Robert Alavi D.D.S.
1420 Guerneville Rd #2 Santa Rosa CA 95403
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| (707) 578-3776 |
SLEEP APNEA
Sleep apnea and snoring have negative consequences for your overall health.
What is an Oral Appliance that treats sleep apnea?
It is a custom oral appliance that fits gently over your teeth and is designed to open up your upper air way comfortably.
What is Obstructive Sleep Apnea (OSA)?
It is s life-long medical condition where breathing stops hundreds of times per night. Most people that suffer from this condition are unaware of it. OSA occurs during sleep as a result of soft tissues at the back of your throat sagging and constricting the airway.
Some of the signs and symptons associated with sleep apnea and snoring are:
- Hypertension
- Heart Disease
- Stroke
- Diabetes
- Acid Reflux(GERD)
- Depression
- Teeth grinding and clenching(Bruxing)
- Unrefreshed Sleep
- Weight Gain
- Increased neck Size
All these conditions can be related to or worsend by obstructive sleep apnea.
Obstructive sleep apnea and snoring discrupt your natural sleep cycle so you don't get all the rejuveneting bone fits of a well nested sleep. With sleep apnea you actually stop breathing for several seconds multiple times during your sleep reducing the oxygen in your blood which causes stress to your body.
If you answer yes to three of the following questions you have a suspected high risk of having Obstructive Sleep Apnea(OSA):
- 1. Do you snore loudly?
2. Do you offen feel Tired, fatigued, or sleepy during day time?- 3. Has anyone Observed you stop breathing during you sleep?
- 4. Do you have or are you being treated for, high blod Pressure?
- 5. Body Mass Index more than 35?
- 6. Age - over 50 year old?
- 7. Neck circumference greater than 17"-male or 16"-female?
- 8. Gender - Male?
Dr. Alavi offers an Oral Appliance (OA) for the treatment of Obstructive Sleep Apnea and Snoring Oral Appliance are a viable alternative to the CPAP (Continuous Positive Airway Pressure) machine. If you are CPAP intolerant an oral appliance that opens up your airway comfortably is agreat alternative. Studies have shown greater compliance with the use of oral appliances v.s. a CPAP machine.
Dr. Alavi's treatment of OSA is as EZ AS 1-2-3.
A better night sleep awaits you ...zzz in the confort of your home.
ORAL and FACIAL PAIN
Your orofacial pain dentist in Santa Rosa, Dr. Robert Alavi, takes into account many factors that can contribute to facial pain among these bad oral habits, stress, poor diet, and poor posture can play a key role. Stress can increase the intensity and frequency of clenching and grinding at night while we sleep and during the day while we are awake without being aware of it. Stress can also cause muscle tension in the neck, shoulders, and back that cause trigger points with referred pain in oral and facial regions. Bad oral habits such as excessive gum chewing, ice chewing, and pencil biting can increase orofacial symptoms. Poor posture can dramatically increase tension placed on the TMJ, neck, and shoulders.
Many people with facial pain and TMD have a great deal of anxiety and can find themselves in a state of depression since pain in the head , neck, and face region is particularly taxing on an individual and there is little understanding and treatment consensus amongst most healthcare providers regarding orofacial pain.
Treating Facial Pain
Treating facial pain requires a comprehensive approach. A thorough medical, dental and social history must be taken in addition to a complete clinical oral, head, and neck examination to help with the diagnosis. In addition, joint imaging maybe prescribed if needed to help determine underlying causes of the pain. Appropriate treatment can then be prescribed such as therapeutic oral appliances, muscle therapy, trigger point treatment, physical therapy, behavioral modification, and medications.
Dr. Alavi believes that the most conservative and least invasive treatment to reach a desired outcome is always the best approach.
FOSA THERAPY
FOSA (Functional Orthopedic Stabilizing Appliance) also known as a TMJ Bite Stabilizer is a mandibular repositioning appliance. It is a therapeutic device used to treat patients with TMD symptoms, severely worn dentition, mobile teeth, bone loss and gum recession due to occlusal trauma and much more. FOSA can give immediate TMJ pain relief. The therapy uses a customized removable hard acrylic appliance that eliminates all occlusal prematurities and interferences to eccentric movements. In other words the appliance will give you an ideal even bite with your jaw joints balanced properly in their sockets.
FOSA Therapy was originally developed by Dr. Thomas Basta and Dr. Jerry Preiner and is taught to dentists at the Foundation for Advanced Continuing Education (F.A.C.E.) in Burlingame, California. The FOSA technique was further refined by Dr. David S. Han, Dr. Yiannis Vlahos and the late Dr. Sacha Dybnis at F.A.C.E.
