compares to mrem of 10, 60 and 72 for chest, abdomen, and mammogram x-rays, respectively.  So as you can see, the relatively small amount of mrem from dental x-rays illustrates the American Dental Association’s confidence in the safety of this very important diagnostic tool.  And as I mentioned before, without x-rays, we cannot identify disease processes that pose risks to your dental and overall health.

If you have any questions or concerns regarding dental radiographs (x-rays), please call the office and ask Dr. Sable to call you to address them. We care about more than your dental health, we care about YOU!

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Have You Ever Had Pain in Your Tooth…But You Are Not Even Sure Which Tooth It Is?

Sable DDS sore teeth

Does that make you feel crazy?  Well…you aren’t! There are actually several reasons why it can be difficult to pinpoint the origin of tooth pain.

Let’s take a step back and consider some of the possible reasons. Tooth decay can cause bacteria to infect the interior of the tooth and then trigger pain from changes in temperature or pressure.  This pain is coming from the nerve, but those nerves aren’t tied to one specific tooth. Therefore, it can feel like the pain is coming from a group of teeth or even from the sinus area. (who knew??) This type of pain may decrease over time, even without treatment, but the problem is simply hiding in the wings… and can lead to a root canal and eventually to gum disease.

Going the other direction, gum disease can lead to root canal infection.  Common periodontal disease caused by plaque along the gum line can lead to inflammation and infection of the gums.  The gum can then begin to detach from the tooth surface and form a “pocket.” As this worsens, the infection can spread to the root of a tooth and then into the tissue inside the tooth.   The resulting pain may feel like gum and tooth pain.  Since some of these roots can be in the proximity of roots of other teeth, the infection and pain can spread to nearby teeth and gum area.

THEN to confuse matters even more, a broken tooth can cause tooth AND gum pain depending on the location of the fracture in the tooth.

So, clear as mud??  We tried to simplify this as much as possible, but we also recognize that not every dental case fits carefully into one bucket. That is why we are here to help figure it out.   If you are experiencing tooth or gum pain, give us a call; we can work together to figure out what exactly is happening and create a treatment plan to make you feel better.

So, there…all better?

(Source:  Dear Doctor Dentistry & Oral Health, Issue 20)

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You Can Get Whiter Teeth All By Yourself and Without Chemicals! WHAT?

Sable DDS dental hygiene

You may wonder “Why Do Teeth Change Color – gosh darnit?” Well, the usual suspects like soda, coffee, red wine have color pigments called chromogens that attach to the the tooth Enamel. (Did you pay attention to the last blog about Parts of the Tooth?) Other common reasons teeth change color: tobacco, trauma and certain medications.  Even aging causes teeth to yellow as the Enamel becomes thinner and Dentin (another glossary word!), which is more yellow, shows through.

SO WHAT CAN YOU DO ALL BY YOURSELF? (Do we really need to mention here that you must have excellent homecare for your teeth too?)

Some of the items below may even be in your household currently, like bananas! By rubbing a portion of the inside of a ripe banana peel on your teeth, you could help to remove stains. Or, you can create a mixture of baking soda and salt to occasionally brush your teeth with in order to whiten up your smile. Turmeric, coconut oil, apple cider vinegar, activated charcoal, and hydrogen peroxide are some other all-natural options that won’t break the bank or harm your teeth or gums. It is important to follow the recommendations for how much and how often to use these home remedies!  These illustrations from Fix.com say it best:

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So, Is Your Dental Insurance Scaring YOU?

Sable DDS insurance

Even though Halloween is over, the scary part of our year may just be beginning?  It is OPEN ENROLLMENT! As you start to choose or renew your insurance, you might have some questions?

open-enrollment

QUESTION:  Are you In network with my new dental insurance?

ANSWER FROM SANDY:  Though the answer should be “cut-and-dried”, In and Out of Network have very different implications for dental insurance and medical insurance because these types of insurance are written very differently.  Dental insurance has specific coverage outlined for preventive care (Come get your teeth cleaned!) and other treatments (“Ouch, my tooth hurts!”) But the difference in coverage for your dental care at Rob E. Sable DDS PC between In and Out of Network for many dental insurances may be a LOT less than you think!

Is this clear as mud yet? I’ll keep going… Our fees are consistent with the “usual and customary fees (who talks like that?) for almost all In-Network plans.  What does that mean?  That means that you get really good insurance coverage in most cases, despite the fact that our our dental practice is not In-Network for your dental insurances.  Do I hear doubt already?  REALLY, I can help you understand your plan if you have questions.

THE MOST IMPORTANT THING YOU NEED TO KNOW: If you have dental insurance, it will cover all or much of your dental cleanings with ROB E. SABLE DDS PC, and much of other treatment you may need. So USE it! I can help you figure it out but so can your dental insurance company which in many cases is not even the same company as your medical insurance.

Open enrollment FEAR?  We call it opportunity to come see us more and let us take care of you, your beautiful teeth and your health.

~Sandy Palermino, Office Manager, 770 475-7551

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Floss, Waterpik, and Then Brush?? Or Molar Opposite??

Question: What order should I be doing my home care?

Our hygienist Kristy Hopper shared this common question for the Blog. There are many opinions about this, but our practice recommends first and foremost, do them in SOME order! ha!

Kristy’s response:  First, you should floss to loosen debris. Then, you should waterpik to wash debris out.  Finally, you should brush your teeth so that you are brushing a much cleaner surface.

If you have any questions about your home care, please email us at frontoffice@sabledds.com.  We know that every patient is unique and special and will have unique and special circumstances!  We are here to support you and make your dental home care as easy as possible!

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