What Every Parent Should Know

What is an airway and why is it so important? For starters, our airway (specifically our upper respiratory system) is the channel through which the body gets oxygen. We can live without food for weeks and without water for days but we cannot live for more than a few minutes without oxygen. “O.K., I knew that already” you might be saying, but let’s go further…. Without question, breathing through the nose is the most effective way to take in oxygen and to allow for complete oxygen transfer across the blood stream. Studies show that breathing through the nose is at least 7 times more efficient than breathing through the mouth. If your mind and body do not get proper oxygenation, they cannot perform properly. The problem is, many children (and adults) for a variety of reasons cannot breathe properly through their nose due to a number of possible causes and because of this they become chronic mouth breathers.

As stated, mouth breathing when compared to breathing through the nose, is grossly inefficient and for that reason alone it is to be avoided, but there are many other things that take place when one has upper airway obstructions and breathes chronically through their mouths. With chronic mouth breathing also comes a series of facial and jaw changes which can be unfavorable in many ways. These changes can manifest as a recessed lower jaw, overeruption of the upper and lower teeth (gummy smile), narrowed archform of our upper and lower teeth, and thus, crowded, poorly aligned teeth, and malocclusion, which can lead to TMJ related symptoms. However, the most potentially serious of these “changes” is the way the face and jaw change as a result of consistent mouth breathing and how those changes further compromise the airway.

Let’s think of the inside of your mouth as a “garage” for the tongue. If the garage is of adequate size, then the car (your tongue) has plenty of room to reside. If , however, the garage is too small, due to the retrusive and narrowing forces on the jaws (induced by chronic mouth breathing), then the tongue is forced back in the throat and the airway is compromised yet again. People who snore experience this to some degree… people with sleep apnea experience this to a large degree… a serious degree and this isn’t just adults either, it’s children…2 to 3% of our children are experiencing sleep apnea according a a recent study. Some studies show that the numbers may be even higher.

What is sleep apnea? Sleep apnea most commonly called obstructive sleep apnea (OSA), is characterized by repeated episodes of upper airway obstruction that occur during sleep, usually associated with reduction in blood oxygen saturation. Daytime symptoms of OSA can include a feeling of fatigue, never feeling fully rested, dozing off during the day, and many others. OSA is a major health concern that is known to induce stroke and fatal cardiac episodes. Unfortunately, it often goes undiagnosed by the medical and dental community. In adults, it afflicts approximately 9% of men and 4% of women.

In children, at the very least, OSA is, according to a very recent Johns Hopkins study, associated with a 10 point drop in IQ as well as the onset of irreversible changes to the cardiovascular system in said children. At a recent meeting of the American Association of Craniofacial Pain in Phoenix, John Remmers M.D. remarked that OSA would become the number one chronic disease in industrialized societies and further noted that 65 -80% of stroke patients suffer from OSA.

The stakes are high and the first step is education, followed by detection, followed by corrective action. If you feel like you may be suffering from OSA symptoms consult a your physician or an Ears Nose and Throat specialist. Persons suffering chronically from symptoms such as these should have a sleep study performed by a trained physician in order to determine if those symptoms are OSA related.

My goal through this article is to properly empower parents to be able to recognize the signs and symptoms of upper airway obstruction and to seek out the appropriate means to reverse the negative trends before more serious complications crystallize. For these reasons I would encourage parents to make the following observations:

  1. Observe your child (or spouse) during sleep to see if they have labored or loud breathing, snoring, or breathing through the mouth. If so, it would be wise to consult an Ear, Nose, and Throat doctor (ENT) in an effort to see if there are any airway blockages due to enlarge tonsils, adenoids, etc. Mouth breathing can also result commonly from allergies. A common allergy that afflicts children and their airway is an allergy to house dust. Allergies such as this cause swelling of the sinus tissues and impair breathing through the nose.
  2. Observe your child to see if they are chronic mouth breathers during the day. If your child walks around during the day, watching TV, while in the car, etc. with his mouth open, then there is a very good chance that they are chronic mouth breathers. Mouth breathing shouldn’t be the path of least resistance so if your child is breathing through his or her mouth then it is almost certainly related to some inability to breath properly through their nose.
  3. Observe your child (or spouse) to see if they have difficulty staying alert during the day. Are they prone to falling asleep in chairs, or while watching T.V.? These signs, if exhibited, on a regular basis, could be reflective of a sleep apnea condition.

