Dental Implants

All Dental implant surgeries performed by Dr. Willoughby are performed using state of the art C.T. guided software and surgical templates which help to increase the accuracy of the implant placement.

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Dental Solutions for OSA and Snoring

Question:

My husband’s snoring is so loud that he’s sleeping more in the guest room than our bedroom! It is now so bad that he is waking up at night gasping for breath! I finally got him to our family Doctor who diagnosed him with Obstructive Sleep Apnea. Problem is he hates the CPAP treatment and won’t wear the device. I’m really frustrated and worried about his health. I’ve heard that there may be a Dental solution to this problem… can you please help us?

Answer:

Yes, I can help. The answer lies in the use of a very special oral appliance called a SomnoDent® which is an ideal alternative to CPAP therapy for patients who suffer from snoring and mild to moderate obstructive Sleep Apnea (“OSA”).

OSA is a serious medical condition in which breathing is interrupted by a partial blockage in your airway, causing you to stop breathing repeatedly throughout the night – literally starving your brain and body of vital oxygen. The result of Sleep Apnea is a severe stress being placed on your body, especially on your cardiovascular system and metabolism. As a result, Sleep Apnea is frequently associated with the following medical conditions:

  • heart disease or irregular heart beat
  • high blood pressure
  • weight gain
  • headaches
  • drowsiness
  • diabetes
  • lowered libido
  • memory loss
  • depression
  • erectile dysfunction
  • stroke and even death.

Although sleep apnea can affect anyone at any age, it is usually males and females between the ages of 45-65. Due to a lack of public awareness, the vast majority of sufferers remain undiagnosed and therefore untreated despite the fact that the disorder can have serious medical consequences.

The SomnoDent® is a custom made removable oral appliance worn during sleep to increase the upper airway volume and reduce collapsibility by advancing the mandible. SomnoDent® devices maximize patient comfort and compliance and have exceptional levels of compliance 88%, treatment efficacy 91% and acceptance 96% of patients with OSA compared to CPAP compliance rates of less than 40%.

When a patient wears a Somnodent Oral Appliance the effect is much like protruding your lower jaw – because the tongue is attached via several muscle groups to the lower jaw, as the jaw moves forward, so does the tongue. This forward tongue posture allows for increased patency of the airway – a bigger breathing hole.

Health Benefits

SomnoDent® treatment has also been shown to have a clinically signif cant impact in reducing patients’ blood pressure and has been predicted to reduce the risk of stroke. In addition, this blood pressure reduction was apparent in the early morning, which is the time of peak risk for acute myocardial infarction.

Clinically Proven

14 independent studies and over 12 years’ worth of research demonstrate SomnoDent’s efficacy and significant clinical benefits.

The updated practice parameters of the American Academy of Sleep Medicine recommend the use of oral devices such as the SomnoDent® for mild-to-moderate OSA (AHI < 25), or for patients with severe OSA who are either unable to tolerate CPAP or refuse treatment with CPAP.

And when you wear a SomnoDent® that has been adjusted by a Dentist who uses TENS and jaw tracking technology, the patient can wake up with less muscle stiffness and a better overall tongue position — all of which helps to create a more comfortable fitting appliance.

If you or a loved one snore or have been diagnosed with OSA please give our office a call today and book a consultation with our office! Find out how you maybe able to get a SomnoDent® covered by your extended medical benefits.

Treating Headaches and a Bad Bite

Question:

For many years now I’ve been suffering from daily headaches. My Family Doctor’s only solution has been pain killers and muscle relaxants! I’ve seen several medical specialists but they have been of little help. I know my bite is off because my jaws ache when I chew and click when I open but, how can my teeth be causing me this constant headache pain?

Answer:

90% of all headaches are muscular in origin and Neuromuscular Dentistry focuses on the relationship between the TemperoMandibular Joint (TMJ), the muscles, nerves and boney structures of the head and neck and how this system is affected by the patients dental occlusion (“bite”). When jaw joint, muscle and related head and neck problems are associated with a bad bite, Neuromuscular-trained Dentists refer to it as Cranio-Mandibular Dysfunction (“CMD”). Signs and symptoms of CMD include; cluster headaches; migraines; clicking and popping jaw joint sounds; limited opening; deviations on opening; neck or shoulder pain; worn or missing teeth; sore tired jaw muscles; tingling in the thumb and fore-fingers; tinnitus; itchy plugged ears; vertigo; speech and or problems swallowing.

Patients suffering from longstanding headaches and TMJ symptoms are usually very skeptical until we complete our examination because NM trained Dentists employ a zero based medical model whereby CMD symptoms are compared to objective, reproduceable computer derived data. Unlike traditional methods for treating CMD, Neuromuscular Dentists recognize that the muscles of the head and neck must be in a state of Physiologic Rest or relaxation – if the muscles are in a state of chronic contraction the patients bite and jaw-joint relationship cannot be optimized. NM trained Dentists evaluate muscle strain and activity using EMG leads and relax jaw and neck muscles using ultra low frequency Transcutaneous Electrical Neural Stimulation (TENS). This type of analytical diagnostic information is preferable to subjectively quantifying pain and discomfort solely through manual muscle palpation.

NM trained Dentists employ digital Joint Sonography and sophisticated realtime computer diagnostics and jaw tracking equipment called “K7” Evaluation system to accurately locate the jaw in a precise position that supports optimal health for the entire body. The K7 system allows a NM tarined Dentist to develop base line data and evaluate tangible improvements in clinical outcomes on a predictable and repeatable basis. This objective data can also be readily shared and interpreted by other healthcare professionals.

Case Study

37 year old Caucasian female presented with a 20+year history of chronic migraine type headaches (3-4 weekly) and was being treated at a Headache Clinic in the lower mainland with a combination of Anti-depressants, NSAID’s, Triptans, and Botox but, her migraines were not improving. In late January, 2012, patient received a complete NM workup utilizing K7 equipment, a CT scan of her TM Joints. The result of her zero based clinical exam was a diagnosis of CMD. The patients malocclusion was causing severe muscle spasm in her Temporalis muscles leading to a torqued and retruded mandibular position causing internal derangement of her disco-condylar complex. Treatment involved fabrication, insertion and adjustment (with TENS) of a removable lower NM orthotic to reposition her mandible and allow for disk recapture. Within the f rst few days of wearing the NM orthotic, the patient’s migraine headaches had reduced in both frequency and intensity. Within 3 months they had almost completely resolved, allowing the patient to successfully titrate off her meds. Physical therapy was implemented throughout this period and all postural manipulations were made while wearing the NM orthotic. Patient is now finishing Invisalign orthodontic therapy and the correction of her malocclusion is nearly completed. Patient remains med free and pain free as confirmed by low EMG rest and adjusted jaw trajectory scans.

FaceLIFT Dentures and Dental Implants

Question:

Back in 1999 I was fitted with a Complete Upper Denture. For the first 10 years or so no one could tell that I had no upper teeth my Denture fit perfectly and the teeth looked very natural. Then my Denture started getting loose, so I had it relined multiple times but recently I’ve started to notice that even my relined denture is affecting the way I smile and talk and my teeth don’t show as much when I smile – it feels like my Denture is letting the skin around my mouth sag more than it should for someone my age. I won’t have a face lift so what can I do to fix this problem will dental implants help? What are my options?

Answer:

There is elegant but simple solution to your problem and it is called a “FaceLIFT Dentures”. Unlike a standard Denture, a FaceLIFT Denture provides for superior lip and facial support which can often provide patients with a startling change in their facial appearance.

As we age, our body produces less and less collagen and so with less elasticity and support things naturally begin to slowly wrinkle, sag and droop. Since a significant amount of lip and facial support is normally provided by the teeth and gums, the problem of a drooping smile and sagging facial skin is further compounded for Denture wearers. Without teeth the surrounding edentulous ridges continue to shrink and change shape through a process called “resorption”. A stable fitting Denture relies heavily upon a good peripheral seal and suction which is usually achieved by setting the teeth over the edentulous ridge but as the ridge resorbs, the tooth position has to change in order to maintain suction which leads to less support for the lips, mouth and surrounding facial muscles. This leads to that typical sunken in look of a standard Denture.

With the fabrication of a FaceLIFT Denture issues of a sagging smile, sunken-in mid face and deep creases at the corner of the mouth can be readily addressed because they utilize the principals of Neuromuscular Dentistry and TENS (Transcutaneous Electrical Neural Stimulation). Using TENS a set of ultra low frequency electrodes can be placed over certain muscles and nerves in the head and neck which allow the patients muscles of jaws opening and closing to ‘relax’ and find a position where they are at physiological rest. Muscles at physiological rest are not contracted or overstretched, which means that the overlying dermal and epidermal layers of “skin” appear to be less stretched, and wrinkled – giving the skin a more even tone and better volume. With FaceLIFT Dentures, TENS is utilized for a) Muscle and Nerve Mediated Border Molding and b) to help find the proper vertical opening for the patient and the ideal relationship of their upper jaw (maxilla) to their lower jaw (mandible).

FaceLIFT dentures can help give you a more youthful facial appearance and a fuller brighter smile

With the help of a TENS device a Neuromuscular trained Dentist can use this Muscle Border Molding technique to help relax the muscles of jaw opening and closing so that the patient achieves a more accurate fitting Denture – one with more stability and improved adhesion/ suction. Because of this increased suction this means the Denture teeth DO NOT have to set over the resorbed ridge which gives the typical Denture that sunken in look. Instead the teeth can be set in a much more ideal position closer to their old vertical opening and rest position for their jaws. This allows for superior lip and facial support often providing the patient with a startling change is their facial appearance. The combination of a more ideal, natural vertical opening plus an improved bite relationship allows for the creation of the FaceLIFT Denture effect.

Typically, a new set of FaceLIFT Dentures can be made in just three simple appointments starting with the TENS Border molding technique using the patients old denture. Then a wax try-in with the new teeth mounted into a more esthetic position for the patient’s smile and facial profile. The last appointment is the delivery appointment which usually requires only minimal adjustments because the Denture has been fabricated using the principals of Neuromuscular Dentistry.

These esthetic Dentures can even be fabricated with the use of a minimum of two (2) Dental implants which can either be used to help to eliminate the palate and significantly increase both speech and taste or increase the stability and retention of a lower denture.

If you or a loved one are considering a new Denture(s), please feel free to give our office a call and book an appointment – our staff would be more than happy to discuss the features and benefits of FaceLIFT Dentures with you.

Root Retained Over-Dentures

Question:

Over the past 10-15 years I have lost more than half of my upper teeth and most of my lower molars. I am now having trouble chewing and my jaw joints are starting to ‘clunk’ when I open and close. I know I need to get this problem fixed but I’ve had partial dentures before and could never tolerate the feeling of something covering the roof of my mouth. I was recently told that the only way to avoid covering my palate was with an implant supported palate-less denture using four or more dental implants. Problem is that I really can’t afford that kind of treatment. I have great dental insurance so are there any other options besides dental implants?

Answer:

First of all your situation is not all that uncommon, and yes, dental implants can be very expensive and time consuming. First, there is the surgical fee for multiple dental implants and then there is the additional cost of the implant denture or crowns. Dental implants placed in the upper jaw can also take 6 or more months to fuse to bone before they can be restored. I strongly recommend a complete Neuromuscular workup to address your TMJ issues. If you cannot afford dental implants and the thought of a regular clasped partial denture is not appealing, then a root retained overdenture may be worth considering.

If you have adequate root length and bone support on three or more of your upper teeth and these teeth are spread out around the arch and your ‘bite’ is within normal limits then you may be a candidate for a root retained overdenture. Rather than utilizing a series of dental implants to support a denture we may be able to design an overdenture which attaches and detached to a series of individual post and root caps which are permanently anchored into the roots of your remaining (retained) natural teeth. This type of a prosthesis is removable by the patient and requires that root canal treatment be performed on all the chosen anchor teeth so that a cast post and root cap can then be bonded inside the tooth after it has been shaved down closer to the gumline. On the top of these root caps the male half of a two piece friction fitted attachment is typically attached and is made to line up with a matching female housing which is permanently buried in the acrylic on the underside of the denture. When three or more of these attachments are utilized, the overdenture can be snapped down on top of these root caps to create added stability and retention such that a large portion of the acrylic overdenture can now be removed to create extra room for the tongue. This has a profound impact on how the patient talks, breathes, laughs, eats and swallows. The added benefit to this type of prosthesis is that it allows the patient to retain several tooth roots and the surrounding jaw bone which helps to maintain the integrity of the patient’s arch shape and facial profile.

When this style of overdenture is fully seated to place nobody can see these attachments because they are all housed on the underside of the prosthesis. From a maintenance perspective, all the patient has to get into the habit of doing is snapping the overdenture in and out of their mouth daily to clean and care for the cast post and root cap screws which can be easily replaced every couple of years.

Esthetically a finished root retained overdenture looks fantastic and can be fabricated and delivered for considerably less than the cost of a 4x dental implant supported overdenture and usually with better insurance coverage. If you are interested in determining if this is a potential option for you or one of your family members, we invite you to give our office a call.