We all know that sleep apnea causes many a difficult night. Noisy snoring, gasping for breath, and waking up dozens of times a sleep cycle are the unhappy consequences of Obstructive Sleep Apnea (OSA). What you may not realize is that sleep apnea can make your days just as challenging.

Obstructive sleep apnea is caused by an obstructed airway. The throat muscles may relax as you sleep and make it impossible to inhale fully with each breath. Or you may have a physical condition such as a deviated septum, enlarged tonsils or excess throat tissue that blocks the free passage of air into your lungs. As a result, you stop breathing for a short time and often choke or gasp for breath. Your body responds by waking every time you need to start breathing properly again, and this can happen dozens of times each hour you are asleep. The result is that, while you may think you have slept through the night, you have never gotten the deep sleep your body needs to restore itself.

How can sleep deprivation affect our daytime hours? You might find yourself suffering from any of these problems:

• Constant drowsiness
• Falling asleep at work or while driving
• Headaches every morning
• Sore throats
• Dry mouth (which can lead to gum and dental problems)
• Memory and attention problems
• Moodiness or depression
• Decreased libido

As if these reasons weren’t cause enough to find a solution to your sleeping disorder, the longer term results of sleep apnea can be devastating. High blood pressure, heart disease, stroke, dangerous responses to medication or general anesthesia, a higher risk of accidents, and many other serious consequences have been linked to sleep apnea.

Sleep apnea doesn’t just ruin your night. If you suffer from any of the daytime problems listed above, please give our Hiawatha, IA office and your doctor a call. If obstructive sleep apnea is the cause, Dr. Sardzinski, Dr. Wilken, Dr. Stanley, Dr. Hanson and Dr. Heying can work with you to find a solution that will improve your quality of life 24 hours a day.

Let’s face it, by now, brushing our teeth is something we pretty much do on auto-pilot. A quick brush after breakfast, a minute or so at night, floss when we think of it. Done. But take a few minutes to review these cleaning tips, and see if a few small adjustments to your routine could make all the difference at your next checkup at our Hiawatha, IA office.

• Tools

Some of us prefer brushing with a manual brush. Some like the electric brush for ease and comfort. Whichever form of brush you choose, be sure that it fits comfortably in your mouth, reaches everywhere it needs to, and has a handle that is easy to grip. There are many bristle options available, so if you are an energetic brusher, or if you have sensitive gums, try a soft bristled brush for gentler brushing.

If you haven’t been exploring the floss aisle lately, there are now many varieties available to suit your particular needs. Besides the traditional floss, there are coated flosses for easy gliding between teeth that fit closely together, dental tape-style flosses to fit teeth with wider spacing, and even flosses designed just for braces that thread between the wires and brackets. Talk to Dr. Sardzinski, Dr. Wilken, Dr. Stanley, Dr. Hanson and Dr. Heying at your next cleaning for product suggestions if you think there’s an easier, more comfortable option out there for you.

• Technique

With proper technique, any toothbrush and floss you choose will do a fine job of removing plaque.

Brushing? There’s a tried and true method for success. Place the toothbrush at a 45° angle at the gum line. Be sure to brush the outside, inside, and chewing surface of each tooth thoroughly. Remember the expression, “Massage, don’t scrub.” Over-vigorous brushing can actually irritate gum tissue and damage enamel. An electric toothbrush should provide a continuous brushing motion without needing any pressure from the brusher. This might be the model for you if you have a too-vigorous approach to brushing, or sensitive teeth and gums. If you like your manual brush, again, give a soft-bristled brush a try!

As for flossing? That harmless-looking little string can cause gum damage if used too forcefully. You can accomplish the placement and cleaning power you need by easing the floss down to the gumline and flossing with gentle pressure against the tooth surface. If you have any questions about technique, remember—we are always happy to let you know the best cleaning methods for your specific needs.

• Timing

Of course, the best tools and the best technique in the world won’t be effective unless you put the right amount of time into brushing and flossing.

The standard rule is two minutes of brushing in the morning and two minutes at night. If you wear braces or have other special circumstances, we might recommend brushing after every meal. And if you brush after breakfast, give your teeth half an hour or so to remineralize. This natural process uses the calcium and phosphate ions in your saliva to strengthen tooth enamel after it’s been exposed to any acidic foods in your breakfast.

Thorough flossing can be accomplished in a few minutes, and might be needed only once a day. But again, depending on your individual needs, we might have other recommendations. Let’s review what works for you at your next visit—we can tailor suggestions for a brushing routine to your unique needs.

It’s a great idea to review your brushing habits periodically to make sure you are getting the most out of those minutes you spend cleaning your teeth. There won’t be a test at the end of this review, and you won’t get a gratifying grade or a gold star. What you will get is much more important—better checkups, fewer cavities, and healthy teeth and gums. Happy cleaning!

From the time you were small, you’ve been warned about the dangers of plaque. Why? Because:

• It’s an unappealing film that sticks to your teeth
• It causes cavities
• It causes gum disease

And really, do we need to know much more than this to motivate us to brush? But if you’re in a curious mood, you might be wondering just how this soft, fuzzy film accomplishes all that damage. Let’s take a closer look at the sticky problem of plaque.

How does plaque form?

We live with hundreds of species of oral bacteria, most of which are harmless, and some of which are actually beneficial. But when our oral ecosystem gets out of balance, problems can occur. For example, without regular and thorough brushing and flossing, we start to build up plaque.

Plaque starts forming within hours of your last brushing. And even though plaque fits the very definition of “seems to appear overnight,” this biofilm is actually a complex microbial community with several different stages of development.

• It starts with saliva.

