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Asthma Marielaina Perrone DDS

Asthma Affects All Ages.

Asthma is a long term chronic condition in your lungs that has two main components. These two components consist of constriction (tightening of the muscles surrounding the  airways, and inflammation, the swelling and irritation of the airways. Constriction and inflammation cause narrowing of the airways, which may result in symptoms such as wheezing, coughing, chest tightness, or shortness of breath. If left untreated, over time, asthma can lead to decreased lung function.

When you have asthma and are exposed to stress, an irritant, or an allergen, the airways leading to the lungs become more inflamed than normal, making it harder for you to take in air while breathing. The airways also get smaller due to a tightening of the muscles surrounding the airways, and they get “stuffed up” due to a build-up of mucus.

Several triggers can cause your asthma symptoms to flare up, and may include allergies, infections, and strong odors or fumes that you may come in contact with during the course of your day. Once you are exposed to a certain trigger, and have an asthmatic reaction, your airways also become more sensitive to other triggers. This is why it is vitally important to manage the symptoms of asthma immediately. An important note is that airway inflammation may always be present even when asthma patients are not showing symptoms.

Quick Asthma Facts

-There is no known cure for asthma, but asthma can be managed with proper prevention, relaxation techniques, and medical treatment.

-Asthma has a genetic component. If only one parent has asthma, chances are 1 in 3 that each child will have asthma. If both parents have asthma, it is much more likely (7 in 10) that their children will have asthma.

-More Americans than ever before say they are suffering from asthma. It is one of this country’s most common and costly diseases.

-Approximately 25 million Americans suffer from asthma (over 8% of adults, over 9% of children), and 60% of asthma cases are “allergic-asthma.” The prevalence of asthma has been increasing over the last 30 years across all of society.

-Almost 5 million asthma sufferers are under the age of 18. It is the most common chronic childhood disease, affecting more than one child in 20.

-Just being exposed to smoke from 10 cigarettes per day may put kids at risk of developing asthma, even if they’ve never had any breathing problems before.

Every day in the United States:

-44,000 people have an asthma attack.

-36,000 kids miss school due to asthma.

-27,000 adults miss work due to asthma.

-4,700 people visit the emergency room due to asthma.

-1,200 people are admitted to the hospital due to asthma.

-9 people die from asthma.

Dentistry And Asthma

Asthma Marielaina Perrone DDSTooth Decay, Bad Breath, Periodontal Disease

With asthma being so prevalent, dentists see more asthmatic patients taking medication, which can lead to increased tooth decay, bad breath, and gum problems. In addition, many of those patients forget to bring their inhalers to dental visits, causing more in-office asthma attacks.

Patients with asthma have a tendency to be mouth breathers. This is due to their constricted airways. Combining this with medications (such as corticosteroids) will cause a decreased salivary flow leading to dry mouth. This can then lead to an increase in bad breath (halitosis) and tooth decay. Periodontal disease can also be an issue for asthma patients with poor oral hygiene maintenance.

Also, asthma inhalers may irritate the back roof of the mouth, causing a reddish lesion. If not treated, this area can become infected. This infection can spread and affect the throat and rest of the mouth.

Children who use inhalers for asthma are prone to  mottled enamel forming on the developing teeth. This happens most on 1st molars, allowing them to break down easier, requiring large fillings and future crowns. Fluoridated water during tooth development helps, as does fluoride supplementation.

Dental Anxiety

Dental anxiety can trigger an asthma attack. So it is important to let your dentist be aware of your medical condition. To overcome this, choose a dentist with good communication skills and specialized training in handling dental anxiety. Always bring your inhaler to your appointment.Tips to overcome dental anxiety include:

-Communicate fears and anxieties before, during, and after dental appointment with dentist and staff.

-Focus on breathing regularly and slowly during dental procedures, meditation and music also help. When you are nervous you tend to hold your breath, which decreases oxygen levels and further increases feelings of panic. Instead of holding your breath, squeeze a relaxation ball and breathe deeply.

-Avoid caffeine prior to a dental appointment.

-Eat high-protein foods which can produce a calming effect.

-Try to choose a time for your dental visit when you’re less likely to be rushed or under pressure. For many, an early morning appointment is best.

How To Minimize Asthma Affects During Dental Treatment

Certain items and materials in a dental office are known to have a potential to exacerbate asthma and its symptoms. These include sealants, rubber dams, tooth enamel dust, prophy paste, acrylic dust, and acrylic liquid. Another note is patients taking corticosteroids may have a higher tendency to have an adverse reaction to sulfites.

You and your dentist can help prevent asthma attacks while promoting oral health, here’s how:

-Inform your dentist know that you have asthma. Also, list all medications you are taking for asthma.

-Describe if your asthma is controlled or uncontrolled as well as what triggers you are affected by.

