dentist appointments are safe Archives - Eggert Family Dentistry Blog

The Seattle Protocol – Tom’s Story

By: Dr. Elizabeth Eggert

How Did This Start?

Tom’s journey began in 2014 when he came to us as a new patient looking to improve his oral health and the appearance of his teeth. During his comprehensive exam, Dr. Elizabeth found the main areas of concern to be the excessive wear, erosion and fracturing of Tom’s teeth. Dr. Elizabeth recommended Tom go through the records process (you can learn more about the records process here) and based on the information gathered during that process, she recommended a full-mouth reconstruction to address his uneven bite and rebuild his broken teeth. Throughout the process of reconstruction, it became clear that the amount of force in Tom’s bite was putting too much pressure on even his temporary crowns, which resulted in the temporaries cracking or falling out on more than one occasion. Dr. Elizabeth was concerned that even after completing the full mouth reconstruction, Tom would have underlying issues. Given Tom’s other symptoms, including difficulty breathing through his nose, dry mouth and use of a CPAP machine, Dr. Elizabeth recommended Tom complete the Seattle Protocol to help address his airway patency.

What Was Involved?

The Seattle Protocol is a six-step process that helps patients with symptoms of sleep-disordered breathing and other conditions determine whether a compromised airway is contributing to their ailments. Each step builds upon the last, but patients don’t necessarily need to complete the entire process as the purpose of the protocol is to determine the phase that provides the best relief of symptoms. You can learn more about the Seattle Protocol and each of the steps here. Throughout the process, Tom noticed improvements in his symptoms such as dry mouth, decreased clenching and grinding, and less waking throughout the night.

What Have Tom’s Results Been?

After completing five of the six steps of the Seattle Protocol, Dr. Elizabeth fabricated a sleep appliance for Tom to continue to improve his airway patency, reduce his bruxism and help him sleep better. Tom has now been using his sleep appliance for over a month and says the results so far have been great! He’s noticed less clenching and jaw pain and experienced an overall improvement in his sleep. Tom said that going through the Seattle Protocol helped him better understand the connection between his sleep and airway issues and he appreciates Dr. Elizabeth’s thorough explanation and care throughout each stage.

What is the Seattle Protocol and How Does it Help Pinpoint Airway Obstructions?

By: Dr. Elizabeth Eggert

When a patient with symptoms of airway issues first comes into our office, we often recommend the Seattle Protocol. This six-step method helps us identify where the issue lies by pinpointing which jaw positioning alleviates our patient’s symptoms. This allows us to create a custom night appliance for our patient that opens up their airway and curbs any inflammation or damage to the teeth, jaws or soft tissue. It also helps ward off serious systemic issues like high blood pressure, stroke or heart attack.

Before you embark on the Seattle Protocol, we may suggest an at-home sleep quality screening device or a sleep study so we solidify our starting point.

Seattle Protocol Step 1: Nose Breathing and Mouth Taping

The first step in the Seattle Protocol is to gently train your body to breathe through your nose, not your mouth. Breathing through your mouth during sleep can lead to snoring and a dry mouth. The Seattle Protocol encourages nose breathing by adding a strip of paper tape vertically across the center of your lips. The light adhesive of the tape keeps your lips together but is easy and painless to remove.

Step 2: Temporary Splint for Lower Jaw and Mouth Taping

Once you’ve adjusted to the mouth taping, the second step of the protocol adds a temporary splint for your lower jaw while you sleep. Adding this splint increases the vertical dimension of your jaw and allows more airway space.

Step 3: Temporary Splint for Lower Jaw with Lower Jaw Pulled Forward and Mouth Taping

If adding the lower splint only isn’t giving you the restful sleep you deserve, we move onto the next stage of the protocol. In this step, we add an element that pulls your lower jaw forward. This realigns your jaw and increases your airway space not only vertically, but horizontally as well. This also can give your tongue more of the space it requires.

Step 4: Temporary Splint for Lower and Upper Jaw with Mouth Taping

With all steps of the Seattle Protocol, if you aren’t getting relief from the previous step, we move on. In this step, we remove the forward jaw posturing component and add a splint for your upper jaw. You then go to sleep with splints on your upper and lower teeth and your jaw is free to move. This stage allows for additional vertical height, opening up your airway, but without restricting the jaw muscles into any one strict position.

Step 5: Temporary Splint for Lower and Upper Jaw with Lower Jaw Pulled Forward and Mouth Taping

If you need to continue in the protocol, step five again adds a horizontal component by linking the upper and lower splints together and moving the lower jaw forward. The intent, as always, is to continue to open your airway more and more.

