dr lund


When people wonder why dentists do Botox, the answer is simple. As dentists, we understand the head and neck anatomy as well as if not better than most physicians. Just as veneers and crowns can improve a patient’s smile and self-confidence, so can helping to minimize his or her wrinkles. Dr. Cara Lund believes in it so much that she has had Botox done on her smile lines herself!

Botox is a prescription medicine that is injected into muscles and used to temporarily improve the look of crow’s feet lines and frown lines. The results typically last up to 4 months. Botox is the trade name for is botulinum toxin A which is a protein produced by clostridium botulinum. There are no bacteria in Botox, only protein. How the protein works is quite amazing and very simple. The protein attaches itself to the nerve endings of the motor muscles, thereby affecting the nerve transmission to these muscles (no sensory feeling is affected). It takes about 2-10 days for this to occur. Once these motor nerve endings are interrupted, the muscles cannot contract. Facial wrinkles are caused by muscles moving under the skin. So, if the muscle cannot move, you will not have dynamic wrinkles!

If you have ever wondered if Botox could work for you, ask Dr. Cara Lund when you are in for your next continuing care cleaning appointment or call and set up a complimentary consultation today.

References: www.botox.com, www.facialesthetics.org

Obstructive Sleep Apnea

Dr. William Lund and I have just completed a comprehensive dental sleep medicine course at Tufts University School of Dental Medicine. The course has consisted of 6 days of classes and hands-on workshops where we have learned how we can help diagnose and treat our patients who have sleep apnea. The lectures provided an understanding of both normal sleep and obstructive sleep apnea (OSA). We learned about the pathophysiology and medical consequences of OSA and how to screen, diagnose, and treat sleep apnea patients, both with the positive air pressure (PAP) therapy and with oral appliances. During hands-on workshops, we performed clinical examinations, took bite registrations, selected oral appliances, and fitted and adjusted these appliances.

I have told many of my patients about the classes we have been taking, and the unanimous response is, “But you’re a dentist? Don’t doctors treat sleep apnea?” Although obstructive sleep apnea is diagnosed by a sleep medicine physician, many patients with sleep apnea can be treated by a specially trained dentist. After the comprehensive course-work we have completed, Dr. William Lund and I are eligible to receive the “Qualified Dentist” designation by the American Academy of Dental Sleep Medicine. This designation provides a distinction regarding our knowledge of and commitment to dental sleep medicine. “Qualified Dentists” are the dentists of choice to provide oral appliance therapy for OSA since the successful delivery of oral appliances requires technical skill, acquired knowledge, and judgment regarding outcomes and risks of these therapies.

Going forward we are going to begin to ask all our patients 3 simple questions: 1) Have you been told that you snore? 2) Have you been told that you stop breathing when you sleep? 3) Do you often feel excessively sleepy during the day? If the answer to any of these questions is yes, additional screening is needed. For those patients we are concerned have sleep apnea, we will recommend they go for a sleep study. Only through a doctor administered sleep study will we know if a patient does suffer from OSA. Then, if a patient is diagnosed with mild to moderate obstructive sleep apnea, we can fabricate a custom oral appliance, often covered through medical insurance. It all sounds so simple, however properly fitting a patient with an oral appliance takes time and skill. The result, as any patient who uses and oral appliance will tell you, is a dramatic increase in his or her quality of life.

Who is at risk for OSA? Studies show that 17% of women and 34% of men have OSA. Risk factors include: age (40-70), gender (male), large neck, obesity (BMI > 30), central body fat distribution, craniofacial and upper airway abnormalities, genetics, smoking, menopause, nighttime nasal congestion, and alcohol use before bed time.

