Factors That Contribute To The Hidden Epidemic - The Hidden: Fill & Download for Free

It depends on the type of appliance design. Partial coverage anterior appliances, a guard that fits on the front teeth only, can lead to changes in tooth position in the long-term. Likewise, appliances worn on the posterior teeth can shift teeth as well. As such, many providers prefer a full coverage appliance to avoid teeth shifting. Yet, for all types of appliance designs I have heard of people chipping and cracking teeth while wearing their appliance as directed.In my view, anyone with nocturnal bruxism or other symptoms that could be explained by disturbed sleep would be best served by having a thorough evaluation of their airway and sleep quality. This can be difficult, as there are currently few medical providers who fully understand how the airway can impact health and a great deal of sleep labs do not offer diagnostics for UARS and the more subtle nighttime breathing issues which are now being understood to often be the underlying driver of symptoms for persons with TMD.It is common for patients who have their sleep and airway adequately treated, who did not have diagnosable OSA, to find their TMD symptoms (bruxism, clenching, craniofacial pain, etc) resolve. Sleep quality improves, fatigue/pain reduces or goes away, TMJs heal. There are many other contributing factors to consider with Bruxism, but airway/sleep is a major one, and one that conventional bruxism/TMD appliances do not directly treat and have been known to make worse (part of why there is chipping/cracking of teeth). In addition, many providers who deliver such appliances will also prescribe medications that can make the underlying airway problem worse even though it reduces the bruxing/clenching.I would encourage anyone struggling with bruxism/clenching/TMD to do their own research. There are many organizations and ways to connect with knowledgeable physicians who understand the critical role airway plays in health and well-being.To make it easier to find someone with the right knowledge I would recommend reading two books: “Jaws: A Story of a Hidden Epidemic” by Paul Ehrlich, Sandra Kahn; and “Gasp!: Airway Health - The Hidden Path to Wellness” by Michael Gelb and Howard Hindin.Some resources that may be helpful are Dr. Stephen Parks podcasts (especially the expert interview series) and blog found on his website, Doctor Steven Y. Park, MD. At Airway Health | United States | Foundation for Airway Health there is a list of providers that have taken a pledge to actively work at helping patients with airway problems. A list of providers associated with the AAPMD (a professional organization focused on airway) can be found at AAPMD.org. There are some knowledgeable physicians at Vivos listed in their provider network as being an “integrated practice”.

