Dr. Luciana Arcaro’s Post

Multi factorial etiology of malocclusions…

Integrating Sleep Dentistry into Holistic Dental Practices

Orthodontic Relapse Due to Airway Issues and Mouth breathing I. Introduction Orthodontic relapse is a persistent issue, often caused by underlying issues like mouth breathing and airway problems. Dr. Amanda from StraightSmile Solutions emphasizes comprehensive screenings and enlisting OMT and ENT experts when necessary. She provides proactive solutions, such as patient release forms and webinars, to address root causes and ensure optimal, lasting orthodontic outcomes. Her insights help practitioners respond appropriately and prevent complications. A. Orthodontic relapse is a common issue often caused by poor habits like mouth breathing and airway problems B. These problems can be addressed with treatments like Orthodontic Movement Therapy \(OMT\) to prevent relapse II. Recommendations from Dr. Amanda A. Get a written release from ENT stating surgery is not needed to proceed with orthodontics ● Template available for free B. Attend Dr. Amanda's webinar to get free documents ● Can request free ENT document ● Also offers document templates for free C. Emphasizes screening patients for sleep disorders and airway issues ● Parents often don't put in the effort to properly screen ● This can lead to patients not getting proper treatment III. Preventing Complications and Relapse A. Record patients' sleep during procedures to identify potential problems B. If airway issues are not addressed, further treatment may be needed ● The jaw may still grow down and back ● This can lead to open bite ● May require jaw surgery later, depending on age and severity C. Need extensive documentation to protect patient ● Free redo of treatment ● Insurance coverage ● Potential refund D. More unpredictable growth with standard braces vs. clear aligners E. Have patients sign informed consent documents to set expectations IV. Role of OMT and ENT A. Can identify issues like adenoids/lingual tonsils with imaging B. If red flags are found, refer to OMT and ENT C. More virtual OMT options and training orthodontic teams on it is helpful V. Importance of patient screening and documentation A. Get a written release that surgery is not needed B. Provide extensive documentation to protect patient ● Free touch-ups, insurance coverage, refunds C. Screen for sleep disorders and airway issues ● Parents often don't screen well enough D. Record sleep during procedures to identify issues VI. Additional treatments sometimes needed A. If the airway is not addressed, further problems likely ● Jaw grows down and back ● Anterior open bite B. May need ortho plus jaw surgery ● Depends on age and severity C. Informed consent doesn't explain enough ● Need to protect patients better VII. Managing unpredictable growth A. Growth unpredictable with standard braces B. Improve informed consent forms C. Check adenoids on x-ray and lingual tonsils VIII. Conclusion Dr. Amanda stresses the importance of screening for airway and sleep issues to prevent orthodontic relapse.

Orthodontic Relapse Due to Airway Issues and Mouth breathing I. Introduction Orthodontic relapse is a persistent issue, often caused by underlying issues like mouth breathing and airway problems. Dr. Amanda from StraightSmile Solutions emphasizes comprehensive screenings and enlisting OMT and ENT experts when necessary. She provides proactive solutions, such as patient release forms and webinars, to address root causes and ensure optimal, lasting orthodontic outcomes. Her insights help practitioners respond appropriately and prevent complications. A. Orthodontic relapse is a common issue often caused by poor habits like mouth breathing and airway problems B. These problems can be addressed with treatments like Orthodontic Movement Therapy \(OMT\) to prevent relapse II. Recommendations from Dr. Amanda A. Get a written release from ENT stating surgery is not needed to proceed with orthodontics ● Template available for free B. Attend Dr. Amanda's webinar to get free documents ● Can request free ENT document ● Also offers document templates for free C. Emphasizes screening patients for sleep disorders and airway issues ● Parents often don't put in the effort to properly screen ● This can lead to patients not getting proper treatment III. Preventing Complications and Relapse A. Record patients' sleep during procedures to identify potential problems B. If airway issues are not addressed, further treatment may be needed ● The jaw may still grow down and back ● This can lead to open bite ● May require jaw surgery later, depending on age and severity C. Need extensive documentation to protect patient ● Free redo of treatment ● Insurance coverage ● Potential refund D. More unpredictable growth with standard braces vs. clear aligners E. Have patients sign informed consent documents to set expectations IV. Role of OMT and ENT A. Can identify issues like adenoids/lingual tonsils with imaging B. If red flags are found, refer to OMT and ENT C. More virtual OMT options and training orthodontic teams on it is helpful V. Importance of patient screening and documentation A. Get a written release that surgery is not needed B. Provide extensive documentation to protect patient ● Free touch-ups, insurance coverage, refunds C. Screen for sleep disorders and airway issues ● Parents often don't screen well enough D. Record sleep during procedures to identify issues VI. Additional treatments sometimes needed A. If the airway is not addressed, further problems likely ● Jaw grows down and back ● Anterior open bite B. May need ortho plus jaw surgery ● Depends on age and severity C. Informed consent doesn't explain enough ● Need to protect patients better VII. Managing unpredictable growth A. Growth unpredictable with standard braces B. Improve informed consent forms C. Check adenoids on x-ray and lingual tonsils VIII. Conclusion Dr. Amanda stresses the importance of screening for airway and sleep issues to prevent orthodontic relapse.