For any further questions regarding chronic mouth breathing and its impact on child development go to www.orthotropics.com.  For more information regarding sleep apnea go to www.sleepapnea.org.
I can be reached at www.bobperkinsdds.com.

If you had fillings placed years ago, you know what an amalgam filling can do for your smile. While these dark metal fillings improve oral health and stop tooth decay from spreading, they also create obvious dark blot in an otherwise white smile. Furthermore, amalgams contain trace amounts of mercury, a hazardous heavy metal. Dr. Perkins uses composite resin to repair tooth decay.

Composite resin, tooth-colored fillings are durable, long lasting, and esthetic. In fact, because Dr. Perkins can tint the liquid resin to match your tooth, you probably won’t even notice the filling when you look in the mirror!

Tooth decay will only get worse if left untreated, but with composite resin fillings, you can enjoy improved oral health and beauty. Our Malibu dentist’s office cares for patients from across the Malibu and San Francisco area area, so call today to schedule your visit with Dr. Perkins.

back to cosmetic dentistry

If you’re interested in experiencing patient-centered dentistry, it’s time you scheduled an appointment with Dr. Bob Perkins. We specialize in enhancing Southern California smiles with exceptional cosmetic dentistry and teeth-straightening options from our convenient Malibu and San Francisco area locations. Contact our Malibu dental office at (310) 456-5700. We look forward to making you smile!

Do you often find that you suffer from inexplicable, intense headaches on a daily basis, particularly in the morning? Have you endured unexplainable pain in your neck and the upper region of your shoulders, even after you’ve taken over-the-counter pain medications to alleviate the ache? Perhaps you deal with jaw pain and stiffness, or soreness in your face or ears. If this describes your experience, it is possible that you are suffering the tell-tale symptoms of temporomandibular joint disorder, or TMJ. At his Malibu dental practice, Dr. Perkins helps patients with TMJ disorder find real relief from chronic, debilitating pain and constant headaches with comprehensive TMJ therapy.

Dental Causes Of TMJ Headaches

Though the distinct cause of temporomandibular joint disorder is not precisely known, the pain associated with the condition can be attributed to a variety of factors. The misalignment of the jaw muscles and the teeth disrupt the fundamental balance of the entire skull, affecting nerves that traverse through the head, neck, shoulders and upper back. TMJ pain may be caused by one or a combination of the following components:

  • Stress that leads to involuntary clenching of the joints and muscles of the jaw
  • Rheumatoid arthritis and osteoarthritis
  • Bruxism (grinding of the teeth, generally during sleep)
  • Dislocation of a cushioning disc of cartilage where the jaw connects to the cranium
  • Injury to the temporomandibular joint

Fortunately, TMJ treatment from Dr. Bob Perkins has been proven to dramatically improve the lives of countless patients with even the most severe of cases, allowing them to return to normal daily activities without the incapacitating pain for which this condition is known.

Alleviate Your TMJ Disorder

If you or a loved one suffers from chronic headaches, pain in the neck and shoulders, or any of the other common symptoms of TMJ, contact our office in Malibu, CA today and talk with our experienced, compassionate team about how Dr. Perkins can help you. From our conveniently located, high-tech practice in Malibu, we happily serve patients from throughout LA and The Valley, including Thousand Oaks, Moorpark, Westlake Village, and more. Dr. Perkins and our entire team look forward to helping you achieve lasting relief from pain and chronic headaches associated with TMJ disorder.

If you’re interested in experiencing patient-centered dentistry, it’s time you scheduled an appointment with Dr. Bob Perkins. We specialize in enhancing Southern California smiles with exceptional cosmetic dentistry and teeth-straightening options from our convenient Malibu and San Francisco area locations. Contact our Malibu dental office at (310) 456-5700. We look forward to making you smile!

Managing Stress to Help Your Jaw Rest

You may spend most of your life unaware of the important little triangular-shaped joints located in front of your ears. Lined with cartilage, these joints move with a smooth, gliding motion. Under normal conditions, they join your lower jaw and temporal bone, allowing your mouth to open and close easily. However, stress or an improper bite can cause the joints to dysfunction, exposing nerve endings to create pain. In fact, the temporomandibular joint is highly sensitive to overall physical, emotional, and psychological stress. It is affected by the mechanics of your bite and the condition of your jaw muscles. A little extra stress, a little extra fatigue, a little change in your bite, and you may temporarily knock the whole system out of balance. The resulting TMJ disorder, or TMD, can create a variety of mild to severe symptoms, from jaw clicking and minor discomfort to sharp pain in your temple, ear, neck, and shoulders.