What is OSA, and why is it so dangerous? OSA is not simply snoring; it is when the airway closes (partially or fully) but efforts to breathe continue, resulting in a reduction of blood oxygen saturation and ending with a sleep arousal. Primary causes of upper airway obstruction are lack of muscle tone during sleep, excess tissue in the upper airway, and anatomical features of the upper airway and jaw. The person experiences apneas (reduction of airflow by 90% for 10 seconds with persistent effort to breathe), hypopneas (reduction of airflow by 30% with 3% arterial oxygen desaturation for 10 seconds associated with a sleep arousal), and reras (sequence of breaths lasting at least 10 seconds characterized by increasing respiratory effort leading to an arousal from sleep). From a sleep study, a person is given an Apnea Hypopnea Index, which tells you how many times your sleep is disrupted in an hour. A score of 0-5 is normal, 5-15, mild, 15-30 moderate, and over 30 severe. Anyone with severe OSA needs PAP therapy (C-PAP), however if you have mild to moderate sleep apnea you can use an oral appliance which is much more comfortable and has a higher rate of compliance.

What are oral appliances for sleep apnea? Oral appliances refer to mandibular advancement (repositioning) devices because they are the most effective and widely used in clinical practice. The function of an oral appliance is to protrude and help stabilize the mandible (lower jaw) to maintain an open airway during sleep. The oral appliance is custom fabricated and cannot be purchased from a store or online. Although not recommended for severe sleep apnea, oral appliances can be used by those who are intolerant of C-PAP rather than no treatment. Dentists with the “Qualified Dentist” certification are the recommended providers to make these oral appliances.

Why is it so important to treat OSA? Sleep loss and sleep disorders are associated with hypertension, diabetes, obesity, depression, heart attack, and stroke. Excessive daytime sleepiness leads to significant impairments in quality of life, cognitive performance, and social functioning. Almost 20% of all serious car crash injuries in the general population are associated with driver sleepiness. Treating OSA is not just about stopping you from snoring; it is about improving the quality and length of your life.

If you think you or someone you know may have obstructive sleep apnea, please call our office and reserve a complimentary consultation with either Dr. William Lund or myself Dr. Cara Lund.

Reference: Dental Sleep Medicine: A Comprehensive Introduction Course (Tufts University School of Dental Medicine Department of Continuing Education)

Give the Gift of Whitening… or Treat Yourself

Lund Dental Associates Offers New Whitening Treatments

Looking for a gift?  Getting married?  Going on vacation?  Or, maybe, you just want to treat yourself?  Lund Dental has three different whitening options now available:  GLO In Office Whitening, Opalescence Custom Take-home Trays, and Opalescence Go.

GLO In Office Whitening is a chair-side appointment to quickly whiten teeth.   The GLO Light is a closed mouthpiece which couples a heat-light and whitening gel.  This offers quick and long lasting results.  Need a touch up after your in office visit?  You take home the GLO Light and extra gel for your convenience.

For an at home whitening experience, try Opalescence Custom Take-home Trays.  These are a patient favorite and offer weeks’ worth of professional whitening from the comfort of your own home.  An impression is take of your mouth and trays are made in office.  We offer three different strengths: 10% for sensitive teeth, 15% for slight sensitivity, and 35% for non-sensitive patients.

Opalescence Go is the professional alternative to over-the-counter whitening options (Crest Whitestrips). These are ready-to-use trays and fit all smiles.  Opalescence Go trays are worn for 5-10 days up to 30 minutes per day.   Wear these getting ready in the morning or during your commute.  This quick daily whitening option makes a great gift!

Are there steps I should follow when I whiten my teeth?  YES.  In order to reduce sensitivity during treatment, we recommended you brush with Sensodyne ProNamel for 2 weeks prior to beginning the whitening treatment. You should record your own before tooth color so you can track your progress (use the same mirror and same lighting conditions every time with natural light being the best).

During the whitening treatment it is required you refrain from consuming any substances that could discolor teeth. These substances include, but are not limited to: coffee, tea, colas, ALL tobacco products, mustard or ketchup, red wine, soy sauce, berry pie, red sauces, chocolate, and chocolate drinks. It is also recommended to refrain from wearing lipstick.

As always, if you experience significant discomfort or any other problem that prevents you from wearing your whitening trays as directed, please contact us immediately.

Call Lund Dental to discuss your whitening options today! Lund Dental Phone Number 781-438-2700