Evidence based orthodontics I always wonder whether we can adopt the acceleration procedures in our practice or not? In the recent study we covered the MID and SWE in treatment duration which help us in making informed decision in our practice. The minimal important difference (MID) is defined as the smallest difference that the patient perceives as important. The smallest worthwhile effect (SWE) is the important change measured with the benefit-harm trade-off method. We have done a study to evaluate the MID and SWE in orthodontic treatment duration. We found that the MID in the treatment duration is one month for both treatment durations 12 and 24 months. A greater SWE than the MID is required to undergo adjunctive procedures to shorten the duration, particularly for surgical procedures. I am indebted to the team for the great work: Despina Koletsi Aya Jourieh, @Haris Khan, Fahad Abdul, @Vasiliki Koretsi, Yaser Alrefaiy, @Zubair Hassan Awaisi, @Rehan Qamar, @Hassan Saeed. Special thank to Prof Theodore Eliades and Prof. Gordon Guyatt for their supervision. For further read RG link: https://lnkd.in/eJxWAJyM Journal link: https://lnkd.in/edaRGWeY

How Your Patient’s Eyes Can Hint At Orthodontic Issues Before a patient’s ortho starts, considering whether there are any “warning signs” is highly important. However, one factor you may not have thought to look at is the eyes. After all, it doesn’t really seem like the eyes will necessarily be relevant for orthodontics cases; however, they can provide useful information that may help. As such, today, we’re looking at how the eyes can help before ortho starts to help you choose an effective treatment plan. How Can The Eyes Be Relevant in Orthodontics Cases? There’s a good chance you don’t spend much time studying a patient’s eyes before ortho starts, but this could leave you missing out. Indeed, the eyes can provide useful info on several things, including breathing, sleep disorders, airway issues, or malocclusion. As such, checking them carefully may prove useful. Some common signs are shiny eyes or Venus Pooling (dark and puffy circles under the eyes). These can be caused by several factors, and may be compounded when the patient has an underdeveloped midface or retrognathic jaws (i.e., a small SNA). Another sign is sclera showing more prominently than you might expect. This could be due to a habit or certain diseases, but this can also suggest a lack of midface or jaw development, increasing the risk of poor airways. Don’t Rule Out Other Causes While we’ve looked at how the eyes could potentially indicate airway issues and the like in your orthodontics patients, it’s worth noting that these signs could come about for a few reasons. However, if you notice these consistently in a patient, it may be worth looking into this.

How Your Patient’s Eyes Can Hint At Orthodontic Issues Before a patient’s ortho starts, considering whether there are any “warning signs” is highly important. However, one factor you may not have thought to look at is the eyes. After all, it doesn’t really seem like the eyes will necessarily be relevant for orthodontics cases; however, they can provide useful information that may help. As such, today, we’re looking at how the eyes can help before ortho starts to help you choose an effective treatment plan. How Can The Eyes Be Relevant in Orthodontics Cases? There’s a good chance you don’t spend much time studying a patient’s eyes before ortho starts, but this could leave you missing out. Indeed, the eyes can provide useful info on several things, including breathing, sleep disorders, airway issues, or malocclusion. As such, checking them carefully may prove useful. Some common signs are shiny eyes or Venus Pooling (dark and puffy circles under the eyes). These can be caused by several factors, and may be compounded when the patient has an underdeveloped midface or retrognathic jaws (i.e., a small SNA). Another sign is sclera showing more prominently than you might expect. This could be due to a habit or certain diseases, but this can also suggest a lack of midface or jaw development, increasing the risk of poor airways. Don’t Rule Out Other Causes While we’ve looked at how the eyes could potentially indicate airway issues and the like in your orthodontics patients, it’s worth noting that these signs could come about for a few reasons. However, if you notice these consistently in a patient, it may be worth looking into this.