The condition is very common in our culture, so we evaluate patients for TMJ dysfunction at their regular dental exam. If we detect a problem, our goals are to arrest it, protect teeth from further damage, and correct underlying bite misalignment. Therapy may involve fitting you with a physiologic bite appliance, suggesting ways to alleviate stress, and recommending symptom relief measures. Typically, TMJ patients need to avoid chewing gum or hard, chewy food, take small bites, and alternate chewing between both sides of the mouth. Good nutrition will help the joint heal more quickly; good posture will also help relieve discomfort. A straight back and relaxed neck is also helpful. To relieve soreness, light temple and jaw massage will stimulate circulation and relax the muscles. If pain is present, we suggest alternating moist heat and cold for 20 minutes to further increase circulation. Over-the-counter anti-inflammatories or analgesics can be very helpful as well.

If you’re interested in experiencing patient-centered dentistry, it’s time you scheduled an appointment with Dr. Bob Perkins. We specialize in enhancing Southern California smiles with exceptional cosmetic dentistry and teeth-straightening options from our convenient Malibu and San Francisco area locations. Contact our Malibu dental office at (310) 456-5700. We look forward to making you smile!

 

A bright smile can take years off of your appearance and give you the confidence boost you need to take your romantic, professional, and social life to new heights! As a cosmetic dentist, Dr. Perkins will talk with you about your goals for your smile, then recommend the teeth-whitening system that will meet those goals while fitting well with your lifestyle. Opalescence is our system of choice for most patients.

Most stains from beverages, foods, smoking, and age can be effectively erased with professional teeth whitening. Even hard-to-remove tetracycline stains, caused by medications, respond to some teeth-whitening systems like Opalescence. And rest assured, our bleaching options, including Opalescence, are safe for your smile and your health.

If you want a brighter smile, call Dr. Perkins today to make your appointment. Our Malibu dentist’s office caters to patients from Malibu, San Francisco area, and beyond with the latest cosmetic procedures and quality dentistry.

back to cosmetic dentistry

If you’re interested in experiencing patient-centered dentistry, it’s time you scheduled an appointment with Dr. Bob Perkins. We specialize in enhancing Southern California smiles with exceptional cosmetic dentistry and teeth-straightening options from our convenient Malibu and San Francisco area locations. Contact our Malibu dental office at (310) 456-5700. We look forward to making you smile!

Teeth Straightening

More adults and older teens than ever wear braces these days. In fact, one in five orthodontic patients is an adult. While the most visible benefit of braces is an attractive set of straight teeth, orthodontics is not prescribed just for cosmetic reasons. In children, interceptive orthodontics or orthotropic treatment at a young age can sidestep worrisome issues in the development of the jaw and teeth. In those cases, Dr. Perkins works with a team of experts to provide your child with the best in specialized care.

As for adults and teens, the savvy consumer knows that it’s never too late to enjoy the health and confidence benefits of a straight smile. For instance, symptoms like earaches, dizziness, headaches, and neck pain can all be associated with a misaligned jaw. Correcting the bite will alleviate these symptoms and improve function and comfort, while reducing the potential for tooth wear. In addition, straight teeth are less prone to decay and gum disease.

Have you considered straightening your smile, but are deterred by the idea of a mouth full of metal? Dr. Perkins has good news for you! Our Invisalign and Six Month Smiles systems are the discreet alternative to traditional braces. Find out which system is right for you at a personal consultation with Dr. Perkins at our San Francisco area or Malibu practice location.

Find out more about our teeth-straightening treatments on the following pages:

If you’re interested in experiencing patient-centered dentistry, it’s time you scheduled an appointment with Dr. Bob Perkins. We specialize in enhancing Southern California smiles with exceptional cosmetic dentistry and teeth-straightening options from our convenient Malibu and San Francisco area locations. Contact our Malibu dental office at (310) 456-5700. We look forward to making you smile!

