What Is a Mandibular Advancement Device? (How It Works)

What Is a Mandibular Advancement Device? (How It Works)

Do you or a loved one suffer from obstructive sleep apnea (OSA)? If so, your dentist may have recommended a mandibular advancement device (MAD), an up and coming alternative to the CPAP machine. Now you might be wondering, “What exactly is a device like this and how does it work?” We’re happy to answer these questions for you today. Dr. Mandanas has been successfully treating OSA patients with oral devices for years and her passion is helping people find a solution that works for them. Enjoy learning from her expertise!

Are you ready to get MAD about sleep apnea? Schedule an appointment with Dr. Mandanas!

What Is a Mandibular Advancement Device and How Does It Work?

The mandibular advancement device (MAD) is an alternative treatment to the CPAP machine for obstructive sleep apnea (OSA). It is a sturdy, plastic, oral device that fits over the upper and lower teeth much like a mouthguard with a hinge in the middle. It works by gently advancing the lower jaw (mandible) forward during sleep. Because the lower jaw is attached to tongue behind the chin, the MAD advances this tissue as well, preventing it from collapsing over the airway (causing obstruction), thereby preventing OSA.

For many years, the mandibular advancement device has been proposed as an effective alternative to the CPAP machine for treating mild to moderate cases of obstructive sleep apnea, especially when the patient is considered a “CPAP reject.” A CPAP reject is someone who cannot tolerate the CPAP machine, which is very common. The continuous positive airway pressure (CPAP) machine works by forcing air through the patient’s airway to keep it open throughout the night. The air is administered from the machine to the patient by means of tubing and a mask. Both the mask and the forced air can be very uncomfortable, causing patients to remove the mask.

The mandibular advancement device is often preferred by the patient and is historically better for treatment adherence than the CPAP machine. That said, whether or not the MAD can treat severe cases of OSA is still under study. One of the latest scientific articles regarding these studies was published in January of 2018. The article confirmed the growing body of evidence that the MAD is an effective alternative to CPAP (in large part due to patient adherence) and typically preferred by patients when given a choice. From the article:

“There is now a strong body of evidence supporting their (oral appliances) use in OSAHS and clinical guidelines now recommend their use in mild OSAHS and in more severe cases when CPAP fails.”

Journal of Thoracic Disease

“It seems that the higher efficacy of CPAP is offset by greater MAD compliance.

Journal of Thoracic Disease

The factors that determine whether or not a dentist will recommend the mandibular advancement device include:

  • The severity of your obstructive sleep apnea
  • The structure of your upper airway
  • Any other medical issues you may have
  • Your personal preference

If you think the mandibular advancement device might be right for you or your loved one who suffers from obstructive sleep apnea, we would love to get you in for an appointment with Dr. Mandanas. The MAD has helped many patients who are “CPAP rejects” sleep deeply through the night and wake up feeling fully refreshed with energy throughout the day! Dr. Mandanas has a strong understanding of what makes someone a good candidate for the MAD. Please schedule an appointment with our office today.

We're Your Anchorage Holistic Dentist. Here's What That Means.

We’re Your Anchorage Holistic Dentist. Here’s What That Means.

Out of all the options for dental care in Anchorage, why should you go to your local, holistic dentist?

It’s true that other dentists offer many of the same services that we do, including general and cosmetic dentistry, implants, dentures, and sedation. It’s also true that we have all the same credentials.

So what makes us so different?

Your Anchorage holistic dentist considers some traditional dentistry practices harmful to the human body, whether or not they are beneficial to the teeth and gums. We provide natural alternatives to these traditional dental treatments that promote the health of your teeth and gums without harming your overall health.

Read this article and explore the links to see what we mean. If you agree with our perspective, you may want to switch to your Anchorage holistic dentist.

Ready to make the switch to your Anchorage holistic dentist? Send us a message or give us a call at (907) 276-5522!