-After using your inhaler, rinse your mouth with water or a fluoride mouthwash. This will moisturize the mouth and prevent the mouth from drying out from the inhaler medications.

-Maintain your dental schedule as well as keeping a good oral hygiene regimen at home.

Asthma Conclusion

Understanding the complications of asthma, and it’s effects on oral health can be a life changer. A lifetime of ongoing dental work can be changed to easy maintenance visits with proper home care and fluoride use. Asthma can be a very controllable disease in most patients. Once an asthmatic is old enough to learn his/her triggers, and relaxation techniques to aid in management, oral issues can be resolved easily. Both patient and dentist need to be aware of the possible issues or complications that may arise so that dental treatment can be completed safely and comfortably. Maintain an open line of communication with your health care providers so that asthma does not hinder your treatments.

Snoring is usually not something we are very concerned about, unless our sleep mate is causing a disruption to your sleep. But, did you know that frequent, loud snoring may be a sign of something more serious than keeping your partner up during the night. This could be a sign of sleep apnea (also known as obstructive sleep apnea – OSA). Sleep apnea is a common but potentially serious condition in which breathing stops and starts up again for periods of 10-20 seconds while you sleep (this can occur hundreds of times a night). Even though sleep apnea is treatable, it often goes undiagnosed. Sleep Apnea affects more than 18 million people in the United States alone and less than 10% ever get diagnosed. If left untreated, sleep apnea can take 8-10 years off a person’s life.

Obstructive sleep apnea (OSA) is actually the most common type of sleep apnea. It occurs when the soft tissue in the back of your throat relaxes during sleep, causing a blockage of the airway (along with loud snoring). In turn this blocks the airflow into the lungs. Obstructive sleep apnea is defined as five or more episodes of apnea (temporary absence of breathing) or hypopnea (diminished depth and rate of breathing)  per hour of sleep (called apnea-hypopnea index or AHI) in individuals who have excessive daytime sleepiness. Patients with 15 or more episodes of apnea or hypopnea per hour of sleep are considered to have moderate sleep apnea

Untreated sleep apnea prevents you from getting a good night’s sleep. The pausing of breathing literally shocks your body out of its natural sleep rhythms. As a result, you tend to spend more time in light sleep and less time in the deep, restorative sleep you need to be full of energy, mentally sharp, and productive the following day.

It can be difficult to diagnose sleep apnea without help, since most symptoms only occur when you are sleeping. So it’s advisable to ask a bed partner or record yourself while sleeping. Not everyone who snores has sleep apnea and vice versa. Some recent studies have also found that if you have snoring and grind your teeth than you likely have some form of apnea, so you should get checked by a physician. So how do you tell the difference between common snoring and a more serious case of sleep apnea? The biggest sign is how you feel during the day. The quality of your sleep is unaffected by “normal” snoring as much as sleep apnea does. So you would be less likely to suffer from sleepiness and fatigue during the day.

So where does the dentist come in? An official diagnosis of sleep apnea must come from a physician with the possibility of sleep center visit. A dentist can fabricate an Oral appliance which are used to reposition the tongue and lower jaw forward during sleep to maintain the open airway. Usually, oral appliances are recommended for mild to moderate Sleep Apnea patients, but can be used in severe sleep apnea patients who cannot tolerate CPAP machines (The standard treatment right now is use of a CPAP (Continuous Positive Airway Pressure) machine, but 25%-50% of sleep apnea patients do not follow thru with or tolerate CPAP machines). Some recent studies have shown these oral appliances to be the most effective in treating snoring and mild to moderate obstructive sleep apnea.

At Dr. Perrone‘s office, we use an oral appliance called a TAP appliance (Thornton Adjustable Positioner). The TAP holds the lower jaw in a forward position so that it does not fall open during the night and cause the airway to collapse. It is able to maintain a clear airway to reduce snoring and improve breathing. We feel this gives the patient the best option for success.

The unique design allows the patient to fine-tune his/her treatment at home and work with the dentist to achieve the best possible results. Patients are empowered to manage the degree of lower jaw protrusion over as many nights as it takes to achieve the optimal treatment position. The TAP has a single point of central adjustment, which prevents uneven bilateral adjustment that can create an irregular bite and discomfort.

The TAP has over a 95% success rate. It is the key to a snore-free, restful night of sleep. This appliance also treats sleep apnea without the need for surgery, a mask, or medication. The TAP is recognized as the market leader in oral appliances for snoring and sleep apnea and is currently prescribed by over 7,000 dentists worldwide to treat snoring and sleep apnea. In addition, it is the most researched oral appliances on the market with over 30 independent peer reviewed published studies. A simple dental examination is necessary to know if the patient will be able to use an oral appliance. So, schedule one today for you and your loved ones!