6/27/13

Bruxism - Fast Facts

  • Bruxism (grinding of the teeth) is common in young children, but generally goes away by age 9.
  • Increased stress, anger, frustration, and anxiety can lead to increased teeth grinding.
  • The condition is common with adults in their 40s. It tends to decrease with older age.
  • Avoid chewing gum as it allows the muscles to get used to clenching and makes you more likely to grind your teeth.
  • According to the American Dental Association, 30-40 million Americans grind their teeth while sleeping.
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6/24/13

Indications for Tonsillectomy

These indications for adenotonsillectomy should only be used as a guideline. Please consult your medical doctor for further information.

  1. Patients with 3 or more infections of tonsils and/or adenoids per year
  2. Hypertrophy (enlargement) causing dental malocclusion or adversely affecting orofacial growth.
  3. Hypertrophy causing upper airway obstruction (sleep apnea), severe dysphagia (trouble swallowing), sleep disorders, or cardiopulmonary complications.
  4. Peritonsillar abscess unresponsive to medical management and drainage
  5. Persistent foul taste or breath due to chronic tonsillitis
  6. Chronic or recurrent tonsillitis associated with the streptococcal carrier state
  7. Unilateral tonsil hypertrophy presumed euplastic
  8. Recurrent acute otitis media or chronic serous otitis media
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6/12/13

More Information on Obstructive Sleep Apnea (OSA)

Diagnosis Guidelines:
  • Apnea Hypopnea Index (AHI):
    • 0-4 Normal
    • 5-14 Mild Apnea
    • 15-29 Moderate Apnea
    • >30 Severe Apnea
Treatment Options:

Adult
  • CPAP
    • Pro: very effective; "gold standard"
    • Con: low compliance, difficult to travel with, can cause tooth movement or orthognathic changes 
  • Surgery - Uvulopalatopharyngoplasty, etc.
    • Pro: best for snoring and/or mild cases; once completed, no compliance issues
    • Con: about 40% success rate, pain, possible complications, may need re-treatment
  • Maxillomandibular Advancement
    • Pro: very effective; once completed, no compliance issues
    • Con: very invasive, difficult patient acceptance
  • Oral Appliance
    • Pro: effective for most mild, moderate, and CPAP intolerant apneas, high compliance
    • Con: must have healthy mandibular teeth, minor jaw soreness and tooth movement possible
  • Co-therapy - Use of CPAP and Oral appliance therapy simultaneously
    • Pro: very effective
    • Con: not acceptable for many patients

Obstructive sleep apnea (OSA) is very common and typically increases with age. However, children are not immune. They too can suffer from sleep apnea.

Children
  • CPAP
    • Pro: effective if tolerated
    • Con: not often tolerated
  • Tonsillectomy/Adenoidectomy
    • Pro: often very effective
    • Con: pain; not 100% effective
  • Orthodontics
    • Pro: can be effective in selected cases
    • Con: none, when used when indicated
Tagawa & Curtis Orthodontics - www.breasmiles.com - 714.990.5414
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