Dr. Nelson Can Help You with Sleep Apnea, TMJ Issues and Craniofacial Pain!

Dr. Nelson Can Help You with Sleep Apnea, TMJ Issues and Craniofacial Pain!

In the course of my daily orthodontic practice, I have noticed an increase in the number of new  patients seeking relief from TMJ and Craniofacial pain, and requests for oral sleep appliances. There were really no good resources for patients, so I  enrolled in and completed  a residency program to learn how to treat TMJ and craniofacial pain disorders.  I have also completed a certification program to treat obstructive sleep apnea, using oral appliances and have implemented these modalities  into my practice and am happy to be able to help patients become pain free and healthy.

TMJ and craniofacial pain typically result from jaw para-function, bite discrepancy or damage to the jaw joint.  Jaw locking, clicking, facial pain and headaches are common symptoms of problems with the temporomandibular joint (TMJ). Physicians are often unsure  how to effectively treat the pain and unclear how to correct the problem.  I am one of very few orthodontists or dentists in the metro area qualified to treat these disorders in addition to doing braces and creating beautiful smiles.

Braces? Of course we still specialize in precision bracket placement (PBP) (customized braces) which reduces the guesswork in bracket placement,  therefore reducing treatment time by moving teeth to their ideal positions over a shorter period of time, with fewer adjustment appointments. This results in less time missed from work or school. 

I am also an ELITE Invisalign provider, which means I am one of the largest providers and most experienced doctors offering Invisalign. Now, in our office everyone is a candidate for Invisalign treatment.  Bottom line; Trinity is constantly producing beautiful smiles that can last a lifetime. 

WHEN SHOULD KIDS SEE AN ORTHODONTIST?


After 23 years in practice, I think seeing kids at age 7 is an ideal time. This is also the age recommended by the American Association of Orthodontists, AAO. At this age the permanent first molars should be erupted and some of the anterior teeth. This starts to give doctors an idea about the future bite of the patient. This is a good time to start looking for tooth eruption problems, especially the maxillary permanent canines.
These are the two teeth that most frequently cause problems by erupting toward the palate. If they erupt toward the palate it is possible that they can dissolve the roots of the front teeth, either partially or totally. Retrieving palatally impacted canines is a routine part of orthodontic practice, but it is not a fun experience for the patients. It is typically a long and painful treatment starting with the oral surgeon bonding a gold chain onto the crown of the impacted canine.
Permanent damage (excessive wear) of the teeth is also something to watch for. Typically this is due to excessive overlapping of the upper and lower front teeth causing wearing of the incisal edges of the mandibular incisors.
Narrow palates causing unilateral or bilateral posterior crossbites start showing up at this time. Skeletal deformities such as narrow palates can cause a host of problems such as: TMJ disorder, restricted airway leading to UARS (upper airway resistance syndrome), excessive occlusal wear and tooth fracture, crowding and unpleasant look of the maxillary teeth.
So, as dentists we all see these developing problems. The big question is what should be done about them. The opinions vary widely amongst orthodontists. In my practice I like to do the least amount of treatment for patients as possible before all of the permanent teeth are erupted. Instead, I prefer to wait until all of the permanent teeth have erupted, or are almost erupted. The rare exception is in the case where permanent damage is occurring. These cases are tooth wear from deep overbites and/or crossbites, skeletal posterior crossbites and severe tooth eruption problems.
Most tooth eruption problems can be simply corrected by the careful extraction of some primary teeth. Permanent teeth erupt through the path of least resistance. Removing the appropriate primary tooth easily creates the needed path of least resistance.
Posterior crossbites are very predictably corrected with a palatal expander. Deep overbites are painlessly corrected with a specially designed removable retainer.
What I almost never do is expansion treatment to create space for permanent teeth. In my experience this is usually unnecessary due to normal growth of kids and space that is always gained when the back baby molars are lost, called leeway space. It is very rare that I extract premolars in my practice and I do not do phase I treatment to make space or "develop the arches".

If you ever have any questions regarding your treatment, please be sure to ask me.

INVISALIGN - Dr. Nelson is now a Preferred Provider !

Clear aligners are virtually invisible, less noticeable than metal braces

With the right doctor, almost all patients can use Invisalign

Removable aligners allow for normal brushing/flossing promoting better oral health (less chance of tooth decay)

Invisalign is a very convenient method of treatment. Fewer and shorter appointments means less trips made to orthodontist office and less time missed from school and work

Aligners are smooth and comfortable. No discomfort from potential broken brackets or pokey wires that sometimes come with traditional braces. Again, this  means no emergency appointments and less time missed from school and work

No food restrictions

Aligners can be removed, if need be,  whenever you want

You can whiten your teeth in your invisalign aligners

Aligners are custom made for YOUR teeth

OCTOBER IS NATIONAL ORTHODONTIC HEALTH MONTH

At Trinity Orthodontics, we want each of our patients to achieve a terrific smile!  

This does not just include having braces, but wearers must hold up their end of the bargain by doing more than brushing and flossing regularly. Just a reminder, some  foods can loosen or break braces and should be avoided —at least until the braces come off

Please be cautious with the foods you eat, especially during the Halloween season!  Stay away from all sticky candy and caramels !

Use your good judgment and be kind to your smile! 

