The Staggering Cost of Undiagnosed Obstructed Sleep Apnea

According to a recent article posted by News Medical, a report reveals the staggering cost of undiagnosed obstructive sleep apnea in the U.S. The American Academy of Sleep Medicine (AASM) released a new analysis, titled “Hidden health crisis costing America billions,” that reveals the staggering cost of undiagnosed obstructive sleep apnea. A companion report was also released, titled “In an age of constant activity, the solution to improving the nation’s health may lie in helping it sleep better,” which summarizes the results of an online survey completed by patients currently being treated for obstructive sleep apnea (OSA). Both reports were commissioned by the AASM and prepared by the global research and consulting firm Frost & Sullivan.

Cost of Obstructed Sleep ApneaOSA is a chronic disease that is rising in prevalence in the U.S. Frost & Sullivan estimates that OSA afflicts 29.4 million American men and women, which represents 12 percent of the U.S. adult population. They also calculated that diagnosing and treating every patient in the U.S. who has sleep apnea would produce an annual economic savings of $100.1 billion.

Treating sleep apnea improves productivity and safety while reducing health care utilization, notes AASM Immediate Past President Dr. Nathaniel Watson. His editorial about the report is published in the August issue of the Journal of Clinical Sleep Medicine.

Frost & Sullivan calculated that the annual economic burden of undiagnosed sleep apnea among U.S. adults is approximately $149.6 billion. The estimated costs include $86.9 billion in lost productivity, $26.2 billion in motor vehicle accidents and $6.5 billion in workplace accidents. Untreated sleep apnea also increases the risk of costly health complications such as hypertension, heart disease, diabetes and depression. The report estimates that undiagnosed sleep apnea also costs $30 billion annually in increased health care utilization and medication costs related to these comorbid health risks.

To learn more about the Sleep Group Solutions protocol, which bring physicians and dentists together to screen and treat Obstructive Sleep Apnea, check out their live 2-day lectures.

I’d be more than happy to discuss any of your thoughts regarding sleep apnea the next time you are in the office. In the meantime, if you have any questions regarding sleep apnea, don’t hesitate to contact me or the staff at my office, Dr. Laurence H. Stone, DDS, any time at 215-230-7667.

Image used in this blog is courtesy of the AASM. Blog courtesy of



Who’s Your Dentist?


I know I’m probably preaching to the choir here, but over the last few months I’ve had occasion to ask several people I’ve met who their dentist was. What I heard in response was the name of some corporate entity, usually beginning with the letter “A”. When I then said: “No, I don’t think you understand…Who is your dentist?”, I would get this puzzled look. They couldn’t tell me the name of their dentist because they didn’t know it. I guess they were just seen by whatever dentist was working there that day!

Dentistry as a profession is changing –no doubt. There are currently about 8,000 dentists in the U.S working in large group practices and many more in smaller multi-office groups. Groups are not necessarily a bad thing, but when corporate entities and franchises like Aspen Dental are dictating (contrary to State laws) how dentists can practice in their offices and forcing dentists to adhere to quotas (as recently happened in New York State), the best interests of patients are not being served.

A friend recently said to me that when a dentist doesn’t feel good enough about what he or she is doing to put his or her own name on the sign in front of the office, you probably don’t want to be going there. By the way, it’s against the law in Pennsylvania NOT to have your name on the sign in front of your office!

Buyer beware! Welcome to the age of consumerism!

Please feel free to discuss this issue with me at your next appointment! If you have any questions in the meantime, you can contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have about this or any other issue in the field of dentistry.

What’s All The Buzz About E-cigarettes?

E-cigaretees_Drl Larry  Stone Blog

E-cigs are electrical devices that vaporize propylene glycol or polyethylene glycol-based liquid solutions into aerosol mists typically  containing various concentrations of nicotine. Having been marketed since 2007 or so, the use of e-cigs (vaping) has now exploded to a multi-billion dollar industry primarily targeted at young people and now heavily controlled by the tobacco industry. The three largest tobacco companies now control over 70% of the e-cig market.

According to the Centers for Disease Control and Prevention the prevalence of use of e-cigs has increased nine-fold among high school students and now exceeds the use of cigarettes in that population. Having prevailed in federal court cases, the industry has succeeded in having e-cigs labeled as “tobacco products” instead of “ drug delivery devices” which makes it much easier to market these products, especially to young people. Because there are currently no product standards for e-cigarettes, they are almost entirely unregulated on the U.S. market!

There have been precious few studies evaluating the health consequences or long term effects of e-cigs, especially in young people. What the scientific community does know is that:

  1. The effects of nicotine on the developing brains of teenagers include altered development of the cerebral cortex and hippocampus.
  2. Smokers who use e-cigs are 59% less likely to quit smoking than those who do not use them.
  3. High levels of nicotine dosing via e-cigs may increase the risk of periodontal disease.
  4. The American Heart Association, The American Association for Cancer Research, the American Society of Clinical Oncology, the Forum of International Respiratory Societies and the American Association for Dental Research have all cautioned against the use of e-cigs.

So there you have it! Just don’t do it!