1. Your Holistic Dentist Cares About the Health of the Whole Body

Your dental health has a greater impact on your overall health than you may think, affecting things like:

Explore the links above that interest you. We have done a lot of research on the connections between dental health and mental and physical health. The treatments you receive at our office are designed with this information in mind and will always promote your overall health, not just your dental health.

2. Your Holistic Dentist Looks for Natural Alternatives

Whenever a dental issue arises, we will recommend the most natural, non-invasive treatment first, such as:

All these treatments are intended to cause the least damage to your mouth and body and protect you from exposure to unnecessary chemicals.

3. Your Holistic Dentist Wants to Make Change for the Better

Many of the alternative dental treatments we provide are in response to patient discomfort and illness with traditional treatments. There are two in particular that we are most passionate about.

Our primary motivation is to provide dental care that is in your best interest.

If you have found that some of these topics are important to you, we would love to talk. Let’s get you in for an appointment with your Anchorage holistic dentist. Send us a message or give us a call at (907) 276-5522!

What Does Sleep Apnea Look Like in a Child?

What Does Sleep Apnea Look Like in a Child?

Is your child snoring heavily at night or have you heard that ADHD can be linked to childhood sleep apnea and you think your little one may be a candidate? Sleep apnea displays differently in children than it does in adults. Take a look at some of the symptoms that may indicate your child has sleep apnea.

Did you know that 1-4% of children may have sleep apnea, many of them between the ages of 2-8 years old?

American Sleep Apnea Association

Whereas obesity is the primary risk factor for sleep apnea in adults, for children, enlarged adenoids and tonsils are more likely to blame, although some children’s sleep apnea can be linked back to obesity. Other risk factors include down syndrome, abnormalities in the skull or face, cerebral palsy, sickle cell disease, neuromuscular disease, a history of a low birth weight, and a family history of obstructive sleep apnea, according to the Mayo Clinic. Dental issues can also be underlying conditions. To learn more, read Dr. Mandanas’ blog about dental signs of sleep apnea.

Nighttime Symptoms of Childhood Sleep Apnea

Your child doesn’t have to struggle with snoring to have sleep apnea; they may simply be experiencing extremely disturbed sleep. Nighttime symptoms include:

  • Snoring
  • Heavy Breathing
  • Chronic Mouth Breathing
  • Long Pauses in Breathing
  • Snorting, Coughing, or Choking
  • Sleeping in Odd Positions
  • Restless Sleep (Tossing & Turning)
  • Teeth Grinding
  • Sweating
  • Bed Wetting
  • Sleep Walking
  • Night Terrors

Daytime Symptoms Childhood Sleep Apnea

Adult, daytime sleep apnea symptoms typically revolve around fatigue, but childhood symptoms typically have to do with behavioral issues. Daytime symptoms include:

  • Difficulty Waking Up
  • Naps
  • Mouth Breathing
  • Nasal-ey Voice
  • Behavioral Problems
  • Hyperactivity
  • Difficulty Paying Attention
  • ADHD
  • Irritability
  • Cognitive Issues
  • Headaches
  • Learning Problems
  • Poor Performance at School
  • Social Issues
  • Poor Weight Gain
  • Stunted Growth
  • Frequent Infections

Dental Treatments for Childhood Sleep Apnea

Many parents do not treat their child’s sleep apnea under the assumption that they will “grow out of it,” however, untreated sleep apnea has many short-term and long-term consequences for children.

Children need restful sleep for healthy cognitive and physical growth and development. When they are deprived of this, they can struggle with behavioral and health issues in their childhood and in their adult life.

One of the most common treatments for childhood sleep apnea is the CPAP machine, although some cases require surgery or medicine. Unfortunately, many children are “CPAP rejects,” which means they cannot tolerate the CPAP machine because it is uncomfortable and annoying. Dr. Mandanas and many other integrative dentists like her offer an effective alternative to CPAP.

For many children, Dr. Mandanas can provide a dental appliance that pushes their lower jaw forward to keep the tissue in the mouth from collapsing and blocking the airway when it relaxes at night. This appliance is far more comfortable than CPAP and Dr. Mandanas has found that her child patients have little trouble adhering to the treatment.