BILATERAL FIXED OCCLUSAL SPLINTS  (BUILDUPS)

One of the most important things we do in our practice is the treatment of TMJ (Temporomandibular joint disorders, TMD)  These problems can cause the mandible to lock closed and the joint to click and pop.  This can cause extreme pain and suffering.  The TMJ is the most complicated joint in the entire body.  When you open about half way the joint acts like a ball and socket joint, just like your knee or elbow.  Then when you open past halfway your lower jaw has to actually slide forward.  The lower jaw moves "out of the socket".  This is the only joint in the body that does that.   It also  has three areas of articulation:  1.  the right joint 2.  the left joint 3.  the bite and the teeth.  If any of these three are out of balance then the whole system is out of balance and then the problems begin.  When we start orthodontic treatment in our office we place mounds of blue glue on the biting surfaces of the lower first molar teeth to separate the teeth.  This removes this third part of the chewing system so that the TMJs can move into their ideal positions without the interference of the bad bite.  As the bite comes together we remove these splints so that we can make the bite as perfect as possible.  These are a very annoying part of the treatment, but is probably one of the most important things we can do for the health of the jaws and bite.

Letter from Dr. Nelson

I have just returned from a national symposium on sleep apnea (February 2014) . Most of the speakers were experts in sleep apnea from the medical field. Ear, Nose and Throat specialists, Pulmonologists, Neurologists and Pharmacologists. They all discussed the importance of collaboration amongst dentists and the medical physicians to effectively treat this life threatening disease. They informed us that a research study from the National Institute of Health (NIH) showed that untreated sleep apnea decreased a person's life by 10 years! The dangers of untreated sleep apnea include high blood pressure, stroke, obesity, headache, extreme sleepiness and cognitive impairment, relationship dysfunction and overall decrease in the quality of life.

Many car accidents are the result of people falling asleep at the wheel. In fact, patients with untreated sleep apnea have a 10 times higher chance of a car accident than patients that do not have sleep apnea. This also translates to accidents in the workplace as well.

Being excessively tired leads to the inability to deal with the demands of work, family and every day life due to impairments in cognitive functioning. Recent research shows that children with untreated sleep apnea have a lower IQ than kids that do not have it. Research needs to be done to see if this lowering of the IQ is permanent or improves with treatment.

Childhood sleep apnea has only recently come the forefront of medicine. It has not really made it to the dental profession yet, but is getting there. Many children have obstructed nasal airways from structural defects in the nose, allergies swelling the nasal mucosa so much that they cannot breath through their nose, narrow upper jaw (maxilla) causing narrowing of the nasal passages just to name a few. Chronically enlarged tonsils and adenoids is one of the main causes. Inability to breath causes unfavorable changes in facial growth patterns as well. Pediatric sleep apnea can typically be treated by removal of the tonsils and adenoids. Orthodontic expansion of the palate is also needed many times in order to improve nasal breathing. Sometimes nasal surgery is needed to open the airway.

Untreated sleep apnea in children can lead to changes in facial growth, obesity, cognitive disturbances causing poor school performance and behavioral problems. Many children are diagnosed with ADHD then treated with a stimulant drug known as Ritalin.

Proper diagnosis and treatment for adults and children with sleep apnea is imperative. It could save your life and definitely improve the quality of your life. We are committed to educating our patients about the problem and the treatments we provide to help you live a better life. Now that is something to smile about! God bless you.

Christianity and Business: Does it work?

In 2006, when Dr. Bryan Nelson began the process of buying out his orthodontic partner, he had the opportunity to re-name and re-structure his business. As he contemplated ideas and prayed for guidance, he was moved to take a bold step and name the practice Trinity Orthodontics; making a direct reference to the Father, Son and Holy Spirit; the essence of God. A risky move? Maybe. A good decision? Definitely.

Along with the name change, Dr. Nelson consciously redirected the focus of his thriving practice to always do what is best and safest for the patients, regardless of what everyone else was doing. He evaluated the benefits of doing early, or phase 1, orthodontics on primary aged kids and decided to recommend this widely used and accepted approach only when there is permanent risk to the teeth and gums, or if there is a significant cosmetic issue affecting the kids' self-esteem. Establishing Trinity as a Christian business moved him to stand by his decision to treat kids with one, cost-effective phase of treatment once the permanent teeth are in, even though it significantly reduced his cash flow. In his heart he knew it was the right thing to do. It was rough going for the first few years but he stood by his decision. He offers early phase treatment to those interested but is very clear in his criteria for recommending it.

When Dr. Nelson saw an increase in patients looking for relief from TMJ or craniofacial pain, and many looking for a treatment solution for sleep apnea, he realized that there were very few treatment options available. In line with doing what is "right and good" for patients, he decided to pursue further education so he could meet the needs of such patients. While running his busy, one doctor practice, he completed a fellowship program at the American Academy of Craniofacial Pain and gained certification from the American Academy of Sleep Medicine. He loves being able to help those in constant pain and those suffering from sleep disorders. His mainstay is still creating great smiles using precision braces, but now he can help with most oral/facial issues, and expose more people to his overtly Christian practice.

The Trinity staff is very customer oriented and committed to patients having a "real" and different experience, and maybe "get a little God" along the way. The scripture "Do what is right and good in the Lord's sight." from Deuteronomy 6:18, is now the foundation of Trinity Orthodontics and that bold scripture is displayed visibly in the front of both Trinity offices. The scripture not only serves as a reminder to the staff, but also as a standard that patients can hold them to. Risky? Not so much. Posting the foundational standard helps Trinity stay committed and accountable in the process.

Now, Dr. Nelson starts out every day with a "prayer huddle" where the needs of patients, staff and the office are lifted to God, there is a prayer request basket at the front desk where patients can request prayers for themselves and their family, Bibles and Christian books are available in the waiting areas, and Dr. Nelson provides lunch so the staff can attend Bible study at work every other week. So, was it a risk, do God and business mix? No, it wasn't a risk to put God at the helm as much as it was a conviction, and YES, if you're a believer, bring God on as your COO (chief operating officer). He'll be in charge of prosperity and your work will be a blessing to many. To the best of their knowledge, no one has ever made a negative comment or chosen not to do business with Trinity because they are a Christian Business.