See you soon for your next appointment! If you have any questions in the meantime, you can contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have regarding the use of e-cigarettes.

Polypharmacy – Are you at risk for prescribing cascade with your medications?


As the population in the United States ages, so does the population of dental patients that are typically seen each day. One of the most noted characteristics of this group is the sheer number of prescription medications they take. The average 65 year old is taking five or more medications for a variety of reasons. One of the most serious side effects of many medications is drug-induced xerostomia (dry mouth), which can be devastating to one’s oral health!  (See my prior blog on Xerostomia.)

Another aspect of this “polypharmacy” is that patients taking five or more drugs are at risk of experiencing “prescribing cascade”, which occurs when unrecognized side effects of an existing drug prompts physicians to prescribe a new drug to then treat these new symptoms! The elderly and persons with disabilities are especially prone to prescribing cascade. The Beers list, developed by an expert panel to assess inappropriate drug prescribing, consists of a list of medications that are particularly prone to adverse effects in the elderly.

Please consult with your personal physician should you have any questions regarding this issue. And please let us know if you are experiencing “dry mouth”. Be sure to ask us at your next visit how you can best treat dry mouth. You can contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have and to schedule an appointment.

Bucks County Veteran ID Card Discount Program – Helps Veterans Afford Area Services


A recent article by a colleague practicing in central Pennsylvania reminded me of my time in the service. I don’t talk about it that much, but for 2 years after completing my dental education I served as a Senior Assistant Dental  Surgeon with The United States Public Health Service. I was assigned to the U.S. Coast Guard for two years and provided dental care to enlisted personnel at small boat stations throughout the Great Lakes. Most of my patients were young, fairly healthy enlisted men and their dependents.

Being in the service doesn’t pay much and I think we all know how much our veterans have suffered following their service to this great country. It’s estimated that 150 million Americans did not see a dentist last year and that in Pennsylvania alone there are dental health professional shortage areas in 64 of our 67 counties.

I’m proud to say that Bucks County has tried to alleviate some of the inequities experienced by our veterans by Instituting the Bucks County Veteran ID Card Discount Program. By presenting the appropriate paperwork to the Bucks County Recorder of Deeds veterans will be issued an ID card entitling them to discounts at local businesses throughout the county- including my office. In addition, I keep a list of resources in the area that may be able to assist all those less fortunate in accessing dental care.

There’s no reason why our veterans, those who have given so much to this country, should have to go without dental care when they need it the most. If you want to help and have a service or product to offer, call the County Recorder of Deeds to volunteer for this worthy program.

If you are a veteran in need of dental services, Be sure to contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have and to schedule an appointment. We look forward to serving you.

Summer Travel Alert: Drowsy Driving Can Be as Dangerous as Drunk Driving

Drowsy Driving

As you get ready to hit the road this summer to enjoy your favorite vacation spots, be aware that drowsy driving can lead to serious consequences for you, your family and others on the road. There are many reasons you can become drowsy when driving, the most important of which is lack of proper sleep. It has been reported by the American Academy of Dental Sleep Medicine (AADSM) that drivers are 15 times more likely to be involved in a deadly motor vehicle accident when they have excessive daytime sleepiness, a common symptom of sleep apnea.

AADSM further states that 12-18 million Americans suffer from sleep apnea and snoring, with millions more going undiagnosed – as many as 30-50 million more as claimed by The Institute of Medicine. Certainly sleep apnea and snoring prevent the person suffering with these conditions, and often those sleeping nearby, a good night’s rest. We have spoken in prior blogs about the remedies for sleep apnea, but for those with mild to moderate obstructive sleep apnea, or those who can’t comply with a CPAP, oral appliance therapy may just be the ticket to a good night’s sleep.

Oral appliances look like a sports mouth guard and travel well. Not only are they quiet in comparison to a CPAP, they are very easy to care for. If you think you suffer from primary snoring or obstructive sleep apnea, ask me for a referral to a board-certified sleep physician. Once officially diagnosed, you can determine the best treatment option for you. We will be happy to fit you with an oral appliance should that choice work for you.

In the meantime, look for these telltale signs of drowsiness when driving:

  • Yawning constantly
  • Unable to keep your eyes open
  • Restlessness and irritability
  • Nodding off
  • Daydreaming, wandering thoughts
  • Drifting into other lanes
  • Can’t remember the last few miles
  • Ending up too close to cars in front
  • Missing road signs
  • Driving past turns
  • Moving onto the `rumble strip’ or road shoulder

If any of these present themselves, switch drivers with someone more alert or pull over into a safe place and take a nap. Then walk around to wake up before driving again.

Be sure to contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have and to schedule your next visit or schedule an appointment to be fit for your oral appliance to assist you in achieving a good night’s sleep.

Do You Grind Your Teeth at Night?


A comprehensive study reported in the American College of Chest Physicians journal found that more than 8% of the population grind their teeth at night at least once a week. Half of those that grind also experience significant consequences including muscular discomfort on awakening, sleep disturbing tooth grinding and the necessity of extensive dental work. Additional consequences of nighttime grinding (also known as sleep bruxism) can include headaches, jaw joint discomfort, and premature loss of teeth due to excessive attrition and mobility.

