Seeing the Bigger Picture for Better Oral Health

With dental health affecting your cardiovascular to immune systems to prenatal health, the mouth is commonly referred to as the gateway to the body.  Dr. Rosa Nguyen, a partner dentist at Dental Depot DFW, has the technical skill and knowledge to deliver excellent patient care in areas of Orthodontics, Obstructive Sleep Apnea (OSA) and Therapeutic Botox.  She believes dental professionals are uniquely positioned to be guardians of that gateway. 

Underlying health conditions like hypertension, diabetes, or even cancer can first manifest themselves as periodontal (gum) disease, lesions in the mouth or breathing disorders.  Specifically trained to look for abnormalities and pathologies in the oral and maxillofacial structures, dentists are at the very forefront of preventive health, something Dr. Rosa—as she’s affectionately referred to by staff and patients—has personal experience with. 

“I’ve been told that I’m a guardian angel,” she says, referencing patients who were referred by her to a physician where a cancer diagnosis was found. 

“If you think about it, many of our patients see us more often than they see their own medical doctor.  We typically see them twice a year, if not more.”

 

Understanding the Why

Dr. Rosa is passionate about helping patients understand the association between their dental health and overall well-being. For her, dental conditions don’t happen as singular incidents; they are part of a larger picture, a patient’s “dental story.”  How they are addressed can impact future outcomes. 

“I like to know the ‘why,’” she says, “so we have a better treatment modality. That’s what eventually led me to further my education in orthodontics as well as dental sleep medicine.”

This commitment to understanding the “why” of a patient’s dental health and having many tools in her treatment “toolbox” have resulted in a professional evolution of constant growth and learning.

Unexpected Discoveries

Dr. Rosa began her dental career well over 20 years ago.  In 1997, she was accepted into the Dental Early Admissions Program at The University of Texas Health Sciences Center at San Antonio, the nation’s number one ranking dental school.  Although she was in this highly esteemed and highly selective program, her heart was set on medicine.  Her family background is heavily tied to the medical community.

However, during her training, she fell in love with dentistry.  She also met her husband—Dr. Vincent To, the orthodontist on the Dental Depot DFW team–further cementing her decision to follow dentistry.  Dr. Rosa had no real interest in orthodontics. Upon graduation, she moved back to the Dallas metroplex to begin her practice of general dentistry.  

As she became more mature in her career, she noticed patients would have many clinical questions on complex clinical situations.  “I felt like I had a sense of duty to learn and understand more.  I could help and serve them better if I had a greater understanding of true comprehensive dentistry.”

So she set out to learn more.  

Dr. Rosa completed an accelerated orthodontics program designed for post-doctorates.  During this two-year “mini” residency, she began to familiarize herself with the scientific background, clinical skill set and case studies.  There, she met Dr. Himesh Kana, a partner owner of Dental Depot DFW.  He was in the midst of building his first Dental Depot in Highland Village, Texas, and was then driving from Oklahoma to Dallas to attend the same course. As Dr. Kana began to grow his practice, Dr. Rosa joined Dr. Kana and began to offer orthodontics with Six Month Smiles.  As Dr. Rosa came into the practice, her and Dr. Kana had great discussions on true comprehensive dentistry, especially on the orthodontic specialty.  

“I was definitely in the right place,” confirms Dr. Rosa.

An Introduction to Invisalign

Over the years, many patients have inquired about comprehensive orthodontics, from adolescents to teens to adults.  Once Dr. Kana opened up the second Dental Depot in The Colony, Texas, he invited Dr. To to join the Dental Depot DFW team to provide these highly sought-after services.  

Once Dr. To joined the team, both Dr. To and Dr. Rosa quickly honed in on Invisalign® specifically, as this treatment was preferred by patients.  Dental Depot DFW is a Diamond Plus certified provider of Invisalign®, a qualification earned and for which just 1% of Invisalign® providers nationwide are accredited. 

As the volume of Invisalign® patients and the variety of cases grew, Dr. Rosa began to notice patterns in skeletal and facial structure, obstructive sleep apnea (OSA), and temporomandibular joint disorders (TMJ). Certain skeletal and alignment issues like a retruded mandible, crowded teeth or a narrow bite—conditions she saw frequently in her Invisalign® patients—can be key predictors of future TMJ and restricted airway concerns.  These irregularities can often be resolved by realigning the teeth with Invisalign® or opening up the airway with a sleep appliance. In fact, Dr. Rosa explains, “I know many dental sleep medicine doctors treating OSA patients through Invisalign®.”

This intersection of orthodontics and sleep apnea piqued her curiosity. 

Making Connections for Complete Dental Health

“I was already managing patients in oral devices for sleep apnea before I did their [iTero Element 2®] scan for Invisalign®,” she says, “and even though I didn’t make the sleep appliance, I saw what a difference it was making in those patients’ lives, and I wanted to know more.”

She also noticed that many of her Invisalign® patients who needed sleep appliances for OSA struggled with TMJ via clenching and grinding [bruxism].  During her rigorous diplomate training for the American Board of Dental Sleep Medicine, she discovered that “sleep apnea and TMJ tend to go hand in hand. You cannot understand or treat one without understanding or treating the other.” 

“I oftentimes see red flags, just by the clinical and skeletal presentation.  Those patients have a predisposition for snoring, sleep disordered breathing and possibly temporomandibular joint (TMJ) disorders,” Dr. Rosa says.  Catching those red flags early, she soon learned, could help her provide better care for her patients. 

“There is a high correlation between patients with obstructive sleep apnea and bruxism. A lot of patients with untreated obstructive sleep apnea will either develop TMJ, or TMJ was present before the OSA.  Was it the chicken before the egg, or vice versa?”

This emerging correlation eventually led Dr. Rosa to direct her efforts from managing Invisalign® patients to training junior doctors on the treatment so she could focus on her next challenge: finding better ways to help her OSA and TMJ patients.  

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