With a track record of over forty years, FOSA therapy has consistently given positive results for improved dental health. Patients love and appreciate the benefits of FOSA and refer their friends and family to doctors who are trained to prescribe and deliver the mandibular repositioning appliance.
FOSA therapy can benefit patients in following manners:
- FOSA therapy can treat patients with extremely sensitive teeth, severely worn dentition, mobile teeth, bone loss, and recession due to occlusal trauma.
- FOSA therapy can effectively bring symptomatic relief to TMD symptoms like reduced ability to open or close the mouth, jaw pain of varying degrees, jaw joint noises like clicking, popping and grating sound, and jaw locking
- FOSA therapy can successfully treat severe headaches, biting or chewing discomfort, intermittent ringing in the ears, dull and aching pain in the face caused by a bad bite or misalignment of teeth (malocclusion).
- FOSA therapy can also be utilized as a diagnostic tool for restorative dentistry. It is used for stabilization of the jaw joints before embarking on complex restorative treatments.
- FOSA also effectively protects esthetic porcelain and resin restorations from the ravages of nocturnal bruxing and clenching.
TMD/TMJ DISORDER
Are you suffering from TMD/TMJ Disorder ?
If you answer yes to any of these following, you maybe suffering from TMD:
- Do you experience pain in your face or in and around your ears, or headaches that your medical doctor can’t explain?
- Do your ears feel muffled or clogged?
- Do your jaw joints (TMJs), located in front of your ears, hurt when you chew and do they make clicking or crackling noises?
- Do your facial muscles feel tired or stiff when you’re awake after a lot of speaking or when yawning?
- Do you clench or grind your teeth together while sleeping or awake? Does your spouse tell you that you make loud noises with your teeth when you’re asleep?
- Do you have headaches in the sides of your temples?
- Are you unable to open your mouth freely, smoothly and as wide as you are accustomed to doing?
- Are you unable to move your jaw from side to side with your mouth open?
- Do you experience episodes when your jaw gets stuck open or closed?
- Do you feel that your upper and lower teeth don't fit together as they used to?
- Is chewing tough foods uncomfortable or painful?
- Do you experience pain in lots of your teeth that your dentist can’t explain?
- Have your teeth been shifting, creating spaces or crowding for no apparent reason?
Are your teeth chipping and are the front teeth worn flat on their edges?
Temporomandibular Joint Disorder (TMD or TMJ Disorder) is commonly caused by disharmony in the joint-bite relationship. The majority of TMD sufferers are unaware of the root cause of their problems.
The chewing system attempts to correct a bad joint-bite relationship by distracting the lower jaw joints from their sockets so that our teeth can mesh together when we close. This places stress on the TMJ discs,ligaments, and muscles that facilitate jaw movement and may lead to TMJ pain and muscle spasms in the face, head, and neck. The disharmonious joint-bite relationship will also trigger muscles that cause grinding (Bruxism) which erodes teeth and jaw joints.
TMD / TMJ Disorder is a common condition with a wide variety of symptoms:
- Worn/Shortened front teeth
- Worn/Shortened back teeth
- Fractures seen in the enamel of teeth
- Sensitive back teeth
- Fracturing of teeth for no apparent reason
- Loosening of teeth
- Bone loss around teeth leading to periodontal (gum) disease even with excellent oral hygiene
- Gum recession
- Tenderness in the jaw joint
- Clicking, popping, and/or grinding noises in the jaw joint
- Neck, shoulder, and back pain
- Muscle pain of the head and face
- Limitations of opening the mouth
- Locking of the jaw
- Sensitivity in the eyes
- Migraine and migraine-like headaches
- Tension headaches
- Stuffiness/Fullness in the ears
- Ringing in the ears
- Vertigo
Treatment for TMD/TMJ Pain
TMD is like having a torn cartilage in your knee. Without proper medical treatment, you will suffer from pain in the knee, ankle, foot, and muscles.
Dr. Alavi can diagnose and effectively treat the underlying causes of the TMJ disorder by utilizing a diagnostic/therapeutic splint. This splint transforms a bad bite into a good bite and aligns the jaw joints in their respected sockets thereby reducing the stress to your teeth, muscles and joints. It is a safe, noninvasive and reversible treatment. You will feel immediate relief in most cases on the first night of using the splint.
HEADACHE
Headache relief such as migraine relief without the use of medications is a possible. Although there are many causes of headaches, most headaches are not life threatening. Only 2% of all headaches may be due to an underlying disease state which may be life threatening such as infections, aneurysms, neuralgias, and tumors. Headaches from such serious disease states are readily diagnosed by physicians after clinical examinations, lab tests, and imagings.
