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Dream Smile Dental News

Always Tired? Maybe You Have Sleep Apnea

Surprisingly, A Dentist May Have the Remedy

CANTON, MASS. (Issued MARCH 2015) -- Have you ever found yourself dozing during the day? If you nod off at work, might you put other people’s lives at risk?

In December, 2013, a train engineer on New York’s Metro North line dozed for a few seconds as his train whipped through a 30 mph curve at 80 mph, derailing and killing four passengers, injuring 70. An investigation determined the engineer suffered from sleep apnea. Now, the transit authority has mandated sleep apnea testing for all engineers. (‘Apnea’ is Greek for a temporary suspension of breathing.)

And what does this have to do with your dentist? According to Dr. Evetta Shwartzman and Dr. Konstantin Ronkin of Dream Smile Dental in Canton, Mass., some 20 million Americans have sleep apnea, though only a small percent has been diagnosed. Dr. Shwartzman, a member of the American Academy of Sleep Medicine, says “Dentists should be seen as the front line for screening patients with sleep apnea, just as we screen patients for signs of oral cancer.”

Both doctors have received advanced training in sleep apnea. After screening, patients may be sent home with an at-home sleep apnea test. The individual wears a cell phone-size device while sleeping. It records sleep activity and the data helps to determine if the person has sleep apnea. (There is a courtesy discount for the at-home test for Dream Smile patients.) Those with low to moderate sleep apnea may be fitted with a customized appliance to wear at night. Patients with severe apnea may be referred to a sleep doctor as they may be a candidate for CPAP therapy.

Besides chronic fatigue, another more visible indication of sleep apnea can be snoring. Prime candidates often have a neck size of 17+, be overweight, and/or have a body mass index (BMI) of 35+, though anyone may have it. With sleep apnea, your deep sleep pattern can be interrupted hundreds of times nightly. Although not enough to wake you up, you never really get deep sleep -- and that can affect your health, quality of life and longevity. Since not enough oxygen is getting into the lungs, respiratory and cardiovascular disease can result, leading to stroke or heart attack. Untreated sleep apnea can result in depression, anxiety, impotence, menstrual irregularities, weight gain, and of course, highway and workplace accidents.

Patients diagnosed with severe sleep apnea by a sleep doctor, pulmonologist or cardiologist may be prescribed CPAP (Continuous Positive Airway pressure) therapy, a mask and device that gently blows air to keep airways open. Less severe cases can benefit from a dentist-supplied device such as SomnoDent or Micro 2. For some, using both CPAP and a dental insert in tandem works well. SomnoDent, a custom-made oral appliance that treats mild to moderate sleep apnea, is worn during sleep. It moves the lower jaw slightly down and forward, opening the upper airway, preventing obstructive apneas. Another device, recently cleared by the FDA, MicrO2 is the first CAD/CAM-milled sleep apnea device.

Drs. Shwartzman and Ronkin founded Dream Smile Dental 20 years ago. They have earned a reputation as pioneers in cosmetic, sedation and neuromuscular dentistry, as well as TMJ therapy. In 1995 they were the first in New England to introduce laser tooth whitening. Both are long-time members of the American Academy of Cosmetic Dentistry, and have trained extensively at the Las Vegas Institute (LVI), attaining advanced certifications in the art and science of dentistry reached by just one percent of dentists.

After 20 Years of Suffering, Dentists Solve Patient’s Pain Mystery

BOSTON, MASS. (Issued Winter 2015) -- What types of specialists and how many doctors would you need to treat such symptoms as mystery migraines, chronic pain in the jaw, neck or shoulders, persistent clenching or grinding of your teeth, dizziness, tinnitus, sinus pain, and bouts of numbness in your extremities?

Two? Three? In some cases, the answer could be ‘one.’

