Snoring – a problem? Ask around! It might be a problem for you, but ask the people around you when you sleep. They will be the people to tell you if it’s a problem – for them! Truth be told? It’s a problem for a lot of people. Since about half of all adults snore at least some of the time, we are all likely to get to deal with this “annoyance”.

Most of us know what snoring sounds like, but what causes it? Snoring occurs when breathing pulls air past the relaxed tissues in the back of the throat and causes the tissue there to vibrate. For many it is simply annoying, but for others, it may indicate a serious health concern.  

There are many things that may contribute to or cause snoring: The anatomy of the mouth and sinuses, including the nose; a cold or allergies may cause the tissue in those areas of your body to swell up and narrow the passage for the air flow; alcohol consumption may  lead to greater relaxation of those tissues; being overweight is a significant contributor since our bellies aren’t the only thing that expands when we are too heavy! And lastly, being a male raises your odds of snoring.

One of the most common areas involved in snoring is the uvula. That’s the triangular or oval shaped piece of fleshy tissue that hangs down in the back of  your mouth. The larger that is, the more the airway is restricted and the more it is present in the path of your airflow to vibrate.

Snoring may be a much bigger concern than simply being a nuisance. Snoring may also be a sign of a serious medical condition called obstructive sleep apnea. Apnea is characterized by periods where a person completely stops breathing while asleep. When that happens, once their body sends out a desperate signal that it needs air, they wake up enough to tighten up tissues to allow the air to pass. For some people this happens many times per hour and can lead to exhaustion. And that exhaustion can lead to falling asleep when the person should be alert, such as when driving — a major potential problem! It can also lead to high blood pressure, heart conditions, and possible strokes.  

A medical evaluation is indicated when you becomes aware of your snoring. The prime purpose of that evaluation is to determine if you are “simply” snoring or if you have sleep apnea or any other medical condition that the snoring is either causing or contributing to. Your medical doctor will want to know when you snore most, how often it occurs, and whether you are aware of ever stopping breathing. There is also an easy screening test that may also be used to provide some information for you and your doctor about your level of alertness or exhaustion.  

If the medical evaluation rules out problems other than snoring, then that snoring can either be ignored (if it is not causing problems for you or others in your life) or treated in a variety of ways.  

Here are some ideas to try for  “self-help” approaches:

• Try changing your sleep position.  
• Avoid consuming alcohol for several hours before going to bed.  
• Weight loss may eliminate the problem.

If those don’t work or aren’t an option, there are treatment approaches with which either your medical doctor or dentist can help you.

• Several surgical approaches are available. In most cases, in my opinion, they are often more involved and carry greater risks than make sense, but there are exceptions to that.
• Treating your allergies may help eliminate the snoring.
• A (CPAP) device (continuous positive airway pressure). This forces air past the soft tissue obstructions, maintaining an open airway and thus eliminating most snoring. This works well, but is usually used for treating obstructive sleep apnea.  It tends to be a fairly costly alternative and many people find it cumbersome or a nuisance.
• Oral appliances are a highly effective alternative. These work by holding a person’s mouth part way open, and thus opening the air passage. These appliances are far less costly than a CPAP.

Snoring is a condition that CAN be successfully treated and doesn’t have to become a life-long annoyance. If you are someone who snores or are the one listening to someone snore, seek help. Rest in peace!

This article originally appeared in Dubuque 365ink magazine. It is republished with permission from the publication.

Molly Molar smiled her persistent smile as a friend talked about happy teeth, fuzzy teeth and sugar bugs.

"Happy teeth are the ones that are smooth and shiny," said Sharon Kuttler, a dental hygienist with the Kuttler Dental Team, while standing next to the huggable, human-sized tooth.

The duo visited Marshall Elementary School preschool, kindergarten and first-grade students in March to help teach healthy dental habits.

Kuttler has made visits to schools for years. Recently, she updated her materials when she joined the National Children's Oral Health Foundation, known as America's ToothFairy. The foundation tries to eliminate children's preventable suffering from pediatric dental disease by providing programs and resources to deliver community-based preventive, educational and treatment services.

Kuttler said she got "carried away" and put together a resource guide, The Tooth Fairy's Toolbox, for local teachers to help them prepare class projects during National Children's Dental Health Month in February.

Nicole Plachetta, a Marshall kindergarten teacher, took those guides and transformed them into packets for some Marshall teachers to help with classroom dental health activities.

"As teachers, we're always looking for community members to come in and speak with the kids," Plachetta said.

She added that she was excited to have Kuttler talk with the students and not only show them the importance of good dental health but also that they can be dental hygienists.

