Of significance from the research presented at this meeting is that SNORING may be one of the causes of Obstructive Sleep Apnea. This is a significant finding in that obstructive sleep apnea (OSA) has been shown to be a cause for:

• High Blood Pressure
• Cardiovascular Disease
• Adult Onset Diabetes
• Accidents (motor vehicle and work related)

The gold standard for treatment of sleep apnea is a CPAP (Continuous Positive Air Pressure). There are many people who cannot tolerate CPAP devices. Research presented at this meeting showed that oral appliance devices are an acceptable alternative for patients who suffer from snoring and mild to moderate obstructive sleep apnea (OSA). In addition, oral appliances may be a front line treatment for severe, obstructive sleep apnea.

All snoring and sleep apneas are not the same. To make a correct diagnosis, a board certified sleep physician will need to complete an examination and will request that a patient complete a sleep study. Once a diagnosis has been determined, then treatment options will be discussed. Dr. Swenda has worked with two sleep centers in the West Chester area. If the CPAP device can not be tolerated by our patients, Dr. Swenda has been trained in the fabrication, fitting and the maintenance of oral devices used to treat snoring and sleep apnea. Dr. Swenda will work closely with your physician and sleep physician to provide the highest quality of care.

Treatment of obstructive sleep apnea has been unequivocally shown to improve patient’s lives and in fact increase the length of lives through lowering blood pressure and improving daytime alertness.

If you have questions about snoring or sleep disturbance issues, do not hesitate to call Dr. Swenda at 610.436.4512.

Our hygienist Maria was chosen by her peers, for her superb personal caring service for the difference that she makes in her patients’ lives.

To learn more please visit  Because You Care | Beyond the Chair Johnson and Johnson

Our office has adopted a program to treat the disease of dental caries and not just the symptoms.  The program is based on the fact that tooth decay is an infection caused by bacteria.

The program consists of the following:

1. Identification of High Tooth Decay Risk.
2. Treatment of Infection:
   • Fillings/Tooth Sealants
   • Anti-Microbial Mouth Rinse
   • Fluoridated Varnish
   • Supplemental Treatments
     • Xylitol Gum
     • Home Fluoride Program (Prevident 5000)
     • ACP – Amorphous Calcium Phosphate
3. Treatment of Salivary Gland Hypo-Function (Dry Mouth)
   • Salivary Substitute
   • Saliva Stimulants
4. Recall Program – Visit Frequency Determined By Risk Factors.
   • Salivary Bacterial Sample
   • Inspection of Sealants
   • Caries Examination
   • Fluoride Treatments

Our aim is to direct treatment at the bacteria that causes tooth decay and to prevent further disease.  This will enable our patients to retain their teeth for a lifetime.

Salivary Substitute and Oral Lubricant

Saliva Stimulants

Periodontal gum disease has dramatically changed.  Bacterial plaque was always thought to be the cause of Periodontal disease and bone loss.  The old theory stated that plaque took 90 days to organize and develop.  Dentists and staff taught patients to brush 3x a day, and only floss once a day, with dental teeth cleanings every 3 to 6 months to remove plaque.  Through new technology with the confocal laser micrograph and advanced fluorescence microscopy, Periodontal disease is now believed to be caused by bacterial biofilms.  Biofilms are resistant to antibiotics and  mouth rinses.  Surprising developments show that plaque can develop in only 8 hours.

Bad bacteria lives and develops between the teeth.  With this knowledge we are suggesting to patients that the patient, not the dentist or dental hygienist, is the main therapist in treating the disease, because of the 8 hour development of biofilms.  Plus, genetics play a role in this disease process so many people have some resistance.  Trauma from the bite and ill-fitting crowns are the major players in this process of developing gum disease through biofilms.

A bad bacterium develops between the teeth so flossing now becomes as, if not more, important than brushing.  New minimum recommendations are to floss at least 3 times per day.  Our office may ask some patients to come in every 2 months for dental cleanings, instead of the 3 or 6 month check-up.