Nationally-known motivational speaker, relationship expert, author, CNN contributor (and mother of three) Mel Robbins visited several specialists to diagnose the cause of debilitating pain she lived with from age 21 to 45. The pain’s source was tough to pinpoint and it was aggravated by such simple tasks as talking, chewing and yawning. Often she found herself clenching her teeth.

The pain in her face, jaw, neck, shoulders and ear was especially unsettling and distracting, especially when speaking in front of audiences such as client Dunkin Donuts or in front of millions of TV viewers on a national news show. The pain caused anxiety and sleepless nights.

After seeing several specialists, Robbins was ready to give up. Then she met Dr. Konstantin Ronkin and Dr. Evetta Shwartzman at Dream Smile Dental in Canton, Mass. They agreed with other dentists’ diagnosis that Robbins was suffering from TMJ disorder (short for temporomandibular Joint) – the joint that enables your jaw to move up and down and side to side, and allows you to talk, chew, yawn, sing, kiss. But none of the prior treatments -- mouth guards, even surgery -- fixed her problem. Drs. Ronkin and Shwartzman recommended Neuromuscular Therapy, an approach that focuses on the correction of jaw misalignment, to adjust how the upper and lower teeth come together (occlusion).

Besides their traditional practice, over the past 20 years the Tufts Dental School alumni have distinguished themselves through years of advanced training to be among the top international experts in Neuromuscular Dentistry.

Dr. Ronkin (photo) says, “In the past, dental treatment was done to fit the position of your jaw when your teeth are together. But there are three factors that determine the bite: teeth, muscles and joints. Using modern technology, we assess the function or dysfunction of the jaw, eliminate the pain, and create a beautiful new smile. “

Drs. Ronkin and Shwartzman used a computer assisted evaluation system to measure Robbins’ jaw and neck muscle movement at various stages of activity and rest. Low-frequency electrical impulses relaxed her jaw muscles until they found their ideal positioning. Then she was fitted with an orthotic mouthpiece to hold the new bite in place. Once the bite was determined, the dentists created her new bite by using precisely measured crowns, veneers or bridges as necessary. The meticulously planned process occurred over several months.

Robbins says, “I felt almost magical relief. My Dream Smile Dental orthotic bite guard instantly relaxes my face muscles and joints. The headaches, crunching, clicking, popping and pain are gone. No joke. They cured my TMJ !”

Robbins, who has interviewed or been interviewed by such high-profile individuals as Barbara Walters, Dr. Oz and Donald Trump is the author of Stop Saying You're Fine. “Here I was advising people to change things for a happier life. I finally took my own advice!”

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All of my life, the financial needs of my children and my business took precedence over my own personal desires. One of these was to improve the appearance of my smile. Once my children were grown and my business had sold, I decided that it was time to do something special just for me.

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I was confident that my expectations would be met because of my positive experience with Dr. Ronkin. Honestly, when I first sat with Dr. Ronkin, my one and only fear was if it was going to be all worth it.

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After years of visiting different dentists and leaving with my questions unanswered, Dream Smile Dental provided the solution that I had been looking for.

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What our Patients are Saying

Front desk people were awesome as usual. Courtney the hygienist is always great too. Pushed me to go have something on my lip looked at which proved to be pre cancer that needs to be removed.

LZ 3-26-13

Dr. Barton was great with my son. He let him "play" with some of the instruments before actually using them so that made my son feel more comfortable. My son, at age three, loves going to the dentist and hopefully this will continue.

CC 11-7-12

Courtney Wager was excellent......she had a thorough understanding of my Son's needs. She also advised me to seek a total diagnosis with an ENT doctor. She was looking at the whole condition (tongue-thrust swallow) not just her speciality. Great experience over all!

RL 11-4-12

Ever since I have been coming to Dream Smile I have had nothing but great experiences. All the employees are very professional and cater to your every need, especially Nicole.

EDC 7-28-11

My visit, from start to the end, was great. When I do have the work done on my tooth, I would prefer the dentist that was on duty that day, as he took the time to explain things to me about the tooth. Also, special thanks to the girls behind the desk who were patient and extremely nice as my Delta Dental Plan was being determined.