When your child sees Dr. Mandanas, she will assess whether or not a dental appliance may be right for them. She may combine this treatment with lifestyle and dietary changes if your child is overweight. For children who have overly enlarged tonsils and adenoids, she may refer your child to an ear, nose, and throat (ENT) specialist whom she recommends. If you are interested in scheduling an appointment with Dr. Mandanas for your child’s sleep apnea, give us a call!

How Dentists Care for Children with Behavioral Disorders

How Dentists Care for Children with Behavioral Disorders

If your child has a behavioral disorder like oppositional defiant disorder (ODD), conduct disorder (CD), or attention deficit hyperactivity disorder (ADHD), you may be wondering what your options are for dental treatment.

In general, children with behavioral disorders are more likely to have poor oral health. According to a recent study, children with behavioral disorders are more likely to have dental anxiety, behavior management problems during dental procedures, and they are more likely to have what the study calls “DMFT” scores, which stands for decayed, missing, and filled teeth.

You may be wondering, “what is the dental field doing to help these children and parents like you?”

The American Academy of Pediatric Dentistry (AAPD) has published a reference manual on “Behavior Guidance for the Pediatric Dental Patient.” In the manual, they outline best practices for dentists working with children who have behavioral disorders. We are going to talk about a few of these today!

Dental Care for Children with Behavioral Disorders

Children with behavioral disorders may respond appropriately to a dental environment or procedure until they are afraid or they feel like the situation is out of their control.

The goal of your child’s dentist will be to provide the dental care your child needs without causing undue fear or helplessness.

The way that they do this is through behavior guidance.

“Behavior guidance is the process by which practitioners help patients identify appropriate and inappropriate behavior, learn problem-solving strategies, and develop impulse-control, empathy, and self-esteem.”

Behavior Guidance for the Pediatric Dental Patient, AAPD

Many behavior guidance techniques are communication techniques. Here are a few techniques your child’s dentist may try to help them succeed at their appointment:

Ex. 1. Positive Pre-Visit Imagery – Your child’s dentist may show your child images of positive experiences in a dental environment or during a dental procedure while your child is in the waiting room, giving them the opportunity to know what to expect and ask questions while they feel safe.

Ex. 2. Direct Observation – Your child’s dentist may allow your child to watch a video of another young patient receiving a dental procedure or they may be allowed to view a procedure live before their own. This gives your child the opportunity to know what they need to do for their procedure and to ask more questions.

Ex. 3. “Tell-Show-Do” – For each procedure your child’s dentist performs, they may verbally explain to your child what they are about to do, then demonstrate the procedure for your child on a stuffed animal or something else, then finally conduct the procedure. This desensitizes your child to the “scariness” of the procedure and can shape their response.

You may have also heard of techniques like “positive reinforcement” and “distraction.” A well-trained pediatric dentist will enlist any of these communication techniques that they consider necessary for your child to have a positive experience.

If the dentist has tried everything in the book but it has not worked, if your child’s health is in good condition, and if your child’s dental needs are deemed significant enough, they may recommend sedation to conduct the procedure. As a parent, you will be fully educated on the risks and benefits of sedation and your informed consent is required to proceed if the dentist has determined that sedation is best for your child.

The dental field continues to research and learn how to better serve children with behavioral disorders and their families. There are many techniques available that can help your child have a successful visit with the dentist! If you would like to work with a dentist who has experience working with children and enjoys helping families, learn more about Dr. Owen Mandanas. Dr. Mandanas is an integrative dentist who cares about the relationship between the mouth and the mind!

7 Ways to Calm Your Child's Dental Anxiety

7 Ways to Calm Your Child’s Dental Anxiety

Many children do not like going to the dentist, but 20% are actually afraid of dental visits, something called dental anxiety or dental phobia.

For these children, an upcoming visit to the dentist is more than just an appointment, it is can be something to fear or even dread.