Here are some tips Kuttler and Molly Molar, played by Rhonda Pope, shared:

• Brush and floss at least two times every day.
• Brush 10 times in every place. It should take 2 minutes to brush your teeth.
• Establish good teeth habits at an early age.
• Children need help flossing through first grade. All children should be supervised until they turn 8 to ensure they brush and floss their teeth correctly.
• Know what is considered good food and bad food for teeth. For instance, white milk and water are good foods and pop and apple pie are bad foods.
• Use your smile to be happy and healthy.

Click here for video of Molly and Sharon's classroom visit.

This article, written by Stacey Becker, and photograph, taken by Jeremy Portje, appeared in the Dubuque Telegraph Herald in March 2013. Both are republished here with permission from the Telegraph Herald.

STRESS! You see it, you feel it, everyone seems to have it – some days more than others, right? That tension you experience finds its way to so many parts of your body, sometimes without your awareness, and sometimes it’s screaming at you. The tightness! The aches! The pains! For many, the discomfort lands in the head, neck, shoulders, jaws, -- and a place that is often overlooked -- the teeth.

Dr. Matthew Messina, a consumer adviser for the American Dental Association, says, “Stress, whether it’s real or perceived, causes flight-or-flight hormones to release in the body. Those released stress hormones mobilize energy, causing isometric activity, which is muscle movement, because that built-up energy has to be released in some way.” That energy may be exhibited in tooth clenching or grinding.

We often see the results of tension and stress as wear on teeth due to clenching and grinding. When we suggest that to people almost everyone tells us they don’t do it, or aren’t aware that they do it. So we suggest that they might notice how their mouth feels when they wake up in the morning; do they feel any tightness or soreness around their temples, jaws, or muscles in their face? Or when they are concentrating at the computer do they notice holding their teeth tightly together? What about the next time they are feeling angry? What’s happening with their jaw? Are they athletes? What about when they are weight lifting for strength training, or on that uphill climb on their bikes? Yep! The next time those folks are reporting, “you know, I catch myself holding a lot tension in my mouth; I find that my teeth are clenched tightly together.” Or “when I wake up in the morning, before I open my eyes, I checked and my jaws were feeling tight and sore – I must be doing that in my sleep!”

So then we need to consider the damage that this stress causes in the mouth, on the teeth, jaws, and muscles of the head and neck. We see this leading to major tooth wear and damage, or causing very sore muscles. Over time it can even lead to wear and damage to the temporomandibular joints (the TMJs), the jaw joints that are located in front of your ears.

Consider this: Dr. Robert Rawdin, a Manhattan prosthodontist, notes that when we chew we “normally exert about 20 to 30 pounds per square inch on our back molars.” As if that isn’t enough force on our teeth, he adds, “teeth grinders, especially at night without restraint, can exert up to as much as 200 pounds per square inch on their teeth.” Just think about how much damage that amount of force can create! For some people the damage is localized to extensive wear or broken or chipped teeth. For others, the muscles or jaw joints take the damage.

While the damage and wear that grinding creates can often be repaired, a far better approach is to prevent it from occurring in the first place. Most grinding and clenching creates some warning signs before the damage is extensive. Regular dental check-ups allow your dentist to monitor those signs to determine if problems are occurring before major damage is the result. And if your dentist determines that there may be a concern, it’s time for you to take steps to prevent further problems.

The first step is often to listen to your body. By choosing to integrate and practice things such as mindfulness, meditation, relaxation and yoga, people can first realize where the tension in their bodies is building up and then learn techniques to eliminate it. Some signs that you may be clenching or grinding your teeth are headaches, over-sensitive teeth, sore facial muscles, jaw pain, flat or sharp teeth, and/or damage or soreness on the inside of your cheeks.

By becoming aware of your patterns and learning to relax your jaw and those muscles, you can prevent problems before they become severe enough to require extensive dental treatment. It’s true: prevention, like honesty, IS the best policy!

This article originally appeared in the January issue of 365ink magazine.

One of the things I most enjoy about being a dental hygienist is helping parents and children from the very beginning (even before the baby is born!) to know the healthy habits that can influence dental health for an entire life.

February is the month that we put a national spotlight on children’s dentistry with National Children’s Dental Health Month. Often, it is the time when teachers will bring dental health education into the classroom. Throughout my career it has been a joy to be invited to a variety of classrooms to talk about teeth, nutrition and the how-to-do-its.

This year I joined The America’s Tooth Fairy Project through the National Children’s Oral Health Foundation, founded by Esther Wilkins, the woman who literally wrote the textbook on dental hygiene - including the one I used in my own educational preparation. With my membership I also received a package of new dental health education materials! Opening up my new box of possibilities, I noticed some of the ‘props’ I have been using had started to look a little tired. That inspired me to investigate other new resources.

The world of online and social networking came to my aid, and I have a whole new set of tools to share! While I began my research to assist teachers for classroom projects and activities, I have found a wonderful treasure of videos, interactive activities and information that could be used by parents (and grandparents!) at home as well as teachers in the classroom.