Sleep bruxism has also been associated with snoring, moderate daytime sleepiness, heavy alcohol consumption, caffeine drinkers, smoking, a highly stressful lifestyle and those with anxiety. Possibly the most serious association with sleep bruxism, however, is those people suffering from obstructive sleep apnea, a potentially life threatening condition!

If you think you may be grinding your teeth at night or if your sleeping partner tells you that you are grinding or snoring, please let us know the next time you are in the office.

It may just save your life!

Be sure to contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have and to schedule your next visit.

Saliva- What Your Spit Can Tell Us About You!


Don’t be surprised if we ask you to spit in a cup at your next dental visit! Salivary diagnostics have been slowly improving as the science grows. Human saliva is now used to diagnose many conditions such as multiple sclerosis; Sjogren’s syndrome; sarcoidosis; metabolic bone disorders; cardiovascular conditions; periodontal disease; genetic disorders; and fungal, bacterial and viral infections.

Our medical colleagues are also using saliva to determine the presence of hypertension, diabetes mellitus, HIV infections, cardiovascular disease, and to monitor drug use.

The advantages of using saliva as a diagnostic aide are numerous. It is non-invasive; it can be self-administered, and because saliva does not clot, samples can be stored and transported more easily. In addition, testing saliva can offer immediate results and is preferable for infants, children, geriatrics and for remotely located populations.

We are currently using salivary diagnostics in dentistry to help identify patients with HPV (Human Papilloma Virus) infections, susceptibility to periodontal disease, Xerostomia (dry mouth) and those with a high caries index. We can then use the results to make intelligent recommendations for treatment and/or prevention. Please don’t hesitate to ask us any questions at your next visit.

So, now you know! Be sure to contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have and to schedule your next visit.

Fifty Shades of Gray – A Reminiscence on Central High School


Before I found out what the movie “Fifty Shades of Gray” was all about (obviously I did not read the book!), I thought they were talking about me. After all, this year I will be celebrating my 50th high school reunion–a very sobering thought. Gray or not, I’m just happy to still have hair!

I went to Central High School in Philadelphia, back when it was still an all-boys school. I am very proud to have had the privilege of attending Central and still carry that pride today. Although I was not one of them, the year I graduated we led the nation in Merit Scholarship Finalists (45). I did in fact receive a Bachelor of Arts Degree from Central, one of the only high schools in the country legally permitted to grant that degree. Only four of my classmates became dentists, while there were over 130 attorneys and probably as many or more physicians.

About twenty years ago my only sister needed to have some gynecological surgery. A now retired classmate of mine, Dr. Larry Seidman, performed the procedure at Rolling Hill Hospital. During the surgery he found a lymphoma on my sister’s colon incidental to the procedure. He removed it and thus saved her life. I hope to see Larry and thank him again at our upcoming reunion.

Please feel free to talk with me at your next visit about the reunion. I will be happy to share my experience. Be sure to contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to schedule your next visit

Alzheimer’s and Dental Health


Cognitive decline, including Alzheimer’s disease, is a major concern of the aging population in America. It may now even be the third leading cause of death in America behind only cardiovascular disease and cancer. Although reporting numbers vary, it is safe to say that as of 2014, Alzheimer’s affects approximately 5.2 million Americans and 36 million people globally. Up until recently all of the research to prevent and treat this disease has been focused on identifying a single pathogenic target, and no single drug has been shown to stop or even slow the progression of Alzheimer’s. But this may be about to change.

In a small study by Dr. Dale E. Bredesen at the UCLA Mary S. Easton Center for Alzheimer’s Disease Research along with the Buck Institute for Research on Aging, it was found that using a complex, 36 point therapeutic program that involves comprehensive diet changes, brain stimulation, exercise, sleep optimization, specific pharmaceuticals and vitamins, as well as additional steps affecting brain chemistry, significant improvement in cognitive function has been achieved. (See Bredesen, Dale E., Reversal of Cognitive Decline: A Novel Therapeutic Program, Aging, Sept 2014, Vol.6 N9).

So what’s all this got to do with dentistry you ask? Well, one of the therapies involved in treating dementia with this protocol is reducing the amount of inflammation in the body. Inflammation was found to be a comorbidity in this study. And for those of us with teeth, it has long been known that infection in the gums contributes greatly to the total amount of inflammation in the body, exacerbating other systemic problems like diabetes. Ergo, healthier gums = reduced inflammation = better brain function.

Nine of the 10 people in this study showed significant cognitive improvement following Dr. Bredesen’s protocol. On a personal note, having watched my mother succumb to dementia in her later years, I was glad to see that dental health was recognized in this study as playing a vital role in contributing to cognitive health.

For more information on Alzheimer’s disease, visit the Alzheimer’s Association web page. If you have any questions we can help with relating to reducing inflammation in your mouth, feel free to contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA with any questions or concerns or to schedule your next visit so we can talk more about this. Remember, brushing two minutes twice a day with fluoride toothpaste and flossing daily are important ways to take care of your dental health.