If you have a child in this state of mind, you are probably wondering what you can do to help them calm down and relax, especially if their fear is keeping them from receiving the dental care they need!

We hope these 7 ways to calm your child’s dental anxiety help!

1. Start Early and Be Consistent

We recommend that you take your child to the dentist as early as 6 months old or before their first birthday. This early exposure will make inroads into calming their dental anxiety from a young age, making dental visits easier as they get older and are more comfortable with the dentist.

It is also a good idea to visit the dentist on a regular basis so that your child becomes used to dental visits. Pick a dentist and stick with them so that your child can build a comfortable relationship with them.

2. Choose the Right Dentist

Find a dentist who has experience with young children and helping them calm their dental anxiety. The dentist should know how to gently explain dental procedures to children, and they should have a few tips and tricks up their sleeve for managing the dental visit.

3. Talk to Your Child About Their Visit

Prepare your child for their dental visit by telling them about it in advance and allowing them adequate time to mentally process. Speak calmly and gently explain what is going to happen. Do not tell them bad stories about your own visits to the dentist and avoid using words like “hurt,” “shots,” or “painful.” Describe the dentist as someone who helps them stay healthy. Answer any questions they may have and tell them that they can ask the dentist questions at their appointment too!

Dolls, stuffed animals, and children’s books about dental visits can be helpful tools for explaining the dentist to your child.

4. Model Good Behavior

Your child is constantly looking to you for what they should think about the world around them how they should respond emotionally. Remain calm and collected when you talk about the dentist and avoid taking your child with you on your own visit. Even if you think you are relaxed, children can pick up on subtle emotional clues that could worsen their anxiety.

5. Practice Relaxation

Before and during your child’s visit to the dentist, practice regulated, deep breathing with them. Show them how this technique can be used to calm them down whenever they feel afraid. You may also practice progressive relaxation, where your child closes their eyes and slowly tenses and relaxes their muscle groups one-by-one from head to toe.

6. Use Distraction

There are several ways you can distract your child from their dental anxiety during a dental visit:

  • Engage them in conversation
  • Discuss a recent, fun event or experience
  • Tell a story
  • Ask them to count something in the room
  • Allow them to play with a favorite toy
  • Play music

7. Exercise Positive Reinforcement

When your child displays good behavior at the dentist or is particularly brave about some part of the procedure, praise them! This will encourage them to use that behavior again in the future.

Alternatives for Children with Dental Anxiety

If none of these methods work, you may want to consider sedation dentistry for your child, or cognitive therapy.

Dr. Owen Mandanas has almost 20 years of experience working with young children at Mandanas Dental. If you would like to learn more about how she has learned to manage childhood dental anxiety, give us a call! We would love to help you make your child’s visits to the dentist as painless as possible.

How to Encourage Dental Health in a Child with ADHD

How to Encourage Dental Health in a Child with ADHD

It’s 9:00 p.m., time for your child’s bedtime routine. You politely ask your child to please go to the bathroom and brush their teeth.

Fifteen minutes later, they are running around the living room with a stuffed toy. You ask them if they have brushed their teeth. They have not. You send them in again.

Another fifteen minutes go by. Same scenario. You send them back into the bathroom with a little more firmness in your voice.

After ten minutes, you can tell that nothing is happening. You walk into the bathroom with your child and help them brush their teeth.

Sound familiar?

If you are the parent of a child with ADHD, you may be struggling to help your child stay on top of their dental health.

Today we are going to talk about how ADHD affects dental health in children, what parents can do about it, and how some dentists are trained to help parents of children with ADHD have a successful visit to the dentist.

How Does ADHD Affect a Child’s Dental Health?

Inattention and hyperactivity do more than make your child’s bedtime brushing routine difficult.

Bruxism (Teeth Grinding)

Children who have ADHD are more likely to grind their teeth during both night and day.

Poor Eating Habits

Because carbs and sugars can help children with ADHD maintain their attention, they tend to be more of a staple in these children’s lives, increasing risk for cavities.