I’m a doctor and usually give novel length answers. For sake of time on Christmas Eve I’ll try to be brief and leave statements as food for thought and your own exploration. This is a very personal question because your experience depends on how healthy you are and what means you have.To answer this question you have to set the stage by asking yourself and him a few questions.What do you see as the priority of how you define healthcare? Do you think of it from a treatment standpoint or prevention?Can you reasonably say you have even a good healthcare system if the system itself operates off of a growing deficit?Can you say you have the greatest healthcare system if a very significant portion of the population can not afford it?Let’s answer the main question by looking deeper into the salient sub questions that might effect your view of the system.What do you see as the priority of how you define healthcare? Do you think of it from a treatment standpoint or prevention?From the standpoint of treatments we certainly are near the head of the pack if not at the front. We have many internationally recognized facilities of excellence which draws the best doctors, researchers, and grant money. We have the cutting edge technology and a plethora of treatment regimens. One of the issues with treatments that is criticized is our FDA approval process. Of course the barriers and lag time are meant to protect consumers from potentially deadly treatments but it takes an excessive amount of time and requires a tremendous amount of money. This in turn is built into the cost of the drug or treatment once approved. Extremely high drug pricing is the norm to offset such things as phase trials cost, funding followup research into further indications and pipeline of drugs, offsetting marketing and making reduced drug price programs for special populations.From the standpoint of prevention we are doing horribly as a nation and on a global level. The focus of exemplifying our performance based on treatments has caused a windfall of improvement in mortality of things like cardiovascular disease and cancer. We have come a long way from 50 years ago when the predominance of medical disabilities were due to cardiovascular disease and cancer. The issue is in conditions which are heavily on the side of prevention. Mental health issues are reaching epidemic levels and are effecting many more children and young adults than prior was the case. Obesity is present in >2/3 of the population which is a much higher ratio than prior. Around 30% of children are now considered obese. Looking at the same statistics of medical disability in the ages past >50 years ago chronic pain issues (which have a significant association with mental health and obesity) and mental health issues accounted for ~20%. In recent years this portion of disability is >50%. We live in a society now where we are spending about 10k per person between insurance, administration of healthcare and treatments. Of this amount only about 3% or less than $300 per year are spent on public health issues which from my standpoint is the main arena for prevention. Our system has it backwards. We are focused too greatly on treatments and too little on prevention. It is almost understandable that prevention is so marginalized. There is no money in it! At least that is the case at the moment because of where the average health consumer puts their value and defines their relationship with their providers. How often have you seen commercials for the latest and greatest treatment for diabetes, cholesterol, blood pressure? How often do you see commercials for new weight loss drugs? The answer to the 1st question is “all of the time”. The answer to the 2nd is rarely, if ever. The irony is that obesity is a big contributor to diabetes, cholesterol, and blood pressure. If you improve the obesity statistics you automatically improve the 3 other diseases. Is it really ironic or is it on purpose? Again there is no money in prevention as it stands. People know their issues and yet they continue their ways that leads towards poor health. Therefore they become chronic drug “addicts” that continue to propagate the money making machine of big pharma. Ask yourself, which provides big pharma the most capital? Treatments for a chronic disease or treatments that would cure a disease even those classically considered chronic? Medical socioeconomic and political norms propels the healthcare system to focus on treatments. Prevention is not readily tangible so many people develop chronic diseases because of it and would willingingly pay for treatments to alleviate symptoms versus pay to meet preventative goals to never have the symptoms to begin with.Summary - we are great at treatment but horrible with prevention. This is vicious cycle in which our ability to treat and prolong life is great but we usually do this while sacrificing quality of life. Treatments may make you survive but often times you have a chronic condition with some sort of associated suffering. This creates a population of chronic disease “drug addicts” that have increasingly more medical issues and lost productivity. This further stretches our cost of care and strains our resources.Can you reasonably say you have even a good healthcare system if the system itself operates off of a growing deficit?The 1st sub question leads into this dilemma. The cost of care and growing deficit will eventually not be sustainable. Many complicated and intertwined issues has contributed to the explosion of cost of health care. One factor includes the cycle of increasing cost as insurance premiums rise to offset drug and procedure costs. Drugs and procedure costs rise partly due to cost sharing where overall cost has to rise to offset those who do not pay, are supported by government or do not have insurance. One hidden cost is that the stress that occurs with higher insurance premiums and lost potential for financial independence is further behaviors and habits that lead to chronic disease. It also limits your ability and willingness to pay for preventative measures.Can you say you have the greatest healthcare system if a very significant portion of the population can not afford it?A sicker population means a less productive population. The health of the nation overall effects our economics. Reduced GDP as well as cost of healthcare is the double edged sword of an ineffective health delivery system. We like to pretend that we have complete control of our outcomes which is independent of the suffering of others. The reality though is success may be determined predominantly by an internal locus of control. However, everyone effects us and our outcomes. You may be able to choose your support network but eventually the far reach of poor health and in particular mental health will reach you. It will either be directly through happenstance or indirectly by effecting the life and personality of a support unit and in turn you. This vicious cycle that is driving health care expenditure means more people are likely to become a chronic disease patient and potentially disabled. Less individual contribution to the workforce and cost of care drives increasing overall cost of care with cost sharing. This therefore decreases access to care for the simple fact it is increasingly unaffordable.There is no true standard for quality of execution. We practice evidenced base medicine but the delivery varies from place to place. The quality of care received even within a health facility is highly variable let alone facility to facility, city to city, and state to state. In comparison to other countries many of our procedures are multiples in cost higher than the same procedure in other countries with similar technicals of procedures used and outcomes. One stark example below is in one of the most common procedures in the US: Cardiac Bypass Graft surgeriesIn summary, from the standpoint of treatments we may be the best in many respects. However, if this remains our focus we will eventually implode either by the ballooning debt or decreased potential of the population as a whole. Remember, good treatments mean a longer but not always equally productive life. Resources become strained as the system becomes flooded with more chronic disease patients and sicker young patients.From the standpoint of primary prevention we are doing horribly. Look around, survey the statistics and you will see this to be the case. Few resources for prevention compared to treatment and a understandable inclination toward lack of active preventation due to a lack of immediately tangible value.P.S. I apologize that this did not end up being brief. The topic really got me going.Philip Tran MD is an actively practicing internal medicine physician. He focuses on preventative medicine through a holistic approach to care delivery. Patients are more than just people with diseased body parts. We are a summation of a spectrum of components that encompasses every aspect of our lives. To do better as patients and physicians we must understand and treat the whole of the human.Dr Tran works on creating community wellness programs as well as mentorship programs for youth and throughout the spectrum of age. He also contributes actively to the digital community through online blogs, personal web blog, and social media. His endeavors can be followed on Change JAX | Healthcare movement.

Apart from the well-known reason i.e. lack of exercise, it is due to impulsive eating between meals. This is triggered by hidden emotions like stress and loneliness. Eating provides instant gratification, that subsides these stress parameters for the time being. Other is eating without discretion, as what you are eating, and drinking less water (thirst is first manifested as hunger, which we fail to recognize, but surprisingly, it is diminished after drinking water). Also eating less fruits, which provide a sense of fullness rather quickly, so you actually eat less.