MG 8-24-11

There was some confusion re: my appointment time. Courtney was kind enough to fit me in. The front desk team is excellent!

PC 9-20-11

I am always treated with respect and Service is always provided in a prompt timely and professional manner. Also Courtney does a great Job cleaning my teeth and providing needed information so that I don't have to make so many vists to the Dentist. Thank you.

PC 9-21-11

All the staff were wonderful!

JF 9-22-11

Sandy and Courtney are awesome. And the girls at the desk treated me great. Always look forward to going to Dreamsmile.

TR 9-30-11

All of the staff was wonderful and the office was the nicest dentist's office I have ever been to. Even my son had a good time and is looking forward to his visit in November.

MD 10-2-11

I just want you to know that Courtney and Sandy are the best!!!

DO 10-5-11

Your office is extemely professional and talented. Thank you so much. I will continue to be a patient here.

CC 10-8-11

The entire staff at DSD is outstanding, professional and makes you feel very comfortable...outstanding!!

MD 10-12-11

The girls were great and were very knowledgeable about what they do.

EC 10-19-11

It is always a pleasure to come in and see everyone again.

AL 10-19-11

Many offices to choose from, but nothing else compares, THE BEST.

RO 10-21-11

Ashlee is always so friendly! It was our first time meeting Dr. Barton but he is also great!

QG 10-25-11

I would like to thank Courtney and Dr Shwartzman for cathing my sinus infection. I saw Dr Dana and I am now on amocicillin for 2 weeks.

DC 10-25-11

It was a very pleasant experience! I'm hoping to dazzle family and friends with my pearly whites during the holidays.

NM 10-25-11

My appt. was for a whitening and the dental technician explained everything clearly and was very attentive to my comfort during the whole procedure. I'm sorry I don't recall her name but she was very friendly, professional did a very good job.

PS 10-27-11

Staff is always friendly, efficient and highly skilled. Although the idea of "going to the dentist" is not something I look forward to, DreamSmile Dental makes it a positive end result.

JV 10-27-11

I think Courtney is a great dental hygenist. She has alot of energy, does a great job, and knows her stuff.

MC 10-27-11

My appointment was at 4:30, I was running late due to traffic. I called and I believe her name was Jeannine. She was great. She reassured me that my late arrival was not an inconvenience for anyone! The administrative assistant at desk, was also very kind and polite. Excellent, flexible with appointments Thanks so, so much. What a great team! Thank you!

CD 10-28-11

Loved the whole team. Courtney was amazing! Very passionate about her work

KR 10-28-11

Jeanine is always so friendly and welcoming!

RG 10-30-11

Everyone was great and actually dont mind coming to the dentist office. Great job.

Anonymous 11-7-11

Staff was great...Yelena was great as well. Thanks

BM 11-16-11

Love Stacey. She is always gentle, kind and keeps me entertained so the time flies by quickly.

RE 11-17-11

Dr. Ronkin is a tremendous asset. He is very helpful. Courtney is a terrific hygenist. I think the world of her and am graeful for the care she provides.

BD 11-28-11

Everybody was great from front desk people to Sandy, Courtney, and, of course, Dr. Shwartzman. Considering a year ago I was totally dental phobic, I can't believe how comfortable everybody has made me feel. Lucky to have such great workers.

JL 11-29-11

The staff and especially my hygienist make my visit enjoyable despite the fact that I hate going to the dentist.

DM 11-30-11

everyone who greeted me was welcoming,those who treated me were efficient and timely.

VP 12-3-11

very good experience! everyone was super friendly and seemed very capable.

RP 12-9-11

Stacy is great!!!!!

JC 12-11-11

I had a wonderful visit. Everyone was very conscientious.

KR 12-14-11

Everyone was polite and professional . didn't have to wait . the service was explained and i'm very happy with the result .

DM 12-15-11