Poor Oral Hygiene

As mentioned, children with ADHD struggle to focus on the tasks required for oral hygiene (brushing, flossing, etc.). According to one study, 48% of children with ADHD brushed their teeth every night, compared to 82% of a control group.

According to one study, 48% of children with ADHD brushed their teeth every night, compared to 82% of a control group.

Dental Caries (Cavities)

Poor eating habits and oral hygiene lead to increased risk for cavities in children with ADHD. One study indicated that children with ADHD were twelve times more likely to have decay, missing, or filled teeth.

One study indicated that children with ADHD were twelve times more likely to have decay, missing, or filled teeth.

Biting and Chewing

Children with ADHD have a higher chance of nail-biting, lip biting, and biting or chewing on objects like pens and pencils.

Risk of Oral Trauma

Children with ADHD also have a higher risk for traumatic oral injuries due to hyperactivity, running, climbing, and falling.

What Can the Parents of a Child with ADHD Do to Encourage Dental Health?

There are many things that parents can do to help their child with ADHD maintain dental health, both at home and at the dentist:

  • Use stimulating tools like mechanical toothbrushes and timers to keep the child interested in brushing their teeth.
  • Talk to the child about visiting the dentist, gently explaining to them what is going to happen. Picture books can be helpful for this.
  • Maybe give the child a tour of the dentist office prior to their visit.
  • Make sure the child is on his or her normal medications before taking them to the dentist.
  • Tell the dentist what they can do to have a successful visit with the child.

What Do Trained Dentists Do to Encourage Dental Health in a Child with ADHD?

Many children who have ADHD struggle at the dentist because they are tired, can’t pay attention, or can’t hold still in the chair. Some dentists are trained in helping children with ADHD have a successful visit. They:

  • Tell the child what to expect of the visit as well as what can be expected of them.
  • Let the child know when they are getting closer to starting a new procedure, providing advanced notice.
  • Use the “Tell-Show-Do” technique when introducing new procedures.
  • Provide short, clear instructions, one at a time.
  • “Contract” the child to behaviors, asking them to promise, “When we get to this step, will you do this?”
  • Reward positive behaviors and the successful completion of tasks with verbal positive reinforcement or toys.
  • Provide the child with plenty of short breaks.

Encouraging dental health in a child with ADHD doesn’t have to be challenging. Dr. Owen Mandanas enjoys helping parents and children with ADHD make a successful visit to the dentist. If you would like to learn more about what Dr. Mandanas can do to create a positive environment at the dentist for your child with ADHD, please reach out!

What Does Sleep Apnea Do to My Body?

What Does Sleep Apnea Do to My Body?

Have sleep apnea?

Here’s how the story goes, from your body’s perspective:

You fall asleep. Your body relaxes all your muscles, including those in your throat.

Uh oh. When your throat muscles relaxed, the tissues in your throat blocked your airway. Your body responds by waking you up, hoping to breathe.

Not only were you momentarily deprived of oxygen when your airway was blocked, decreasing the levels of oxygen in your blood, but your awakening has plunged you out of any deep sleep you were experiencing.

This awakening creates stress that causes your body to increase hormone production.

These episodes occurring at multiple points over the course of the night, by the time you wake up, your body and its systems are exhausted.

Sleep apnea can have severe long-term consequences to your health. Today, we are going to talk about what some of those may be.

Let’s first focus on the results of the sleep deprivation caused by sleep apnea. Did you know that people with sleep apnea are five times more likely to get involved in car accidents? Sleep deprivation can cause:

  • Severe Fatigue
  • Mental Confusion
  • Difficulty Concentrating
  • Memory Loss
  • Headaches
  • Moodiness, Irritability, and Depression
  • Car Accidents

Now let’s talk about what stress and deprivation of oxygen can do to your body.