Step 6: Temporary Splint for Lower and Upper Jaw with Lower Jaw Progressively Pulled Forward and Mouth Taping

If you still aren’t getting that good night’s sleep, we move to the final stage of the Seattle Protocol. In this stage, we keep moving your lower jaw forward, incrementally, until you feel well-rested.

In summary, after the initial two weeks of nasal breathing therapy and sleeping for 2-3 nights with each temporary night guard, once you experience relief of symptoms, we stop the protocol. This helps us identify which splint appliance/positioning alleviates the airway obstruction and allows us to fabricate your custom night appliance.

The further you progress through the steps in the protocol, the more severe your obstruction. If you progress into steps 4, 5 or 6, we may discuss the possibility of oral surgery to help you achieve optimal results.

If you’re concerned that you or your loved ones are dealing with sleep-disordered breathing, schedule an appointment with Dr. Elizabeth or Dr. Jeff by calling our office at 651.482.8412. Both Dr. Elizabeth and Dr. Jeff have the knowledge and experience to walk you through the Seattle Protocol and the best next steps.

Your healthy future starts today.

Confused by the Process? Learn How Sleep Apnea is Diagnosed

By Dr. Elizabeth Eggert

Do you deal with snoring, gasping for air in your sleep, a dry mouth, headache in the morning or daytime fatigue? Sleep apnea could be the culprit. It’s important to begin by making an appointment with Dr. Elizabeth or Dr. Jeff as well as with your primary care physician. Sleep apnea can be life-threatening and should always be carefully investigated.

The first time we see you for sleep apnea symptoms, we will perform an assessment for signs of structural abnormalities or any physical issues that could be contributing to airway obstruction. This could include an enlarged tongue or tonsils, a small jaw or a large neck.

If your primary care doctor is concerned that sleep apnea is an issue for you, they will refer you to a sleep specialist. A board-certified sleep specialist will evaluate you by performing an overnight sleep study. This will give them more insight into the severity of the situation and help them determine the best course of treatment.

There are two different types of sleep studies your sleep specialist may recommend: a polysomnogram test or a home sleep apnea test.

Polysomnogram test:

A polysomnogram test is a sleep study, performed in a sleep lab, that helps diagnose sleep-related conditions.

During your night at the sleep lab, you will be hooked up to equipment that will monitor your heart, lungs and breathing patterns, brain, general movement and oxygen levels while you sleep. In some cases, your sleep specialist will let you sleep all night long. If your physician detects signs of sleep apnea, they will more than likely wake you up in the night and hook you up to continuous positive airway pressure, or CPAP. A CPAP machine has a mask that covers the nose and/or mouth, that is connected to a tube and the base of the machine and that delivers continuous air pressure all night long, allowing the airway to remain open.

When your sleep specialist tests the CPAP machine on you, they will watch how it improves your airway obstruction and will calibrate it for your specific needs.

Home sleep apnea test:

In some cases, your sleep specialist will give you an at-home sleep apnea test kit that monitors and tests breathing patterns and sleep disturbances. This can be a good solution for individuals who find the polysomnogram test cost-prohibitive or difficult to coordinate. However, if sleep apnea is suspected from the results of your home test, your doctor may still recommend a visit to the sleep lab for further testing.

After you receive your results from your sleep specialist, if they indicate the presence of sleep apnea, we recommend you contact our office to set up another appointment. At this appointment, Dr. Elizabeth or Dr. Jeff will walk you through our records process.

During this comprehensive analysis, they will determine if a sleep apnea appliance would help alleviate your symptoms of sleep apnea. If they decide it would be helpful, Dr. Elizabeth or Dr. Jeff will confer with your general practitioner, sleep physician and lab to design a sleep apnea appliance, custom fit for you, that supports your jaw in the position that best improves your airway, often a forward position.

We may also recommend that you adjust your sleeping positioning or we may refer you to an orthodontist for another consultation if we believe that braces or other orthodontic treatment could help better keep your airway open.

If you’re experiencing sleep apnea symptoms, reach out to us at 651.482.8412 to make an appointment with Dr. Elizabeth or Dr. Jeff. They will perform a thorough assessment and collaborate with your other physician(s) to find the best treatment plan for you.

Sleep Apnea and Oral Health Share A Few Primary Connections

By: Dr. Elizabeth Eggert

Obstructive sleep apnea (OSA) is a condition that must be taken seriously. Obstructive sleep apnea is an airway blockage that occurs when, during sleep, muscles in the back of the throat relax and/or the tongue and surrounding tissues migrate back into the throat, obstructing the airway.