Saliva is vital to our oral health, because it keeps us hydrated, washes away food particles, neutralizes acids in the mouth, and provides minerals which keep our enamel strong. Saliva also contains proteins, which help form a healthy, protective film on the tooth surface. This film is called a pellicle.

• Bacteria attach to the pellicle.

There are species of oral bacteria that are able to attach themselves to the pellicle film within hours of its formation. As they become more firmly attached, they begin to grow and divide to form colonies, and are known as the early colonizers of the plaque biofilm.

• A complex biofilm forms.

If you’ve skipped brushing for a few days (please don’t!), you’ll notice a fuzzy, sometimes discolored film on your enamel—that’s a thriving plaque community, and it only takes a matter of days to go from invisible to unpleasant.

If you’re not removing plaque regularly, it can harden further and become tartar. And once you have tartar buildup, you’ll need the care of a dental professional to remove it.

• What happens if we ignore plaque and tartar?

We get cavities and gum disease.

How does plaque cause cavities?

• The bacteria in plaque, like all organisms, need nutrients.

Our normal oral environment and the food in our everyday diets provide the nutrients plaque needs. And, as we mentioned above, certain types of oral bacteria convert these nutrients into acids. Foods such as carbohydrates, starches, and sugars are most easily converted into acids, which is why we recommend that you enjoy them in moderation.

• The biofilm promotes acid production.

Within the plaque film, anaerobic bacteria (bacteria which don’t use oxygen) convert sugars and starches into acids. As the plaque film becomes denser, it blocks acid-neutralizing saliva and oxygen from reaching these bacteria close to the tooth’s surface, creating an ideal environment for the bacteria to produce their acid waste products.

• Acids attack enamel.

The sticky nature of plaque keeps these acids in contact with tooth enamel, where, over time, acids dissolve minerals in enamel, weakening the mineral structure of the tooth.

How does plaque cause gum disease?

• Bacteria cause inflammation and gingivitis.

The bacteria in plaque irritate the delicate tissue of the gums, which causes an inflammation response which can leave your gums swollen, red, bleeding, or tender. This early form of gum disease is gingivitis. Fortunately, good dental care and careful brushing and flossing can usually prevent and even eliminate gingivitis.

• Plaque and tartar can lead to periodontitis.

When plaque and tartar build up around and below the gumline, the gums pull away from the teeth, leaving pockets where bacteria collect, leading to infection as well as inflammation. Infections and constant inflammation not only harm gum tissue, they can destroy the bone supporting the teeth. This serious gum condition is periodontitis, and should be treated immediately to avoid further infection and even tooth loss.

How do we fight plaque?

From the time you were small, you’ve learned how to fight plaque:

• Brush at least twice a day for two minutes, and be sure to brush all of your tooth surfaces and around the gumline.
• Floss to remove plaque from between the teeth and near the gumline.
• Visit our Hiawatha, IA office for a thorough professional cleaning.

Be proactive. If you have any questions, talk to Dr. Sardzinski, Dr. Wilken, Dr. Stanley, Dr. Hanson and Dr. Heying about the best way to keep plaque at bay. We can show you the most effective ways to brush and floss, recommend anti-plaque toothpastes and rinses, even suggest plaque-revealing tablets if you’re missing some trouble spots.

We’ve only brushed up on some plaque basics, because there is a lot more to discover about this complex biofilm. Happily, even with all there is to learn about plaque’s growth and development, it’s reassuring to know that getting rid of it is quite simple—with just a soft-bristled brush, some dental floss, and a few minutes of your time each day, you’re on the way to a healthy, happy, plaque-free smile.

You’ve planned your dream vacation. Your reservations are made. You’re packed and ready. You’ve even scheduled a dental checkup at our Hiawatha, IA office to make sure you catch any potential problems, have finished any major work, and have an up-to-date chart.

But things don’t always go according to even the best of plans. So, what to do if you find you have a dental emergency while traveling? Dr. Sardzinski, Dr. Wilken, Dr. Stanley, Dr. Hanson and Dr. Heying and our team have some recommendations for problems that might arise.

• Toothache—Rinse your mouth with warm water and use dental floss to remove any food particles. Never put aspirin directly on a tooth or gum tissue. If the pain persists, call a dentist.
• Cracked or broken tooth—Immediately rinse with warm water to clean the area and apply cold compresses to the face to minimize swelling. Get in touch with a dentist.
• If you lose a tooth—Keep the tooth moist at all times. Put the tooth back in the socket without touching the root if possible. If that is not an option, place the tooth between the cheek and gums or in milk. See a dentist as soon as possible.

Know where to get help if you need it! If you are traveling in the United States, the American Dental Association offers Find-a-Dentist, a website that can locate a member dentist closest to you. If you are traveling to another country, there are steps you can take to prepare for an emergency.

• If you are out of the country and need to locate a dentist, your local embassy or consulate, your hotel concierge, or friends abroad can be a useful resource.
• Before you go, check your insurance to see if you are covered while traveling.
• If you have travel insurance, find out if it covers dental treatment and can provide information on qualified local dentists and translation help, if necessary.
• Good dental care is available in many areas internationally, but it is important to know what standards are present in the countries you plan to visit. The Organization for Safety and Asepsis Procedures offers a checklist for safe treatment in their “Traveler’s Guide to Safe Dental Care.”

If you have any questions, Dr. Sardzinski, Dr. Wilken, Dr. Stanley, Dr. Hanson and Dr. Heying and our team are happy to do all we can to answer them. While it’s unlikely that problems will arise, we are always available if you need to contact our Hiawatha, IA office. Bon voyage, and we look forward to hearing about your trip!