Sleep apnea is a serious medical condition that is often overlooked by the medical and dental community. Recent studies suggest that it affects from 5 to 10 % of men and from 2 to 5 % of women. Untreated Sleep apnea can greatly increase the risk of high blood pressure, heart attack and stroke. It can also be associated with chronic tiredness or a feeling of not being fully rested. This is because people with sleep apnea have chronically interrupted sleep. They experience frequent episodes where breathing stops …sometimes for 30 seconds or more and at a frequency of up to 30 times per hour. Despite the seriousness of the symptoms, most people are not aware that they are experiencing sleep related problems. Dr. Bob is very concerned that patients don’t pass through his doors with undiagnosed sleep apnea. For this reason, he has studied sleep apnea extensively and has trained his team to properly recognize and screen patients who could be experiencing sleep apnea.

There are dental and skeletal conditions that can greatly predispose a patient to sleep apnea. We are trained to recognize these conditions and to recommend the proper treatment in order to properly treat sleep apnea.

The first step in dealing with a patient who may be experiencing sleep apnea is to refer them for a proper sleep analysis test, or sleep study as it is often called. Only a qualified medical doctor can interpret the results of these tests and from those results a course of action can be taken. Many people, after receiving a sleep study, are told that they must wear a device at night (CPAP) in order to get proper airflow into the lungs. This is certainly true with patients who are diagnosed with “severe” sleep apnea, as defined by a qualified medical doctor.

Many more people, after the sleep study, are diagnosed with mild or moderate sleep apnea and they can be oftentimes be treated successfully with a removeable appliance that allows for proper airflow.

For more informaiton please go to www.sleepapnea.org and read Dr. Bob’s article below to understand how sleep apnea can be treated or avoided in children.

Read Article : What Every Parent Should know

If you’re interested in experiencing patient-centered dentistry, it’s time you scheduled an appointment with Dr. Bob Perkins. We specialize in enhancing Southern California smiles with exceptional cosmetic dentistry and teeth-straightening options from our convenient Malibu and San Francisco area locations. Contact our Malibu dental office at (310) 456-5700. We look forward to making you smile!

Short-Term Braces

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Adults and teenagers looking to straighten their teeth can now get the smile they have always wanted in about 6 months. Dr. Perkins uses short-term orthodontics to provide fabulous smiles faster than with traditional braces. How can Six Month Smiles create straighter smiles so quickly? By focusing only on teeth that show when a person smiles, an aesthetic result can be achieved faster

Six Month Smiles is designed specifically for adults and older teenagers without major bite issues who have crooked, crowded, or unevenly spaced teeth. These quick braces work by targeting the appearance of your smile, not more complex issues like bite and jaw alignment.

The advantages over traditional orthodontic treatment are:

  • Unlike traditional braces people must wear for 2 years or more, this procedure straightens teeth in an average of just 6 months and uses low force to move teeth comfortably. A faster result with quick braces does not mean extra pain!
  • Also, six month braces use clear braces and tooth colored, nickel-titanium wires–making them virtually invisible. quick braces are both efficient and discreet.

The Six Month Smiles process requires fewer dental visits and is typically less costly. If you have any questions about the quick braces process with Dr. Perkins, call our dental offices in Malibu and San Francisco area today.

For more information about Six Month Smiles go to www.6monthsmiles.com

 

short term orthodontics - before short term orthodontics - after
six month braces - before six month braces - after

 

If you’re interested in experiencing patient-centered dentistry, it’s time you scheduled an appointment with Dr. Bob Perkins. We specialize in enhancing Southern California smiles with exceptional cosmetic dentistry and teeth-straightening options from our convenient Malibu and San Francisco area locations. Contact our Malibu dental office at (310) 456-5700. We look forward to making you smile!

Oral Conscious Sedation

A visit to the dentist can cause fear and anxiety. Patients who experience dental phobia may postpone or avoid vital dental appointment, and multiple dental visits are out of the question. Neglecting your oral health can lead to tooth loss, disease, and overall health problems. However, you can overcome dental fear with oral conscious sedation from Dr. Perkins.

What is oral conscious sedation?
Oral conscious sedation is the use of oral medication in combination with nitrous oxide to achieve an appropriate level of relaxation so that a fearful patient can calmly receive the dental care he or she needs. Most states require board-certification, which involves additional training in dosage, monitoring, and safety. The entire process is simple and comfortable.

