Wednesday, May 23, 2012

Temporary Restorations

An acrylic temporary restoration
Many of us find temporary restorations to be a big pain in the buttocks. Dentists and patients dislike them equally. There are many instances when a temporary restoration can be avoided. However, we often find that a temporary restoration must be placed and must last for at least a couple of weeks. I will make a few comments that may be helpful.

It is imperative that a permanent restoration be placed as soon as possible--usually within a couple of weeks. I do not advocate longer periods of time. The longer the period, the more likely issues will arise.

Temporary restorations can be made from various materials. In 2012, the most common method to make temporary restorations is to make them with tooth colored bis-acrylic which is very similar to the materials used in acrylic finger nails.

Bis-acrylic is the most aesthetic option. However, there is a drawback to this material. It is very weak and susceptible to fracture. It is also porous and after a short period of time may become discolored. This is especially true when certain foods and drinks are consumed such as red wine, coffee and tea.

A metal temporary restoration
Metals of various types can also be used. These are fairly strong and resilient, but obviously are not very aesthetic.

One problem that is likely regardless of the type of material used is that it may simply come off. Sometimes the length and shape of the tooth may make it a challenge to keep a temporary restoration on. Sticky foods such as taffy, gum, caramel and Tootsie Rolls can also displace temporary restorations. Also, when flossing, it is advisable to slide the floss gently through and out rather than upward since this can also displace the temporary restoration.

If the temporary restoration comes out you may just simply replace it back on the tooth. If it doesn't stay on, a denture adhesive such as Fixodent or tooth paste can be placed inside of it and it should provide adequate retention. If you have difficulty replacing it or keeping it in place, contact your dental office and they should be able to help you with it. Even then, some temporary restorations are incredibly difficult to keep in place such as veneers and onlays.

Another potential problem is tooth sensitivity. Temporary restorations are not held in place with a permanent cement. Therefore, there may be exposed tooth structure that can be very sensitive to cold, air, sweets and touch.

Do not hesitate to contact your dentist or his team if you have any questions or concerns with a temporary restoration.

Once the permanent restorations are placed, these issues are typically resolved. If not, it may need to be investigated further to determine if there are any other causative factors.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit

Wednesday, May 16, 2012

Sleep Apnea Revisited

A couple of weeks ago I briefly discussed sleep apnea. It was basically an overview or summary. I feel that I must elaborate a bit. There is so much I could write about it that it could fill textbooks.

The purpose of this blog is to discuss some of the medical issues that result from a lack of oxygenation and the inability to reach deeper levels of sleep. I will still keep the information brief and as simple to understand as possible.

I recommend reading the previous blog on this topic. I previously listed some of the potential sequelae of sleep apnea. This time I will discuss the reasons why medical issues arise.

Many health professionals are unaware of how problematic and widespread sleep apnea is. Most of us believe that snoring is just a social issue. We may have loved ones and friends that do not want to sleep near people that snore since it disrupts our own sleep. There are several organizations such as the Academy of Sleep Disorders Disciplines and the American Academy of Sleep Medicine that are actively educating us about this unrecognized issue.

Most of us will find it shocking to know that sleep apnea is much worse for us than smoking. Yes, this is a fact. The average lifespan of a smoker is decreased by roughly eight years. The average lifespan in people suffering from sleep apnea is 14 years.

There are two major reasons why sleep apnea is so detrimental to our health.

The first major reason is from a lack of oxygen. Our bodies need oxygen to survive. When our organs and target tissues are denied oxygen, they simply begin to die.

The second major reason is from the inability to reach and remain at the deeper levels of sleep. These people must be aroused from deeper levels of sleep to a level where they can take in an adequate breath. The problem here is that these people can never reach the deeper levels of sleep that are so vital in the regeneration of numerous hormones, enzymes and other biochemicals. Newborns can require up to sixteen hours of sleep each night and adults between seven and eight hours. Unfortunately, many adults never get a single hour of the deeper levels of sleep.

We can live for three weeks without food. We can live for three days without water. We can only live for  a few minutes without oxygen.

Many hypoxic episodes last for minutes at a time. Many people have numerous episodes each hour. It isn't uncommon to have more than 30 episodes each hour. This has reached epidemic proportions. At least one in six Americans suffer from sleep apnea.

We can now see why diseases and disorders like, diabetes, hypertension, heart disease, atherosclerosis, strokes, obesity, ADHD, hypothyroidism, fibromyalgia, restless leg syndrome, depression, gastroesophageal reflux, erectile dysfunction, bruxism, chronic headaches, dementia, Alzheimer's disease  and even birth disorders of infants in mothers suffering sleep apnea. There are obviously many more that we can add to this list.

The most commonly prescribed drugs in the United States are for the treatment of these medical issues. There is a better drug that could prevent some of these issues. That drug is simply oxygen from the air we breathe. In addition, reaching deeper levels of sleep for an adequate amount of time is equally important.

If a CPAP (Continuous Positive Airflow Pressure) device is helpful, then continue to use it. If you have a CPAP and cannot tolerate using one, then an oral appliance may prove useful. You must have a sleep study to diagnose sleep apnea and you must also have a sleep study to determine if the CPAP or oral appliance is effective.

If your airway isn't opened properly, it is possible that an oral appliance may cause more harm by decreasing airflow. This is why a follow-up sleep test is imperative.

For more information, review the medical and dental literature from credible sources. If you have untreated sleep apnea or suspect it, contact your physician or dentist that is well versed in sleep medicine.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit

Monday, May 7, 2012

The Benefits of Straight Teeth

Most of us associate straight teeth with an attractive smile. It is true that a straight dentition can improve the overall appearance of the face. However, there are other benefits.

Straight teeth may prevent premature tooth loss. A major reason why this is the case is because oral hygiene is much improved. Straight teeth enable better access to more surface area with the brush bristles and floss. If debris is not removed from these surfaces, decay is much more likely to develop.

Tooth decay is only part of the equation. Gingivitis (inflammation of the gums) and periodontitis (inflammation/infection of the bone surrounding the teeth) are much more likely to develop. If there is no support of the teeth from the bone and gums, even if the teeth are in good shape, tooth loss is likely.

Another major reason for tooth loss is simply malalignment. In order to have proper function and maximum efficiency, it is vital that teeth are properly aligned. In my practice, I often use the analogy of the gears in a car engine. If the teeth are aligned properly, it is likely that your vehicle may get a couple hundred thousand miles. However, if gears do not match up properly, it is highly unlikely that the vehicle will get many miles.

Tooth loss of course has other significant medical sequelae that are too numerous to discuss and beyond the scope of this blog. The link between cardiovascular disease and periodontitis has been discussed in a previous blog. I will discuss other medical concerns in future writings.

The social and psychological benefits of straight teeth are also evident and numerous. Our cultural beliefs tend to consider straight teeth to be more attractive than crooked teeth. This perception leads to social advantages. Attractive (real or perceived) people tend to have better relationship opportunities, better jobs, more status, are less likely to be discriminated against, make more money in their lifetime, and have more confidence.

There are basically two options for straightening teeth. We can use traditional wires and brackets, or we can use clear acrylic aligners such as Invisalign. I will discuss the advantages/advantages and indications/contraindications in a future blog.

Discuss the options and the feasibility of straightening your teeth with your dentist if you are one of the millions of people with crooked teeth.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit