Rumors

Rumors can be a deadly thing.  Rumors not only destroy people and destroy relationships, but they also can affect a person’s well being.  The rumor that I have in my mind is the rumor that TMJ treatment is expensive.  I cannot tell you how many times I have heard that just as a person going to the stores and meeting people.  People hear these rumors and they decide not even pursue treatment because it is “too expensive.”  They decide to suffer with it or they decide to go to the drug stores and sport stores and buy mouth guards and never even consider actually getting a proper diagnosis.

 This rumor will have an adverse effect on their overall health.  TMJ disorder, if it is related to the joint itself, is a degenerative disease that will continue to destroy the joint unless intervention is considered.  The longer a person waits, the more expensive the treatment will become.  The longer person waits, the less effect of the treatment will be.  So in reality the greatest value of TMJ treatment is to catch it early because the money spent for treatment will have the greatest effect on dealing with the problem.

 Therefore, the rumor that TMJ treatment is expensive is not only detrimental to the health, but is also very costly to the patient.  I suppose that pertains to any type of degenerative disease that patient can possibly have.  The longer they wait to get properly diagnosed, less effective the treatment will be.  That is an adverbial truth and there is no way to get around it.  Because of that, I would encourage anybody who has got any type of TMJ disorder to get properly diagnosed and to make investment of time and money early on in disorder, and start to get the most effect and benefit from the least amount of financial investment.

God bless,

Dr. Ron Prehn

NEW OFFICE

I have decided to open up an office in the galleria area of Houston.  This is in the close proximity to the medical center downtown.  There is a huge need for a sleep dentist in that area and there are some excellent sleep doctors in the downtown area who are treating patients at a very high level.  If you are reading this and in that area please call the office for more information. 

 The reason I am doing this is because I believe that the Dentist can offer many options for the patient who has been diagnosed with obstructive sleep apnea.  The Physician is able to do the proper diagnosis and to manage the disorder at many different levels; however, the only physical way they are able to treat collapsing airway is with CPAP machine.  A great addition to a sleep physician’s team would be a Dentist such as myself that could open the door to many other options to treat a collapsing airway to include a mandibular advancement appliance and combination therapy.  It is a Dentist such as myself that has actually many more tools to be able to get the patient to compliance to resolve the issue of a small or collapsing airway. 

 The advantage of having a dental sleep professional on a team of sleep disorders clinic is the number of options that a Dentist has available.  We are highly trained in the head and neck area and especially the airway.  It is something we deal with every single day and our knowledge of the anatomy and structure of the mandible and airway is what we are trained to do and able to apply to any situation concerning pathology of this area.  To open up an airway for a Dentist is something that can easily be accomplished because we are able to use the dentition as anchors for various appliances.  This is something that a medical doctor is unable to do.  Therefore it takes a team approach to this problem because many times the airway alone is not the only sleep concern.  The other factors such as restless legs syndrome, periodic leg movements, and fragmented sleep by other causes that must be addressed by the sleep physician.  A Dentist working with the Physician is the best way of treating the total sleep disorder patient.

  God Bless,

Ronald S. Prehn, D.D.S.

Proper Diagnosis of Sleep-Disordered Breathing

I had mentioned in previous blogs how the only way to properly diagnose sleep-disordered breathing is to have a nocturnal polysomnograph (NPSG).  This is because sleep-disordered breathing is a dynamic process that can only be recorded while the pathology occurs.  Examination and history alone has been shown by various studies to be unpredictable in diagnosing obstructive sleep apnea.  The only way to properly diagnose is with an NPSG.

 With that information as a medical fact then treating sleep-disordered breathing such as snoring needs to have a NPSG in order to be treated properly.  The reason for this is because often times there is what they call central apneic events, which have nothing to do with sleep-disordered breathing.  Sleep-disordered breathing is a situation where the patient cannot breathe; however, central sleep apnea is a situation where the patient will not breathe.  There are some pathological, physiological events that occur that decrease the desire to breathe causing cessation of breathing.  This usually has to do with CO₂ levels in the blood and the monitoring of the CO₂ level by the brain.  The point is that if the patient is being treated for snoring or obstructive sleep apnea without an NPSG, these hidden central apneic events may be undiagnosed and untreated.

God bless,

Dr. Ron Prehn