The same biofilms in the mouth are the same biofilms associated with cardio-vascular disease and pneumonias.  If you have any questions about the above information on biofilms, please call our office to speak to our  hygienist, Maria, for the new treatments that we are using.

A dental implant is a predictable, cost-effective way to replace one or more teeth that have been lost or should be removed. The trained dentist, periodontist, or oral surgeon very gently places a hollow cylinder made out of titanium, into the jaw bone. Injury to the gum or tissue and bone is minimized. In fact, today, in many cases, the implant can be placed with minimum or no incisions. The dentist may then construct a temporary tooth to replace the missing tooth, while the bone and gum tissue grow around the screw. After this, a natural-looking and durable prosthetic tooth (or bridge replacing multiple or all teeth) is attached to the implant.

Who is a candidate for dental implants?

Almost anyone who is missing a single tooth, or all of their teeth, is a candidate for dental implants. One must keep in mind that when a tooth is removed, the supporting bone for that tooth breaks down by as much as 40% in the first four to six months after the loss of the tooth.

Your dentist will want to complete a comprehensive dental examination to determine what specific needs one may have. Your dentist will recommend a consultation with a periodontist or an oral surgeon to determine what specific procedures will be needed. Your medical history will be reviewed. There are some medical conditions which may require special consideration before dental implants can be placed.

Your dental implant team may ask you to undergo a special x-ray, called a Cone-Beam CT. These in-office Cone-Beam CT units are state-of-the-art for implant diagnosis. Your implant team can actually plan the surgical phase and the tooth replacement phase virtually on the computer screen. This allows for better diagnostics, and in many cases, less surgical treatment.

How long will it take to start and finish an implant?

The length of time is dependant on the individual patient and individual treatment plan. Basically there are three steps of the process:

1. Diagnosis and treatment planning by your restorative dentist and the surgical team members.
2. The surgical placement and healing of the dental implant and tissues – This sometimes involves pre-implant bone grafting (growing bone), and/or gum grafting. Many times these grafting procedures can be combined with the actual implant placement. The implants are then given time for the bone to grow against the implant, and to be anchored to the bone. This typically takes 4 months in the upper jaw, and 3 months in the lower jaw. Today with changes in implant surface treatment and designs, these time periods can be sped up. In fact, in some cases, a temporary crown or bridge can be placed on the implant, or implants, the same day, or next day, that the implant is placed.
3. The fabrication of the crown, bridge, or dentures, on top of the implant, or implants -Timing of this phase will depend on how many teeth are being replaced and what type of restoration you and your dentist opt for.

What are the advantages of implants over dentures?

The loss of a tooth or teeth can be emotionally devastating. The loss of a tooth affects the ability to chew and speak. The loss also creates open space into which the surrounding teeth can shift and move. This movement alters the normal anatomy around that now missing tooth, and can lead to gum problems, bone loss, tooth decay, and significant bite problems.

Dentures can be used to fill the vacated space and provide a biting surface, but anchoring dentures on adjacent teeth can place stress, and cause wear on those teeth. Removable dentures have a tendency to slip, interfering with conversation and chewing. The bone underlying traditional dentures often gradually deteriorates, resulting in loose adjacent teeth and bite problems.

In summary: implants are more comfortable than traditional dentures. Implants improve function (our ability to chew) and can improve one’s appearance.

What are the success rates of dental implants?

Generally, implants carry a success rate of around 95% as reported in the International Journal of Oral Maxillofacial Implants, in November, 2007. That is the simple answer, however, the truth is – it depends!

• Was the implant placed in the patient’s native bone, or was the implant placed in grafted bone?
• Does the patient have a medical condition that will compromise the success of the implant?
• Does the patient smoke or abuse alcohol?
• Does the patient grind his/her teeth, and is he/she willing to wear a bite guard at night?
• Will the patient keep the implant-supported teeth clean, and maintain routine dental cleaning visits?

The bottom line is, with careful planning by your implant team, with careful surgical and restorative care, and with care and maintenance by the patient, implants can replace teeth with comfort, function, and appearance at a very high predictability for many years.