  • High Blood Pressure – The stress created by waking up due to oxygen deprivation increases blood pressure.
  • Atrial Fibrillation – Abnormal heartbeat such as atrial fibrillation, a fast, fluttery heart, is linked to sleep apnea.
  • Stroke – Increased levels of stroke is also linked to sleep apnea.
  • Heart Disease – People who have sleep apnea are more likely to have heart attacks, which may be attributed to high blood pressure, the stress of waking up, and oxygen deprivation.

Sleep apnea can also cause the following blood sugar, cholesterol, and weight-related issues.

  • Type 2 Diabetes – Sleep apnea strongly correlates with Type 2 Diabetes, with 80% or more of people who have Type 2 also struggling with sleep apnea. Although obesity could be the root cause of both diseases, lack of sleep can make it hard for the body to process insulin correctly. Sleep apnea increases your risk for developing insulin resistance which leads to Type 2.
  • Abnormal Cholesterol Levels – People who struggle with sleep apnea are more likely to have high levels of bad cholesterol, LDL, which is a risk factor for heart disease.
  • Weight Gain – Sleep apnea also correlates with weight gain. When the body releases additional hormones as a result of the stress caused by waking up, it releases a specific hormone called ghrelin, which makes you crave carbs and sugar. Additionally, when you’re exhausted from sleep apnea, your body struggles to convert food into energy rather than simply storing it as fat.
  • Metabolic Syndrome – Metabolic syndrome involves high blood pressure, high blood sugar, abnormal cholesterol levels, and weight gain. It is also linked to higher risk of heart disease. In general, metabolic syndrome is correlated with sleep apnea.

Finally, the following health issues are related to sleep apnea:

  • Chronic Obstructive Pulmonary Disease (COPD) – If someone already has COPD, sleep apnea can worsen their symptoms.
  • Liver Problems – Sleep apnea is correlated with higher than normal levels of liver enzymes and even fatty liver disease.
  • Complications with Medications and Surgery – People who struggle with sleep apnea can have issues with certain medication, specifically general anesthesia. Some have complications after major surgery because of their breathing problems, especially when they have been sedated or they were lying on their back.
  • Adult Asthma – It has been reported that people who receive treatment for sleep apnea have fewer asthma attacks.
  • Weakened Immune System – Lack of sleep weakens the immune system, something caused by sleep apnea.
  • Acid Reflux – People also report fewer cases of acid reflux after being treated for sleep apnea and vice versa.

Although sleep apnea is a sad story for your body, it can still end with a “happily ever after!” There are treatments available for people who struggle with sleep apnea, specifically mandibular advancement devices, which are far more comfortable than CPAP. Dr. Owen Mandanas would be happy to discuss your options with you. Reach out today!

You Can Have Sleep Apnea and Not Know It - Here Are the Signs

You Can Have Sleep Apnea and Not Know It – Here Are the Signs

It is estimated that 80% of people who have moderate to severe obstructive sleep apnea go undiagnosed. That’s a shocking statistic when you consider how detrimental sleep apnea can be to one’s quality of life!

As an integrative dentist, I (Dr. Mandanas) have a few ways to identify patients who are more likely to have sleep apnea than others. I cannot provide diagnoses, but by looking at facial structures, I can tell you if it might be a good idea for you to ask your doctor about sleep apnea. I also have some alternative treatment methods for patients who suffer from diagnosed sleep apnea but cannot tolerate CPAP!

Early Warning Signs of Sleep Apnea

If you are reading this blog, it is likely that you have already done some research into the signs and symptoms of sleep apnea. Snoring, choking at night, and chronic exhaustion during the day are all important symptoms that should not be ignored, but the root cause of sleep apnea is actually in the anatomy of the jaw and tongue.

1. Retrognathia (Poor Jaw Alignment)

Retrognathia is a developmental deficiency affecting the lower jaw where it is set back further than it should be. In a properly aligned jaw, a ruler can be set against the chin, lips, and nose such that all three of these facial features touch the ruler in an almost perfect line with each other. Here is an example of a properly aligned jaw (after) versus a retrognathic jaw (before):

Source: Deskgram

When the lower jaw is set back, the tongue and other mouth tissues are pushed backwards in the throat, creating the airway blockage that causes sleep apnea.

