Take Home Pearl:

Background: Many patients today suffer from obstructive sleep apnea, which can have a negative effect on their health and quality of life. Would doing something as simple as placing a mandibular advancement splint significantly improve their sleep apnea?

Objective: The purpose of this study was to investigate psychosocial function in patients with obstructive sleep apnea before and after mandibular advancement splint therapy.

Participants: The sample for this study consisted of 85 patients with mild-to-moderate obstructive sleep apnea.

Methods: The participants in this study were separated into 2 groups. One group received conservative treatment consisting of advice on sleeping position, avoidance of alcohol in the evenings, and weight loss. The second group received mandibular advancement splint therapy, which included a modified Herbst appliance. Two standardized tests to evaluate psychosocial health and daytime sleepiness were used to evaluate each participant at baseline and again 3 months later.

Results: 68% of the patients in the mandibular splint therapy group showed an improvement in energy and vitality, and 80% showed improvement in sleepiness. This was a significant improvement compared with the conservatively treated group. The improvements in energy and vitality scores in the mandibular advancement splint therapy group were similar to those seen in continuous positive airway pressure (CPAP) studied.

Conclusions: The use of mandibular advancement splints can result in a significant improvement in energy, vitality, and sleepiness for patients with obstructive sleep apnea.

Reviewer’s Comments: The results of this study were very impressive. I would not have thought that improvements with a mandibular advancement splint could be comparable to CPAP. In interpreting the results of this study, it is important to understand that the participants had mild-to-moderate sleep apnea and were preselected based on the likelihood that they would respond positively to mandibular advancement splint therapy.

Reviewer: John S. Casko, DDs, MS, PhD

Now in its 63rd year, this month-long national health observance brings together thousands of dedicated dental professionals, health care providers and others to promote the benefits of good oral health to children and adults, caregivers, teachers and many others.

Parents and teachers can help kids celebrate and learn more about the importance of a healthy smile. The ADA offers free downloadable information, kid-friendly oral health worksheets and games on MouthHealthy.org, the ADA’s consumer website. Click on the For Kids tab on the left side of the page for a variety of age-appropriate activities, games and videos and presentations. There are also teaching guides that adults can use at home, in the classroom or in other community-based settings.

MouthHealthy.org also offers a variety of tools to help consumers learn more about oral health or address their concerns, including the new ADA Dental Symptom Checker. This new tool is designed to understand what your dental symptoms may mean so that you can make informed decisions about your dental health.

Families who don’t have a regular dentist can use the ADA Find-A-Dentist online feature that uses a zip code search feature to help locate a dentist in their community. Find a Dentist listings include information like office hours, insurance accepted, languages spoken and photos of the dentists.

MouthHealthy.org Dental disease can lead to difficulty eating, sleeping, paying attention in school and smiling. The ADA urges parents to make sure their children brush twice daily with fluoride toothpaste, floss daily, eat a balanced diet and see their dentist regularly to address tooth decay in its earliest stages.

©2010 American Dental Association. All rights reserved. Reproduction or republication is strictly prohibited without the prior written permission from the American Dental Association.

John S. Casko, DDS, MS, PhD

How Does Orthodontic Treatment Affect Young Adults’ Oral Health-Related Quality of Life?

Palomares NB, Celeste RK, et al: Am J Orthod Dentofacial Orthop; 2012;141 (June): 751-758

How do Sugars Attack Your Teeth?
Invisible germs called bacteria live in your mouth all the time. Some of these bacteria form a sticky material called plaque on the surface of the teeth. When you put sugar in your mouth, the bacteria in the plaque gobble up the sweet stuff and turn it into acids. These acids are powerful enough to dissolve the hard enamel that covers your teeth. That’s how cavities get started. If you don’t eat much sugar, the bacteria can’t produce as much of the acid that eats away enamel.

How Can I “Snack Smart” to Protect Myself from Tooth Decay?
Before you start munching on a snack, ask yourself what’s in the food you’ve chosen. Is it loaded with sugar? If it is, think again. Another choice would be better for your teeth. And keep in mind that certain kinds of sweets can do more damage than others. Gooey or chewy sweets spend more time sticking to the surface of your teeth. Because sticky snacks stay in your mouth longer than foods that you quickly chew and swallow, they give your teeth a longer sugar bath.

You should also think about when and how often you eat snacks. Do you nibble on sugary snacks many times throughout the day, or do you usually just have dessert after dinner? Damaging acids form in your mouth every time you eat a sugary snack. The acids continue to affect your teeth for at least 20 minutes before they are neutralized and can’t do any more harm. So, the more times you eat sugary snacks during the day, the more often you feed bacteria the fuel they need to cause tooth decay.

If you eat sweets, it’s best to eat them as dessert after a main meal instead of several times a day between meals. Whenever you eat sweets — in any meal or snack — brush your teeth well with a fluoride toothpaste afterward.

When you’re deciding about snacks, think about:

• The number of times a day you eat sugary snacks
• How long the sugary food stays in your mouth
• The texture of the sugary food (chewy? sticky?)