Not only can sleep apnea cause fatigue, headaches and memory loss but it can also lead to even more serious health issues such as hypertension, heart failure and stroke.

Many people don’t understand what causes sleep apnea and how it affects oral health. We’re going to take a few minutes to unpack some of these connections.

Risk factors for sleep apnea

When you come in for an appointment, we look for signs or symptoms that could be considered “red flags” for airway conditions, including sleep apnea. Dr. Elizabeth or Dr. Jeff perform an assessment to see if you have any of the following risk factors among many others:

Over 40 years of age
Obesity
Large tongue or tonsils
A large neck
A small jaw

If we think you might be dealing with an airway issue like sleep apnea, we’ll ask you if your loved ones complain that you snore or gasp for air when you sleep. We’ll ask you if you deal with insomnia or daytime drowsiness. Do you wake up with a headache or a dry mouth? Do you have nasal or sinus problems?

We will also look for signs of TMD, bruxism or dry mouth, all of which can be connected to OSA.

TMD goes hand in hand with sleep apnea

Did you know that, in 52% of obstructive sleep apnea cases, a person also struggles with temporomandibular disorder or TMD?

TMD occurs when the temporomandibular joint (TMJ) doesn’t function properly. When the joint is irritated, chewing and talking can be mildly to moderately painful.

So why do sleep apnea and TMD often occur together? When a person is deprived of oxygen during sleep, their body will compensate in unconscious ways. In many cases, their jaw muscles clench and release or grind the jaw around to gain more airway space. When sleep apnea is left untreated, this jaw motion becomes habitual and can cause TMD or even deterioration of the jaw joint itself.

Bruxism goes hand in hand with sleep apnea

Bruxism is another condition that is often present alongside obstructive sleep apnea. Often intertwined with TMD, bruxism describes a condition caused by the clenching or grinding of teeth. It occurs unconsciously during sleep and can be another way a person’s body compensates for an airway obstruction.

Symptoms of bruxism include broken, cracked, chipped or worn teeth. Because the clenching and grinding of teeth cause tension in a person’s head, jaw and muscle discomfort are commonly present.

Of the 31% of adults who deal with bruxism, at least 25% of them also battle OSA.

Sleep apnea leads to mouth breathing

As we already stated, sleep apnea is an airway obstruction often caused by soft tissues that move towards the back of the mouth during sleep. In addition to clenching and contracting your jaw muscles in response, a person will typically also mouth breathe in an attempt to get more oxygen.

Mouth breathing leads to snoring but it also leads to other, more serious oral consequences.

Saliva plays an important role in rinsing food and harmful bacteria out of our mouths. When a person breathes through their mouth, it becomes dry and becomes a haven for food particles and bacteria. Without this natural “rinsing” function, plaque easily grows under the gumline and can cause tooth decay, gingivitis and in extreme cases, periodontal disease.

If you’re experiencing symptoms of sleep apnea or related conditions, Dr. Elizabeth or Dr. Jeff would love to see you in our office. They can evaluate your situation, determine which factors are present and, if they see evidence of sleep apnea, refer you to your primary doctor who may refer you to an ENT or sleep specialist. Then Dr. Elizabeth or Dr. Jeff will partner with these specialists to determine the best courses of action to help alleviate sleep apnea and any peripheral issues and restore your health. Schedule your appointment by calling our office at 651.482.8412!

What Can I Expect at My Recare Visit During COVID-19?

By: Dr. Elizabeth Eggert

Most people understand the importance of regular dental visits for maintaining good oral health. Oral health has a run-off effect on a person’s overall health as well. Gum disease can easily creep in and, when left untreated, can lead to heart disease, stroke or even death. Sadly, during the COVID-19 pandemic, some have been avoiding the dentist for fear of catching or transmitting the virus. Our team at Eggert Family Dentistry wants you to know the facts about our COVID-19 safety measures and what you can expect at your visit as well as answer some common questions so you can feel comfortable coming in to see us!

Safety measures at Eggert Family Dentistry

When you visit our office, you can be assured that we are:

Keeping up with the latest CDC and OSHA guidelines
Running HEPA air scrubbers to remove particulates from the air
Disinfecting all surfaces regularly throughout the day
Providing hand sanitizer
Mandating face coverings for all our patients
Mandating PPE such as face shields, long gowns and high-filtration respirator masks for our team members.