Even though most headaches are not due to any serious illness, the pain can incapacitate the individual. Most headaches that people suffer form are either vascular headaches (6-8%) such as migraine and cluster headaches or tension-type/muscle contraction headaches (90-92%).
Healthcare providers are good at diagnosing migraines usually treat them with prescription medications. However, compliance is an issue since migraine medications can have unpleasant side effects. Furthermore, migraine medications do not treat the underlying triggers that cause headaches, some of which maybe TMD related.
Tension-type headaches are underdiagnosed or misdiagnosed by many healthcare providers. Tension-type headaches are related to temporomandibular joint dysfunction (TMD)which causes prolonged muscle contractions and inflammation of the muscles of the head and face leading to pressure and pain in the forehead, temples, occipitals, and even neck and shoulders. As the constant tight muscle fibers reduce blood flow, the body compensates by sending more blood to the area increasing the blood pressure to muscles of the head resulting in headaches.
Headache Treatment
Fortunately, Dr. Alavi can provide headache treatment in Santa Rosa and provide migraine relief and tension-type headache relief by using a properly made mandibular repositioning appliance made to address one of the greatest underlying causes that trigger headaches. This appliance will be worn only at night when the greatest stress is placed on the muscles of the head and face reducing inflammation that triggers tension-type headaches and migraine events.
Dr. Alavi
can alleviate most headache problems resulting from temporomandibular joint/neuromuscular disorder..
NEUROPATHIC PAIN
Neuropathic pain is a pathophysiologic pain that is chronic in nature even after all injured tissues have healed.
If pain in an area persists long enough, peripheral and central nervous system changes can occur that perpetuate and even amplify the sensation and experience of pain after the offending cause of the original pain is no longer present. When such a pain state exists, prescription medications and alternative modes of therapy such as acupuncture, stress reduction, and meditation can help break or reduce the pain cycle.
Chronic/neuropathic pain in TMJ and face can be a result of long-standing:
- Microtrauma such as grinding and clenching
- Macrotrauma such as whiplash or blow to the face, chin, or head
- Dental restorations that significantly increase disharmony
- Tooth loss
- Osteoarthritis
- Rheumatoid Arthritis
FULL MOUNTH RECONSTRUCTION
Who Needs Full Mouth Reconstructive Dentistry?
You may need a full mouth reconstruction if you have any of the following:
- Many teeth that need restorating due to extensive caries or failing old restorations.
- Ongoing pain in jaw joints, facial muscles, or head region that are caused by a disharmony between proper joint position and ones bite after other conservative treatments have failed to satisfactorily reduce or eliminate the pain.
- Teeth that are severely worn because of long-term acid erosion or tooth grinding.
- Traumatic injury that resulted in destruction of most of your teeth.
Full Mouth Reconstruction:
Dr. Alavi employs a comprehensive and aesthetic approach to reconstructing and restoring your mouth to total health. He understands how teeth, gums, jaw joints (temporomandibular joints), bite (teeth alignment and occlusion), neuromuscular mechanisms and facial muscles interact and affect each other, and that any imbalance can jeopardize the health and comfort of your mouth.
Initial evaluation and diagnosis is critical for full mouth reconstructive dentistry:
- Complete examination of your jaw joints, teeth, bite, gums, facial muscles, neuromuscular mechanism and any required X-rays
- Dr. Alavi takes diagnostic molds (impressions) of your teeth, relates your upper jaw to your lower jaw by taking advanced recordings based on a precise position of your jaw joints(TMJ)
- He transfers your jaw relationship to an articulator, which duplicates your bite and the movements patterns made by your lower jaw
- You cannot solve what you do not see! Dr. Alavi gets a clear three dimentional view of your entire mouth in action; therefore, he can discover any anomalies that are the root causes of your dental problems. This diagnostic aid will be crucial in the evaluation and treatment plannig of your case.
Full month reconstruction can only be done after orthopedic splint therapy when the jaw joints are healthy and stable. The jaw joints exact movement patterns can then be transferred and programmed into a fully adjustable articulator that duplicates the exact movements of your jaw in all 3 dimensions. This will allow for crowns to be made so that your bite aligns exactly with your proper joint position and for your teeth to function properly during jaw movements such as chewing and sliding side to side.
All the teeth for a full month reconstruction are prepared in only 2 visits. And all the crowns cemented in just one visit with very little or no adjustment needed to the bite. This type of precision dentistry can only be accomplished when you have a stable, healthy jaw joint, and with the use of high-tech prescision instruments that can record and duplicate your exact jaw movement patterns.