If you snack after school, before bedtime, or other times during the day, choose something without a lot of sugar or fat. There are lots of tasty, filling snacks that are less harmful to your teeth — and the rest of your body — than foods loaded with sugars and low in nutritional value. Snack smart!

Low-fat choices like raw vegetables, fresh fruits, or whole-grain crackers or bread are smart choices. Eating the right foods can help protect you from tooth decay and other diseases. Next time you reach for a snack, pick a food from the list inside or make up your own menu of non-sugary, low-fat snack foods from the basic food groups.

How Can You Snack Smart? Be choosy!
Pick a variety of foods from these groups:

Fresh fruits and raw vegetables
Berries
Oranges
Grapefruit
Melons
Pineapple
Pears
Tangerines
Broccoli
Celery
Carrots
Cucumbers
Tomatoes
Unsweetened fruit and vegetable juices
Canned fruits in natural juices

Grains
Bread
Plain bagels
Unsweetened cereals
Unbuttered popcorn
Tortilla chips (baked, not fried)
Pretzels (low-salt)
Pasta
Plain crackers

Milk and dairy products
Low or non-fat milk
Low or non-fat yogurt
Low or non-fat cheese
Slow or non-fat cottage cheese

Meat, nuts and seeds
Chicken
Turkey
Sliced meats
Pumpkin seeds
Sunflower seeds
Nuts

Others
(these snacks combine foods from the different groups)
Pizza
Tacos

Remember to:
Choose sugary foods less often
Avoid sweets between meals
Eat a variety of low or non-fat foods from the basic groups
Brush your teeth with fluoride toothpaste after snacks and meals

Note to Parents
The foods listed in this leaflet have not all been tested for their decay-causing potential. However, knowledge to date indicates that they are less likely to promote tooth decay than are some of the heavily sugared foods children often eat between meals.

Candy bars aren’t the only culprits. Foods such as pizza, breads, and hamburger buns may also contain sugars. Check the label. The new food labels identify sugars and fats on the Nutrition Facts panel on the package. Keep in mind that brown sugar, honey, molasses, and syrups also react with bacteria to produce acids, just as refined table sugar does. These foods also are potentially damaging to teeth.

Your child’s meals and snacks should include a variety of foods from the basic food groups, including fruits and vegetables; grains, including breads and cereals; milk and dairy products; and meat, nuts, and seeds. Some snack foods have greater nutritional value than others and will better promote your child’s growth and development. However, be aware that even some fresh fruits, if eaten in excess, may promote tooth decay. Children should brush their teeth with fluoride toothpaste after snacks and meals. (So should you!)

Please note: These general recommendations may need to be adapted for children on special diets because of diseases or conditions that interfere with normal nutrition.

For additional copies of this pamphlet contact:

National Institute of Dental and Craniofacial Research

How Does Orthodontic Treatment Affect Young Adults’ Oral Health-Related Quality of Life?

Palomares NB, Celeste RK, et al: Am J Orthod Dentofacial Orthop; 2012;141 (June): 751-758

Feel a little self conscious about your crooked teeth? You aren’t alone. Thankfully, braces aren’t just for kids any more. Today, adults make up nearly 20% of brace wearers, says Michael B. Rogers, DDS, president of the American Association of Orthodontists.

Although there are many reasons for adults to consider braces, most people simply want to look and feel their best. Here are a few leading reasons to make a trip to the orthodontist:

 A straighter smile. It’s no surprise that many people want to perfect their pearly whites to achieve a winning smile. And, those smiles pay off. A recent study compared people’s reactions to photos that were manipulated to show either straight or crooked teeth. People with straight teeth rated higher on scores of leadership, popularity, and sports ability. (The only score that didn’t change was intelligence.)

Shifting teeth. Just because you had braces as a kid doesn’t mean you’re off the hook. “Teeth tend to move a little throughout your life,” Rogers says. “Your teeth may shift a little back toward their original positions.”

Better oral health. It’s no surprise that straight teeth are easier to brush and floss. So — if you’re doing your part — expect less decay and healthier gums, says Pamela K. McClain, DDS, president of the American Academy of Periodontology. Antibacterial mouth rinses can also help keep your teeth and gums free of plaque-causing bacteria that can lead to gingivitis, an early, mild form of gum disease.

Braces can help people manage some more serious issues, too, like bite problems that cause jaw pain. In some cases, braces are necessary to change the position of neighboring teeth for a new bridge, crown, or implant.

New Options

Thankfully, we’ve come a long way from the days when kids were called “Brace Face.” Today’s options are barely noticeable. They include:

• Ceramic braces made of a clear material that is much less obvious than traditional metal braces.
• Customized plastic aligners that fit like tooth guards over teeth, gently moving them into a new position.

 What to Expect

How long you’ll need to wear braces depends on what you have done. Most treatments range from 6 to 20 months. Once teeth are in the desired position, you are likely to need to wear a retainer. Many orthodontists now recommend permanent retainers that are fitted and attached to the back of teeth.