I am delighted to share my 'toolbox' with you and hope that you will find something here to be a resource for the children in your life. We need all the ‘tooth fairies’ we can get!

Ad Council Partnership for Healthy Mouths, Healthy Lives
Great videos, information, and helpful ideas for parents, children and educators

National Institute of Health: Open Wide - Trek Inside
A series of age appropriate materials, including kid-friendly videos that parents and teachers will love

American Dental Association
The Smile Smarts Oral Health Curriculum is designed for preschool through grade eight students — offering flexible lesson plans, support materials, hands-on classroom demontrations, student activity sheets and suggestions for further oral health activities

California Dental Hygienists Association
Excellent resources for teachers that are specific to different age groups

Cases for Student Dental Hygienists
The 'Classroom Activities, Community Dentistry and Public Health' section (used for dental hygiene students) has some great ideas including these PowerPoint presentations

South Carolina Department of Health and Environmental Control
A good list of links, including resources for Head Start programs and other early childhood programs

Colgate Bright Smiles, Bright Futures
Educational resources for brighter smiles and futures with dental care activities, information and more

Colgate Oral Care Education - Health Dental Care Habits Information for Educators
Free educational materials to teach children the importance of dental hygiene by building a fun brushing and flossing routine together (also promotes Colgate products)

Practical tips for parents looking to break sucky habits:

1. Don’t Plug the Baby
Because no parent likes to hear their baby cry, it can be tempting to help, hush the baby by plugging in a pacifier, thumb or bottle. Weigh this impulse against the possible long-term difficulties and address why the baby is crying. Try the reassurance of holding the child for a period of cry time to release the day’s energy and allow the child to fall asleep before encouraging the thumb, finger or pacifier.

2. Pacifier or Fingers and Thumbs
A pacifier has the major advantage that it can be gradually limited during the day, and eventually used at bedtime only. While habitual sucking on anything can create dental malformations, pacifiers may exert less pressure against the teeth than thumbs. However sucking can be more intense with a pacifier, which leads to greater potential for a dental cross bite. NEVER dip a pacifier in something sweet to encourage use; this has devastating effects on baby teeth as they come in. Speech–Language pathologist at Mercy Service Club Autism Center Laura Keehner advised parents to “choose a pacifier over a thumb and keep the habit to sleeping time and not all day long.” She explained that this allows for more normal tongue and articulator movement during the waking hours, so toddlers don’t “talk around” a pacifier.

3. Reducing the Habit
After age two the sucking habit is less a physical need and is more emotional. The longer the habit persists the more difficult it is to break. If your child has celebrated his second birthday, you should consider reducing pacifier use.

Start by noticing when and where the sucking is prevalent; is it with a favorite toy or blanket? You can start by limiting the ‘props’ during the day, keeping them only in the bedroom. Offer reassuring hugs instead of putting something in the child’s mouth (including food, milk or juice). Avoid reacting strongly to these limits; rather than ‘rules’ use good humored, gentle reminders such as “teddy stays in your crib” or “no blankets in the kitchen.”

4. Stay Positive
As soon as the child is able to engage in self-responsibility, the process of ending the finger or thumb habit can begin. Ending the habit is more of a process than an event, and it’s critical that parents approach this with gentleness and kindness, or the habit may become more intense. No punishing, no negativity—only measures to reinforce and assist, so you can positively work together. The child must also be at a stage where she is psychologically equipped to want to change, and choose to participate in the process. Think of this like potty training time, when time and intent are focused on the desired outcome. Understanding the readiness of the child is the key to success with changing these habits. Discuss it, but don’t make it an argument. A gentle discussion at a dental visit can help set the stage to move in the right direction.

Dr. Valerie Peckosh, a Dubuque dentist who specializes in pediatric dentistry, shared ideas that have worked well in her practice. To be successful, all of these require the commitment and willingness of the child and the patience and perseverance of the caregivers to stay with the process. Use encouragement and positive words like “this will help you remember” or “this will help remind you to choose” rather than “this will make you stop.”

1. Use a positive reward system. Keep a chart, decide on a gift or treat.
2. A fabric style band-aid on the finger or thumb can be a helpful daytime reminder.
3. Attach a sock with a few stitches to a pajama sleeve to help keep thumbs and fingers out of the mouth during sleep time.
4. For known ‘sucking times,’ use a distraction technique to keep hands busy. For example, carry extra toys in the car to occupy the child’s attention, or at home have a squeeze ball available when watching television.

Any parent will tell you that this process can wear on your patience, but in those moments, remember the peace and comfort the pacifier or thumb brought. Then look ahead to the beautiful smile your little one will shine back at you.

This blog post is continued from Sucky Habits: Part One.

The original article appeared in Parenting Today & Tomorrow magazine.