Dentistry Services in Highlands Ranch, CO
Surgery & Other Services
- Bite Guards for TMJ and Sleep Apnea
- Dental Implants
- Emergency Dental Services
- Sedation Dentistry
- Wisdom Teeth Removal
Bite guards for TMJ / TMD
A bite guard is made of plastic and snaps onto the teeth (in this photo the upper teeth). It is the treatment of choice for excessive tooth wear, pain in the temporomandibular joint (TMJ), pain in the jaw muscles, or pain in the teeth caused by grinding or clenching. The bite guard is usually worn while sleeping because grinding is most common during sleep. It may also be worn during the day if grinding or clenching are daytime habits.
Why does a bite guard work? It limits wear and tear of the teeth. Even if you grind and wear out the bite guard it is better to wear out the plastic that can be replaced rather than your own teeth. When you grind or clench in your sleep the pressure on the teeth is many times greater than normal chewing forces when eating.
The bite guard also keeps the teeth apart or open a few millimeters when compared to the natural bite without the bite guard. This slightly-open position stretches the jaw muscles to a weaker position, so even if you continue to grind or clench is done with lower forces. These weaker forces are will reduce or eliminate pain in the jaws and teeth.
Furthermore, bite guard is flat. The lower teeth will skate smoothly along the bite guard. This also reduces the force of any grinding when compared to grinding on the teeth that interlock. Teeth without a bite guard that fully interlock suffer during grinding due to side-to-side forces on the teeth. Grinding on the smooth surface of the bite guard eliminates these damaging side-to-side forces.
Sleep apnea is a condition that causes pauses in breathing during sleep. These pauses–like holding your breath–last from a few seconds to a few minutes. Sleep apnea is caused by the tongue or throat collapsing to block the airway (as shown by the white circle in the graphic on the left). These apnea events can happen through the night from 5 to 30 times every hour.
If I start breathing again, why is this a problem? Untreated sleep apnea has some serious negative health consequences. The most serious is heart disease that can lead to heart attacks and death. During apnea–think of what happens when you hold your breath – carbon dioxide levels are rising and oxygen levels are dropping. Blood pressure in the lungs is rising. When the apnea episode is over and you start breathing again the heart races to push through the blood pressure in the lungs, decrease carbon dioxide, and increase oxygen. Overworking the heart like this night after night leads to congestive heart failure and increases the risk of a heart attack. A racing heart and regaining oxygen are stimulating enough that the deeper levels of the proper sleep cycle are never reached. This causes non-restful sleep and all the negative effects of poor sleep (fatigue, narcolepsy, psychological stress, poor metabolism, weight gain, etc.). Loud snoring is also common in people with sleep apnea.
Treatment options for sleep apnea include a dental bite guard, a positive-pressure air flow mask (CPAP), and surgery of the soft palate. A special dental bite guard is designed to open the airway while you sleep. The only way the teeth will fit into the bite guard is with the chin slightly jutting forward. With the chin in this position the soft tissues of the tongue and throat are pulled forward, causing the airway to open and improving airflow, as shown in the lower half of the graphic above. Depending on the severity of the sleep apnea, this bite guard can be the only treatment, or it can be used in combination with a CPAP device or surgery. Because a bite guard is minimally invasive, we recommend patients try it before committing to surgery. Most of our patients are satisfied and comfortable using a bite guard. Rarely we see patients who cannot tolerate them. A sleep apnea bite guard will also protect the teeth from grinding or clenching.
Patients who are candidates are those who have their own natural teeth or a well-fitting upper denture and their own natural teeth on the lower jaw. Patients are not candidates if they have a full lower denture or are missing all of their upper teeth without an upper denture. It takes a minimum of two appointments to make and fit the sleep apnea bite guard.
Proper breathing will provide a better night’s sleep and help keep the heart relaxed and healthy for a lifetime.
- Do your best to push the tooth back into the proper position.