One more sleep till the ClearCorrect elevating ClearCorrect Excellence - Annual Clinical Conference. A day of education and development. ClearCorrect are a leader in the field of aligner therapy. The brand is focused on helping all dental teams big and small to be successful with this treatment option. Here is my two pennies' worth of why you should chose ClearCorrect; but you can believe what you like. 🤷🏻♀️ 🔈 Attracting New Patients: By offering ClearCorrect, you can attract patients interested in clear aligner therapy. Many people prefer clear aligners over traditional braces due to their aesthetic appeal and comfort. 🔈 Increasing Revenue: ClearCorrect treatments can be a lucrative addition to your practice. The demand for orthodontic treatments is high, and clear aligners often have a higher profit margin compared to traditional braces. 🔈 Expanding Services: Adding ClearCorrect to your list of services allows you to offer a more comprehensive range of orthodontic options. This can make your practice a one-stop solution for patients seeking dental care. 🔈 Enhancing Patient Satisfaction: ClearCorrect aligners are known for being comfortable and discreet. Happy, satisfied patients are more likely to refer friends and family to your practice, helping to grow your patient base. 🔈 Marketing Advantages: ClearCorrect can be a strong selling point in your marketing efforts. Promoting advanced, patient-friendly orthodontic solutions can help differentiate your practice from competitors. 🔈 Training and Support: ClearCorrect offers training and support for dental professionals. This can enhance your skills and confidence in providing orthodontic care, leading to better patient outcomes and practice reputation. 🔈 Retention of Existing Patients: Offering ClearCorrect can prevent existing patients from seeking orthodontic treatments elsewhere. This helps in retaining patients who might otherwise leave your practice for another that offers clear aligners. 🔈 Efficient Treatment Planning: ClearCorrect's technology allows for precise treatment planning, which can improve the efficiency and predictability of outcomes. This can reduce chair time and increase patient turnover. 🔈 Patient Financing Options: ClearCorrect often offers flexible financing options, making it easier for patients to afford treatment. This can increase case acceptance rates and boost your practice’s revenue. 🔈 Technological Integration: ClearCorrect integrates with various digital tools and technologies, which can streamline your workflow and enhance patient communication and engagement. For example 3Shape Implementing ClearCorrect in your practice requires an initial investment in training and marketing, but the long-term benefits can significantly contribute to the growth and success of your dental practice. Dr. Sze Hwei L. Rebecca Swanton Kate Keating Heidi Jeremy Prav Solanki Straumann Group #dentalaligners #oralhealth #straumanngroup

From the most recent Anesthesia Patient Safety Foundation Newsletter, a well-considered Article from the Society of Anesthesia and Sleep Medicine, regarding the incidence of Obstructive Sleep Apnea in Patients presenting for Surgery - and of course - Anesthesia in order to undergo the Surgical - or other Interventional - Procedures. According to this article, OSA in Patients about to undergo a Surgical Procedure is still widely Underdiagnosed and remains considerably Underrecognized in patients that are scheduled to undergo Surgical or other Interventions using Anesthesia. If you have concerns about a patient who has undergone surgery or other invasive procedure, using Anesthesia to facilitate the procedure, and may have had difficulty regaining "full wakefulness" after the procedure, this may be part of why their recovery of baseline cognition took "a while" after the procedure. This may not be the Only Factor in that situation, but when there are reasons to have considered O.S.A. as a substantial contributor to a patient's "delayed emergence" from Sedation or General Anesthesia, this condition should be given consideration. Thanks for your time and your thoughtful consideration. This article was submitted to the APSF by Dr.'s M. Singh, J. Dominquez, M. Lyons, S.K. Ramachandran and B. Gali, who are affiliated with the Society of Anesthesia and Sleep Medicine also known as SASM.

Experience the ultimate comfort and support with orthopaedic pillows! These specialized pillows offer a range of benefits that can enhance your sleep quality and overall well-being: Improved Spinal Alignment: Orthopaedic pillows are designed to align your spine correctly while you sleep, reducing the risk of waking up with a stiff neck or back pain. By maintaining proper alignment, you can enjoy a more restful and rejuvenating sleep. Pressure Relief: The unique contours of orthopaedic pillows help alleviate pressure points, particularly around the neck, shoulders, and head. This can prevent discomfort and promote better blood circulation, reducing the likelihood of waking up with numbness or tingling sensations. Neck and Head Support: Orthopaedic pillows provide optimal support for your neck and head, ensuring that they remain in a neutral position throughout the night. This support can help alleviate tension and strain in the neck muscles, leading to a more comfortable sleep experience. Reduced Snoring and Sleep Apnea: By promoting better alignment of the airways, orthopaedic pillows can help reduce snoring and alleviate symptoms of sleep apnea. This can lead to quieter nights and improved breathing patterns, resulting in a more restorative sleep for both you and your partner. Customizable Comfort: Many orthopaedic pillows come with adjustable features, allowing you to customize the height and firmness according to your preferences. This versatility ensures that you can find the perfect level of comfort and support for your individual sleep needs. Investing in orthopaedic pillows is not just about achieving a good night's sleep; it's about prioritizing your health and well-being.