2. High Tongue Placement

You might think that a tongue is a tongue, and that all tongues operate pretty much the same way. That is not entirely true! Different people have different anatomical structure of the face, making some tongues set higher and lower in the mouth than others. People who have high tongues tend to have more trouble with sleep apnea. When we sleep, the muscles in our mouth relax and our tongue collapses into the back of our throat. In a mouth with a high tongue, it is more likely this will cause airway blockage.

3. Mouth Breathing

Mouth breathing can be a bad habit that you were never able to kick or it can be the cause of a developmental deficiency such misalignment of the upper jaw or a collapsed arch. Either way, if someone is a mouth breather, it is likely that they also suffer from sleep apnea.

The tonsils in the back of the throat are filters designed to catch bacteria and fight it off. Your tonsils can usually handle the amount of bacteria you throw at them on a given day, that is, unless your mouth is open 24/7. Mouth breathing can cause swelling of the tonsils that block the airways.

4. Tongue Positioning

The tongue is a powerful muscle. Ever wondered why the top of you mouth fits your tongue just right? You might think you were born that way, but the reality is, your tongue has been hard at work over the course of your life applying slow but steady pressure to shape your mouth for a perfect fit.

Some people do not have as much luck, and their tongue does not fit in the top of their mouth. This is called a collapsed arch, and it is caused by not positioning one’s tongue in the right place in the mouth. The tongue is supposed to rest on the top palate just behind the front teeth. Improper tongue positioning can cause collapsed arches and mouth breathing, both of which can cause sleep apnea.

If you are experiencing any of these signs–especially combined with other symptoms of sleep apnea–you are probably wondering what can be done! At Mandanas Dental, we provide an alternative treatment to the CPAP machine called a mandibular advancement device (MAD). The device is comfortable and easy to use. Learn more about our sleep apnea services!

Finally, An Alternative to the CPAP Machine for Sleep Apnea

Finally, an Alternative to the CPAP Machine for Sleep Apnea

The CPAP (continuous positive airway pressure) machine has long existed as the “go-to” treatment plan for patients suffering from sleep apnea. It only makes sense–a great way to prevent the airways from collapsing in the back of the mouth is to force air through them. Unfortunately, many people are “CPAP rejects,” struggling to adjust to the “side-effects” of the machine, such as discomfort, dry mouth, and inability to sleep.

Several years ago, our practice discovered the mandibular advancement device (MAD) as an alternative treatment to sleep apnea. These devices are not only more comfortable, but they avoid some of the common “side-effects” of the CPAP machine altogether! Learn more about MAD and if it may be right for you.

Problems with the CPAP Machine

Below are some of the common complaints reported by patients struggling with their CPAP machine:

  • Discomfort – A lot of people find the CPAP mask, worn over the course of the night, to be very uncomfortable. Although the masks come in a variety of styles and sizes, it can be impossible to find a “perfect fit” when you are not used to wearing something on your face while you sleep. Some people describe their CPAP mask as “claustrophobic.” The forced air distributed by the CPAP machine can also be difficult for some people to tolerate.
  • Dry Mouth and Nose – Because the CPAP machine forces air through your airways while you sleep, your mouth and nasal passages can dry out, causing irritation.
  • Skin Irritation – Depending on the style of CPAP mask you have chosen, the mask rests against parts of your nose, mouth, forehead, and chin. As you move around in your sleep, rubbing on these pressure points can cause irritation.
  • Trouble Falling and Staying Asleep – This can be caused by a variety of things. Mask discomfort, forced air intolerance, and skin irritation can all contribute to challenges with sleeping while using a CPAP machine. The CPAP machine also makes a lot of noise–especially older models–which can prove challenging for some people.
  • Difficulty Keeping the Mask On – People who toss and turn in their sleep find it difficult to keep their CPAP mask on over the course of the night.