Important instructions for your visit

Throughout the last year, we have been maintaining some infection control protocols of stricter magnitude, out of an abundance of caution. We know these measures have been keeping our patients, as well as our team members, safe from COVID-19. While we are happy to see so many members of our community able to get vaccinated, we wanted to review the current protocols as change can only come slowly and only as the virus continues to decrease in our state. Therefore, when you come in to see us, you will still notice the COVID-19 protocols we have in place.

In addition to asking that you wear a mask to your appointment, we will:

Have you wait in your car and text us upon arrival since our reception area is still closed due to the need to socially distance. When possible, you may also be asked to come into our building and wait in the hallway near our door.
Ask you to complete a COVID-19 screening questionnaire. You will see that you can save time in our office by filling out your survey electronically prior to your appointment. See your email for details.
NO LONGER take your temperature prior to entering the office unless requested by you. It has been decided by the CDC that temperature screening is not an accurate tool.
Continue to ask that you don’t bring guests along with you to your appointment unless it’s absolutely necessary. This continues to minimize contact with other people.

FAQs about your recare visit during COVID-19

I would like to see that things have been wiped down—the community pen, the electronic pen, the handles of the chairs, etc.

“Even before the COVID-19 outbreak, our office followed strict infection control guidelines that would have prevented the transmission of the novel coronavirus (or any other virus) to our patients or staff. In an abundance of caution, we have increased the frequency and thoroughness of our sanitizing procedures and we are following safety procedures recommended by the Center for Disease Control, American Dental Association and OSHA. Our cleaning procedures include the electronic pen and the chair handles. We also either wipe any touched pens or ask you to take home any pen you use.”

I am concerned that the risk of virus transmission is too high for the benefits associated with a routine checkup.

“Our hygienists have streamlined their protocols so that patients can return to their recare intervals which are key in maintaining health and well-being. There are many articles noting that those with the highest levels of inflammatory diseases are the most at risk for contracting COVID-19. We are happy to be able to provide high-level dental care to reduce whole-body inflammation and keep you at your healthiest.”

How will I be safe if my mouth is open?

“All patients coming to the practice will be asked to wear a face covering, limiting the particles in the air. Patients will be ushered directly to a clean and sterilized treatment room. All clinical team members will be protected with eye protection, a tight-fitting respirator mask, a surgical mask to eliminate contamination and often a face shield. This will mean that, if your mouth is uncovered, it will be your particles in the air. In addition, we have HEPA air-scrubbing units in the clinic area to eliminate particles in the air.”

I am concerned that dental tools are being used on multiple patients. What are you doing for safety and sanitizing?

“We have always maintained a high level of cleanliness and sterilization in our office, our operatories, and with our dental instruments, or tools. In addition to our new high powered instrument washer to remove debris, we use an autoclave to sterilize our instruments which destroys all forms of microbial life, including viruses and bacteria. The autoclave accomplishes sterilization by using steam under pressure. All instruments that are placed into the autoclave are completely sterilized at the end of the complete sterilization cycle and we ensure that the sterilization indicators prove that before using the instruments on another patient.”

To see our full list of FAQs, visit this link on our website.

If you have any questions about our COVID-19 safety measures or to get on our schedule for your next recare visit, contact us at 651.482.8412!

Exploring the Oral Health and COVID-19 Connection and How Dental Care Can Help!

By: Dr. Elizabeth Eggert

For over a year now, with the COVID-19 pandemic, many people have been nervous about going out in public and maybe have even been choosing to put off routine dental care. At Eggert Family Dentistry, we now have had nearly a year to refine our infection control practices, specifically as they relate to COVID-19. We are happy to report that our abundance of precautions have been paying off to make your experience in our office extremely comfortable and safe.

It’s especially important to us to maintain an environment where our patients feel at-ease. While we have seen a vast majority of you this last year, we wanted to share the latest links between COVID-19 and your dental health and urge those of you we haven’t seen back yet to give us a call today! We know now that recent studies show a connection between oral health and COVID-19 complications. Let’s take a closer look.

The link between periodontitis and respiratory conditions

Periodontitis, or gum disease, is a gum infection resulting from poor oral hygiene that causes bacteria to build up under the gums. Periodontitis is commonly linked to tooth loss as well as severe conditions such as cardiovascular disease and certain respiratory conditions.

Findings from the CDA Journal (California Dental Association)

One primary COVID-19 complication is respiratory distress which often leads to pneumonia.

Because periodontitis is linked to respiratory conditions, researchers have been exploring the possible link between periodontitis and COVID-19-related respiratory complications.

In an October 2020 journal article, one study found that, when oral bacteria is aspirated into the lungs, it can increase the risk of pneumonia, COPD and COVID-19-related respiratory complications.

