Sunday, November 27, 2016

I can fix that!



Orthodontists have many skills which are useful to straighten teeth.  These skills can also be used outside the office.
Recently my bottom refrigerator shelf split from using it to support heavy pots.  It seemed ridiculous to replace the refrigerator when the motor still worked.  After staring at the broken shelf for months I said to myself, “I can fix that.”  Using the method which my grandfather, Dr. Joseph Okun, used to repair dentures, and which my father, Dr. Stanley Okun, adapted to repair retainers, I set out to repair my refrigerator shelf.  I drilled holes on both sides of the crack, and sewed .012 ligature-wire across the crack.  On the top side of the shelf I flowed Triad Gel over the “stitches” to create a smooth surface, and light cured the gel.  Then I used cold cure acrylic on the underside of the shelf, to add strength to the repair.  I restored the support leg with .045 retainer wire and cold cure acrylic, the same way that I used to transfer copings when I still did general dentistry. Now my refrigerator shelf is as good as new!

How handy is your orthodontist?

Monday, November 21, 2016

The Danger of Undiagnosed Sleep Apnea, and Dental Treatment for Sleep Apnea

Once again, undiagnosed sleep apnea is in the news, as the cause of the September 29, 2016 Hoboken Commuter train crash.  It was also the cause of a New York City commuter train crash in 2013 and of freight train crashes in 2011 in Iowa, and in 2013 in Missouri. According to a CBSnews.com report on 11/21/16), “Metro-North started testing for sleep apnea after the 2013 crash. Metro-North’s screening program has found sleep apnea in 51 of its 438 engineers and trainees, spokesman Aaron Donovan said. They are undergoing treatment, he said. Now Federal regulators are urging railroads across the country to test train operators for obstructive sleep apnea.”
Sleep apnea is especially troubling for the transportation industry because sufferers are repeatedly awakened and robbed of rest as their airway closes and their breathing stops, leading to dangerous daytime drowsiness. Studies have long concluded that people with the disorder have diminished performance in multiple areas during the daytime.
“You end up with an engineer who is so fatigued they’re dosing off, they’re falling asleep in these micro bursts and they often have no memory of it, and they’re operating a locomotive at the time, so they’re putting hundreds of people in danger,” (Sarah)Feinberg (of the Federal Railroad Administration) said.
“Airplane pilots with sleep apnea aren’t allowed to fly unless they’ve been successfully treated. Regulators are also pushing for bus and truck drivers to get tested.”
Treatment for sleep apnea may include:
Sleep hygiene measures such as: going to sleep the same time every night and getting up at the same time every morning in order to train your body when it should be sleeping, sleeping in a dark room, using the bedroom only for sleeping, and avoiding blue light from televisions, tablets and smart phones before bedtime.
Sleeping with a Continuous Positive Airway Pressure (CPAP) mask over the mouth and nose.  The air which blows into the mouth and nose keeps the airway open so that it doesn’t collapse when the airway muscles collapse during sleep.
Sleeping with a dental appliance which positions the lower jaw forward, so that the jaw position holds the airway open despite the collapse of the airway muscles during sleep.
In extreme cases there are surgeries which either cut away soft tissue or reposition bones to change the anatomy of the face and jaws, so that the airway is not obstructed during sleep.

All of these treatment options have side effects, but the consequences of leaving sleep apnea untreated are far more severe.  If you, or someone you know, is interested in treating their sleep apnea with a dental appliance, schedule a consultation appointment with Dr. Judith Okun to discuss your options and questions.

Wednesday, November 9, 2016

Yes, "It is your fault."

“It ain’t my fault”
Yesterday I heard Zara Larson, a singer who was on TV singing "it ain't my fault", a song about how it isn’t her fault if she falls for a man and can’t control her actions.  Every day we hear from politicians that the status quo is not their fault; it was caused by their predecessor. (Unless it was favorable, then they claim it for themselves.) We seem to live in a society of people who don’t make an effort to take responsibility (or make an effort to not take responsibility.)

Orthodontic treatment requires responsibility and effort by both the doctor and the patient. The orthodontist sets up the system, and the patient “drives” it.  I explain it to patients as if it is a car.  You can spend a lot of money on a car, but if you don’t put gas into it, it won’t drive; You can spend a lot of money for braces, and if you don’t put in your effort (wear elastics, eat in ways that won’t break your braces, and keep regular
appointments) your treatment will not progress.  It’s like saying that it is a two hour trip from here to Philadelphia, but you never turn on the car.  Two hours later you won’t be in Philadelphia.  Your case may take two years to complete if you follow directions, but you won’t have a complete result in two years if you don’t put in your effort.  The patient has to take responsibility and put in the effort to get that satisfactory result! Yes, “it is your fault” if you don’t. All of us are much happier when the result is amazing, so please take responsibility, and help make your smile spectacular.