Monday, December 10, 2012

48 hours with no sleep before going to the dentist?

Q. Hello!

I have a Dental-phobia(a serious one) and i wondered if not sleeping for 48 hours or so will get me to sleep at the dentist?

Or at least lose my time perception or fear sensation?

Thanks ahead!

A. You're more likely to crash into a bus on the way *to* the dentist.

That said, try running this idea by the dentist or his hygienist. Some are more than willing to provide a short-acting benzo to help with agitation and anxiety.


How much does it cost to be put to sleep at the dentist?
Q. I need to have two wisdoms pulled one is impacted the other is not. If I have medicade they won't cover being put to sleep rite? I live here in Michigan where an extraction can be 99.00 dollars and up if you pay cash.

A. If you want to be put under General anesthesia for your extraction, most likely you will have to go to Oral Surgeon. Usually 4 wisdom teeth extraction and G.A. cost $1500 (doesn't matter they are impacted or not). If you don't have that much budget then you have 2 options left:

1) Get them taken out under Local anesthesia ( without putting you to sleep). or

2)Get Nitrous oxide (laughing gas) to relieve anxiety and then get your teeth pulled. This option is comparatively cheaper . Nitrous cost about $55 and if you are lucky medicade might even cover it.!


How can I overcome my fear of the dentist?
Q. I have a dentist appointment in the morning, and am so scared that I know I will be up all night just thinking about it.
This happens every time I need to go to the dentist and I don't know what to do about it. Please no rude answers-- this is a real question/concern that is really impacting my life.

A. I feel your pain. Really there's not much you can do about the night before... make sure you're good and tired, maybe take a sleeping pill. work on relaxation techniques, or distract yourself with TV or a movie until you can fall asleep. And I always book an AM appointment so I don't have to try to eat beforehand and worst case, can just go home and take a nap afterwards.

If you're anxious In the actual chair it has helped me to wear a ring on my finger I can concentrate on playing with while the hygienist is doing their thing. And try to avoid any of the sickly sweet types of fluoride... stick to mint! And try to remember you get through one visit you don't have to go back for another whole year :)


Is sleep apnea a condition your born with or can u develop it?
Q. I used to sleep through the night without waking up most of the time. Now I wake up maybe 3 or 4 times a night. I never get restful sleep. I also experience a lot of sleep paralysis. Could this be linked to sleep apnea?

A. What Is Sleep Apnea? Are you feeling sleepy all the time? Do you snore? Is your doctor having a difficult time treating your high blood pressure? If you answered 'yes' to any of these questions, then you might have Sleep Apnea (also called Obstructive Sleep Apnea or OSA).

Sleep Apnea is a condition involving pauses or decreases in breathing during sleep. It is usually due to airway collapse. This collapse occurs in the nose and/or the throat - anywhere from where air enters the nostrils to the back of the tongue. Imagine a straw collapsing when trying to suck on a thick milkshake. Frequently, this airway collapsibility problem is inherited and starts in childhood. In the daytime, it is not a problem because there is good muscle-tone in the airway and the brain monitors breathing. But at night, the throat muscles become relaxed and the brain is not as attentive to the airway. So on inhalation, the airway walls can either completely collapse or significantly narrow. This is a problem because 1) the body must struggle to breathe and 2) the brain has to 'wake up' to reopen the airway.


These frequent awakenings lead to fragmentation of nighttime sleep. You may not remember them because they are so short. In fact, patients with sleep apnea can wake-up more than 30 times an hour and think that they slept uninterrupted through the night. Since sleep must be continuous and consolidated in order to be restorative, a number of cognitive problems can occur with sleep fragmentation: daytime sleepiness, memory problems, concentration difficulties, emotional instability, irritability, slowed reaction time, and most importantly, an increased risk of motor vehicle accidents.

There are also cardiovascular consequences of this constant 'struggling to breathe.' This puts a strain on the heart and blood vessels, leading to increased risk of high blood pressure, heart disease and stroke.

Finally, there are social implications to Sleep Apnea. The snoring associated with sleep apnea can disrupt the sleep of others. In fact, one study showed that when a person treats his/her sleep apnea, the sleep partner gets the equivalent of one hour more sleep per night.

Sleep apnea is a progressive disease and often gets worse with age. Weight gain, alcohol, and other sedating/relaxing substances exacerbate it.

Who Gets Sleep Apnea?

A common misconception is that only overweight men that snore loudly have sleep apnea, but the facts are:

1) Sleep apnea can occur without snoring
2) Thin people can have sleep apnea
3) Women can have sleep apnea
4) Children can have sleep apnea

In other words, anyone can have it. Even skinny women. Even children.

I Think I Might Have Sleep Apnea, How Do I Find Out If I Have It?

Make an appointment with your primary care physician, or if your insurance allows it, go straight to a sleep specialist. If your physician thinks you might have sleep apnea, then he/she can refer you for a sleep study or comprehensive sleep evaluation.

How Is Sleep Apnea Treated?

There are four main categories of treatment for sleep apnea: Continuous Positive Airway Pressure (CPAP), Surgery, Oral Appliances, and Behavioral Modification.

The most effective way to treat sleep apnea is with CPAP. CPAP is a mask worn over the nose attached by a hose to an air compressor. The air compressor gently and quietly blows room-air into the nose, which 'stents' the airway open, preventing airway collapse. This is the most effective way to treat sleep apnea, and all patients diagnosed with sleep apnea should at least try it before considering other options.

Surgery can be an effective way to treat sleep apnea. A number of different procedures can be performed. These range from nasal septum repair to jaw reconstruction. Talk to your doctor about whether surgery is the right option for you.

An oral appliance is a device made by a dentist or an orthodontist designed to pull your lower jaw forward. By pulling your lower jaw forward, the tongue is pulled away from the back of the throat. If your airway obstruction is occurring behind the tongue, then this can be an effective way to treat your sleep apnea. The treatment of sleep apnea with oral appliance should be a coordinated effort between the sleep physician, the dentist/orthodontist, and the patient.

Behavioral modifications can help in the treatment of sleep apnea, but are usually the least effective. These include such techniques as weight loss, sleeping on your side, and avoiding alcohol before bedtime.

None of these treatment options is ideal, but they all can be useful in treating sleep apnea and resulting in more restful sleep. With risks like heart attack and stroke, you should do everything you can to get your sleep apnea under control. If you think you have sleep apnea, contact your doctor or go to a sleep center. It could be the best decision you ever made.
By: Scott Fromherz
Ar





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