An Effective Alternative to the CPAP Machine

The mandibular advancement device (MAD) is more comfortable than the CPAP machine, does not force air, and does not require users to stay on their back while they sleep–you can roll around in a MAD device without knocking it out!

Mandibular advancement devices (MAD) are worn in the mouth and work by progressing the patient’s jaw forward, with minor adjustments over time. This prevents the lower jaw and tongue from slipping back in the mouth to block the airways. These devices are custom-made and can be very comfortable! At Mandanas Dental, we use Panthera and SomnoDent brands of devices if you would like to learn more.

If you are interested in mandibular advancement for the treatment of your sleep apnea, give Dr. Mandanas a call! Dr. Mandanas is an integrative dentist who cares about the impact of sleep apnea treatment on the rest of the body. She would love to hear your concerns about the CPAP machine and help you return to comfortable, healthy nights of sleep!

What Is the Safe Mercury Amalgam Removal Technique? Get SMART About Your Fillings

What Is the Safe Mercury Amalgam Removal Technique? Get SMART About Your Fillings

In a previous article, we discussed five reasons why you should get your mercury amalgam fillings removed. We mentioned that our own Dr. Mandanas is trained in the safe removal of mercury amalgam. But what does that mean?

The Safe Mercury Amalgam Removal Technique or “SMART” was developed by the International Academy of Oral Medicine & Toxicology (IAOMT) as a set of scientific research-backed safety recommendations and protective measures for the removal of mercury amalgam silver fillings. It was built on traditional practices of safe removal combined with new conventions as scientific research continues to make new discoveries regarding mercury amalgam fillings. The technique protects both people and the environment from the harmful impact of mercury vapors and amalgam particulate. It is presented as a set of recommendations and not requirements, so it is up to the discretion of licensed practitioners to determine how they will use SMART in their practice. For this reason, it is important for you, the patient to be educated in SMART so that you can be an advocate for your own safety and the safety of those around you!

The Safe Mercury Amalgam Removal Technique (SMART)

The Safe Mercury Amalgam Removal Technique is fully outlined by the IAOMT but it can be summarized into ten steps. Be sure to view the IAOMT’s detailed outline for a complete understanding of the SMART process. Generally speaking, SMART involves the following requirements:

  1. In order to prevent mercury amalgam from getting into the liquid waste of the dental office and releasing into the environment, the dentist should install an amalgam separator in their wastewater system.
  2. The room where the mercury amalgam removal procedure occurs should have proper air filtration systems in place and any windows should be opened to remove the mercury vapor and amalgam particles released by the procedure.
  3. Before the procedure, the patient should be given a mixture of charcoal (or a similar absorbent material) and water to rinse and swallow unless she declines or if she has a medical reason now to take it.
  4. The patient, dentist, and dental personnel involved in the procedure should all be wearing protective gowns and covers to protect them from mercury amalgam particulate.
    • The dentist and dental personnel should also be wearing non-latex nitrile gloves, face shields, hair/head coverings, and a proper mask.
    • The patient should also be wearing a nasal mask, a non-latex nitrile dental dam, and a saliva ejector beneath the dental dam.
  5. An oral aerosol vacuum should be used within two to four inches of the patient’s mouth.
  6. Significant amounts of water and an evacuation device should be used to reduce heat and capture mercury discharges.
  7. The mercury amalgam should be removed in as large of pieces as possible.
  8. After the procedure, the patient’s mouth should be thoroughly flushed with water and rinsed a second time with the charcoal mixture.
  9. The dentist and the dental personnel should comply with all federal, state, and local regulations for the proper cleaning and disposal of all mercury-affected clothes, covers, equipment, and surfaces.
  10. Protective equipment should continue to be used during the maintenance of the suction system.

If you are interested in getting your mercury amalgam fillings safely removed, get in touch with Dr. Mandanas! As mentioned previously, Dr. Mandanas is fully trained in the SMART process and she will be an advocate with you for your safety. Dr. Mandanas is an integrative dentist who views the body as a whole and cares about the effects of dental materials, including mercury amalgam, on the rest of the body.