At your first appointment, we will discuss with you your overall health and medical history. If you feel comfortable, we will take X-rays and examine your teeth and supporting tissues. This will give us the information we need to determine which dental treatments will restore your smile. Before you leave the office, we will schedule your next appointment and prescribe an anxiolytic, or anti-anxiety, medication.

Dr. Perkins will advise you as to when you should take the medication, usually 1 to 2 hours before your dental appointment. Accompanied by a responsible friend or family member, you’ll arrive at the dentist’s office more rested and relaxed. We will gauge your anxiety level when you arrive for the appointment. If needed, nitrous oxide will be given to further relax you, and an experienced sedation dentistry team will monitor your vital signs during the procedure. Your friend or family member will accompany you home once your dental work is complete. The effects of the sedative should subside by the following day. It is wise to have a friend or relative stay with you until the medication wears off.

Although your dental procedures may take hours, you will feel as if they take only minutes. Some patients become so relaxed that they fall asleep in the dentist’s chair. Sedation medications have an amnesic effect, so you’ll have few, if any, memories of the visit. You can immediately enjoy your improved smile.

Who should consider oral conscious sedation?
You may want to consider oral sedation if:

  • You are fearful or anxious of dental treatment and dental instruments
  • Local anesthetics do not have a numbing effect on you
  • You have a sensitive gag reflex
  • You suffer from any health issues, such as neck or back pain, which could lead to discomfort while sitting in a dentist’s chair

Oral conscious sedation can give you the peace of mind you need in order to undergo dental work. You may enjoy better overall health, an improved self-image, and better quality of life with a healthy, beautiful smile.

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IV Sedation

Think it’s impossible to relax at the dentist’s office? Reliable intravenous (IV) sedation techniques let you rest comfortably while receiving the dental care you need and want at our Malibu or San Francisco area dental offices. If fear of the dentist keeps you from necessary treatment, ask us about IV sedation to ease you through any procedure.

While mostly used for oral surgeries or time-consuming procedures, IV sedation can alleviate severe anxiety and phobias associated with dentists, needles, and drills to make any dental procedure pleasant. In addition, patients with sensitive gag reflexes and those with TMJ or other neuromuscular disorders that make it hard to keep their mouths open for long periods of time often benefit from IV sedation. Dr. Perkins will consult with you to determine your anxiety level and decide whether IV sedation is safe for you, based on medical history and present health conditions.

The sedative dosage we administer correlates to the intensity of your anxiety or discomfort. IV sedation allows us unprecedented control over relaxation levels, so we can tailor the sedation to your specific needs. Depending on the amount of sedative you receive, you will feel extremely relaxed, drowsy, or you may fall asleep completely. Typically, patients remain conscious and can respond to questions but do not experience extreme nervousness or discomfort, remembering little about the appointment afterwards.

As with any procedure we perform, your physical safety remains our top concern. To prepare for an appointment in which you will receive IV sedation, do not eat or drink anything for eight hours prior to your procedure, except for prescription medications, unless advised otherwise. While you are under sedation, we closely monitor blood pressure, breathing, and heart rate. After your dental work, we stop the IV and let you rest comfortably for 15 to 20 minutes before you leave our office. If necessary, we prescribe pain management medication after your visit, particularly after an oral surgery. You must arrange to have a responsible adult drive you home from your appointment and remain with you until drowsiness wears off. You should be able to resume normal activities the day after the appointment.

We understand your fear about visiting the dentist, as well as your desire for healthy, beautiful teeth. We can help you achieve the smile of your dreams with the compassionate care you deserve. Ask us if IV sedation is right for you!

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Our office is happy to offer Nitrous Oxide for all patients.

Nitrous oxide, or “laughing gas” as it’s more commonly known, is a safe and effective sedative agent that is mixed with oxygen and inhale through a small mask that fits comfortably over your nose. The goal is to make you as comfortable as possible during your dental treatment. For those of our patients who experience anxiety or fear before a dental appointment, we recommend using this helpful service. The process is simple: you will be asked to breathe normally through your nose, and within a few short minutes you should start to feel the effects of the nitrous oxide. The feelings will wear off soon after the mask is removed. Your comfort is our top priority and nitrous oxide therapy is perfect for patients who get a bit nervous before receiving dental treatment.

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