- If the tooth has been knocked out completely, hold it by the white enamel end (not the yellow root end), rinse it gently with water only, (do not wipe it or scrub it). Rinse the tooth socket with water, and place the tooth back in the socket, as close to the proper position as possible.
- If the tooth has been knocked out completely and you can’t get it back in the socket, store the tooth in:
- Hank’s Balanced Salt Solution or Save-A-Tooth (available at pharmacies)
- Cool milk
- 0.9% saline water (available at pharmacies)
- Saliva. Have the person whose tooth was knocked out hold it inside their cheek. All these solutions have the purpose of keeping the cells of the tooth alive until it can be placed back in the socket.
- Call your dentist immediately. If the tooth is repositioned and stabilized in one hour or less, it has a much better chance of healing well and staying alive. If it takes longer than an hour, then it runs the risk of the body rejecting it as if it’s an extracted tooth.
When a tooth has been knocked out of place there are three areas that might be injured: the nerve inside the tooth, the ligament that secures the tooth root to the tooth socket, or the bone surrounding the tooth. Immediately repositioning the tooth gives the ligament the best chance at survival. If the ligament dies, the tooth may become fused to the bone, or the tooth may fall out completely. If the nerve is injured the tooth may need a root canal within a few days after the injury or even years later.
Baby teeth do not heal well if stabilized because they do not have enough root. If a baby tooth gets bumped, contact your dentist with any questions about what is best for your child.
Treatment for a dental injury to permanent teeth includes repositioning the tooth, stabilizing it, prescription medication, and evaluating the health of the nerve.
More than half of Americans delay seeking dental care due to anxiety. Delay in dental care may be the difference between a small filling and a root canal or extraction. The need for sedation dentistry to reduce anxiety is undeniable. In our dental practice, we offer three forms of sedation dentistry: oral, nitrous oxide, and IV sedation. Each offers a different level of sedation and relaxation.
Oral sedation is a prescription tablet that you take at home before coming to your dental appointment. Most commonly we prescribe Halcion, a sedative. This medication causes drowsiness and amnesia. When you take Halcion you must have someone else drive you to your appointment and drive you home afterwards. Patients who have taken Halcion report feeling relaxed or forgetting parts of their appointment. While some patients sleep through their appointment others will be comfortably relaxed. The medication will wear off within one to two hours after your appointment.
Nitrous oxide, or laughing gas, causes mild anesthesia and reduces anxiety. It is always combined with 30 percent or more of O2 to ensure safe oxygenation. Patients report feeling heavy or relaxed and sounds seeming muffled. At the end of the appointment nitrous oxide quickly leaves the lungs while the 100% oxygen is given, before you leave the dental chair.
Intravenous sedation (IV sedation) is the most effective form of sedation. Medications are given with sterile water into a vein and have rapid effect. Patients report feeling that just a few minutes have passed and being surprised that the appointment is already over. You will need someone else to drive you home. Medications wear off in about an hour, though it is recommended not to drive or to operate a hazardous device for 24 hours afterward.
Dr. Morris completed his IV sedation training at Duquesne University in Pittsburgh, PA. He is certified by the state of Colorado to perform sedation.
Different sedation options may be used in combination. You may be prescribed oral sedation before coming to the office, then also receive nitrous or IV sedation once you arrive. The purpose of sedation is to eliminate fear or anxiety about dental treatment. It is a comfortable way to get dental treatment done.
Frequently Asked Questions
If I’m sedated will my mouth also be numb?
Yes. We still use local anesthetic to ensure your comfort during the appointment. Many patients report not being aware of when anesthetic was given because the sedation had already taken effect.
Will I be asleep?
Everyone responds differently to sedation medications. Some patients sleep while others remain conscious and relaxed. You will be given enough medication to ensure your comfort: anxiety will be gone, and you will have amnesia about some or all of your appointment. While sedated you will be able to talk to your dentist and answer questions, though you may not remember this.
Dr. Morris has helped hundreds of teens and adults through the process as painlessly as possible. Read more about these services (and our Internet pricing specials!) on our dedicated web page.