The study states, “Successful control of periodontal inflammation can be beneficial to the lungs, possibly decreasing severity and risk of COVID-19 respiratory problems.”

Findings from the British Dental Journal

A team of British researchers suspected that there is a connection between COVID-19 infection and a person’s bacterial load. In a June 2020 study, they explored the connection between a high oral bacterial load and COVID-19 pulmonary complications.

They also wanted to find out if putting a greater emphasis on an individual’s oral health could reduce ensuing CoV-2 complications.

This research team concluded that good oral hygiene is especially effective in preventing airway infections in seniors. Additionally, people with periodontal disease are at a much greater risk for heart disease, diabetes and high blood pressure, all of which contribute to severe COVID-19 side effects.

“Oral hygiene [should] be maintained, if not improved, during a SARS-CoV-2 infection in order to reduce the bacterial load in the mouth and the potential risk of bacterial superinfection.”

The ADA addresses the oral health and COVID-19 connection

In a February 12, 2021 article on the ADA website, they reference a study from the Journal of Clinical Periodontology that concludes that people with severe gum disease are at an increased risk for severe COVID-19 complications.

Indeed, there is mounting evidence to suggest that good oral health helps protect people against some of the severe effects of COVID-19.

If you’ve put off your recare visit or dental work this past year, don’t wait any longer. Give us a call at 651.482.8412 to set up your next appointment. We can’t wait to see you in our office and help you get back on the path to optimal health and wellness! We are so grateful for the increase in vaccinations in our community as more of you have been returning. We will see the rest of you back very soon!

In Spite of COVID-19, Dentist Appointments Are Safe: Here’s Why

By: Dr. Elizabeth Eggert

According to the ADA, dentistry is an essential medical service. Dentists are responsible for maintaining systemic health by evaluating, diagnosing, preventing and treating oral diseases. Consequently, during the pandemic, dental professionals are working hard to ease patients’ fears about coming into the office and they’re taking steps to ensure that it continues to be a safe experience for everyone.

There’s no evidence of COVID-19 transmission in dental offices.

During a 2020 NPR interview, Dr. Michele Neuburger, Dental Officer for the CDC’s & COVID-19 Response Team, stated “There have been no confirmed cases of COVID-19 transmitted in a dental office so far. And that includes follow-up by the CDC of false news reports suggesting such infections.”

Similar findings have been reported by industry experts throughout this past year. We are also EXTREMELY proud to note that there is no evidence of any COVID-19 infection stemming from our office.

Unfortunately, there’s still been an increase in the number of people who’ve delayed routine dental care or elective procedures for fear of contracting COVID-19. This has led to an increase in tooth loss and gum disease which, over time, could lead to more serious systemic health issues such as cardiovascular disease, stroke and even death. We are so happy to see most of you back, including a slew of recent “returnees” because of the rapid increase in vaccinations. We want share the latest information to encourage and guide the few of you remaining who are taking it just a little slower.

Dentists are used to working around infectious diseases.

Rest assured. COVID-19 isn’t the first infectious disease dentists have encountered. HIV, hepatitis, influenza, strep throat…these are just a handful of viruses that dentists ward against every day. Dental professionals wear scrubs, masks, and latex-free gloves to protect themselves and their patients. And our precautions have only increased since the pandemic began.

Offices are implementing increased safety measures.

The ADA released additional guidelines for preventing the spread of COVID-19, including reduced use of aerosols and dental dams and an increase in the use of high-power suction for hygiene procedures.

Eggert Family Dentistry is working hard to keep you safe!

At Eggert Family Dentistry, we recognize the importance of routine dental care and following through with recommended procedures to keep your teeth, mouth, and body in optimal health. That’s why we’re going the extra mile to make sure each one of our patients feels comfortable when you come in for a visit.

Our protective measures include:

Paying close attention to the evolving CDC and OSHA guidelines and continuing to make our practice safe for all those we are honored to serve.
Running HEPA air scrubber units in the office to remove particulates from the air, including germs like viruses.
Personalizing arrival procedures to guide you directly from your car or the hallway of the building to your treatment rooms to eliminate contacting surfaces and promote social distancing.
Requiring the use of a face covering and social distancing protocols.
Providing a hand sanitizer station.
Wiping surfaces regularly in the administrative areas and between each patient in the clinical areas.
Continuing to keep the reception area and restroom closed.

If you’d like to learn more about what we’re doing to keep our office clean and safe or if you’d like to get on our schedule for your next appointment, give us a call at 651.482.8412.