Many people are surprised to hear their dentists asking questions about sleep. “Do you snore? Do you feel tired throughout the day? Does your bed-partner hear gasping or choking sounds while you sleep?” These probing questions help us understand your risk for the condition known as sleep apnea. The reason your dentist cares about a sleep problem is because dental treatment can help!
Sleep apnea, or more specifically Obstructive Sleep Apnea (OSA), is a condition during which a person stops breathing while he or she is sleeping. The word apnea literally means “not breathing”. Any interruption in breathing can lead to a lack of oxygen in the blood and to the brain, so this is a serious medical condition.
There are two major categories of sleep apnea. The one we have already mentioned is obstructive. This is the type of sleep apnea on which dental treatment can have a positive effect. In OSA, the cause behind the disruption in breathing is a restriction or obstruction of the airway. When something blocks the passage from the nose and mouth to the lungs, breathing stops, and oxygen levels drop.
The other is Central Sleep Apnea. In a central apnea, the cause behind the lack of breathing is a problem with the breathing reflex in the brain. This is obviously much more complicated and requires treatment by a medical doctor who specializes in sleep disorders.
The lack of blood flow to the brain, caused by the disruption in breathing, leads to a reflex response. The brain signals the body to do a few things in order to get some much needed oxygen. The most common thing that occurs is the brain tells the body to “wake up”! During OSA, your sleep is constantly disrupted by the need for oxygen. A person with sleep apnea is unable to reach consistent, deep levels of sleep.
This poor quality of sleep leads to daytime sleepiness, and even more important than that, it leads to a higher risk for other diseases. Not only does the tiredness and fatigue that accompanies sleep apnea place you at a higher risk for accidents and injuries. Patients with sleep apnea are also more likely to suffer from heart attacks and strokes. Up to 70% of patients with obstructive sleep apnea have high blood pressure. They tend to struggle with weight gain and obesity, which in turn increases the risk for Type II Diabetes.
Some research studies, showing the importance of quality sleep to your body’s ability to heal and repair at the cellular level, even link sleep apnea to an increased risk for cancer!
Another message from the brain in response to a drop in oxygen levels is “open the airway”! The lower jaw responds to the message by clenching the teeth together or pushing the lower jaw forward in a grinding motion. People often ask the question, “Why do I clench/grind my teeth? I don’t feel stressed out!” The answer may be that your clenching or grinding is your body’s attempt to open the airway and improve blood oxygen levels to your brain.
The consequences of these heavy forces on the teeth are many. People with sleep apnea and its accompanying disorder of bruxism (the official term for nighttime clenching and/or grinding) may experience one or more of the following symptoms:
Untreated sleep apnea can lead to the need for expensive dental treatment to restore and repair these problems.
First of all, we can protect your teeth against the dental consequences of Obstructive Sleep Apnea. When one of our knowledgeable dentists finds evidence of nighttime clenching and/or grinding in your mouth, we will recommend a preventive option to stop further damage. This will not affect the apnea itself. It will simply prevent more destruction to the teeth, gums, muscles and jaw joints. By wearing a custom-made professional nightguard to separate the teeth and reduce forces on the teeth and joints, you can prevent these problems from occurring.
There are dental treatments that have an effect on the size of the airway, and these treatments do have an effect on the apnea. By opening the airway, either temporarily or permanently, we improve breathing ability and oxygen levels during sleep.
A temporary option for opening the airway is using a dental appliance during sleep known as a Mandibular Advancement Device (MAD). Some doctors also refer to this as OAT, which stands for Oral Appliance Therapy. An oral appliance improves sleep apnea by repositioning the lower jaw. When the lower jaw is closed and slightly protruded, the airway is open. This creates the opposite effect that you see with the jaw hanging slackly open and pushing back against the throat. By wearing this type of appliance during sleep, you can temporarily open your airway, allowing better airflow and higher oxygen levels in the blood and brain.
We can also affect a permanent improvement on the airway through orthodontic treatment. In general, our ability to have a positive impact on the size of the airway is limited to periods of growth. This means the orthodontic treatment that will be most effective at lowering the risk for sleep apnea needs to occur during adolescence and teen years.
At Premier Dental of Ohio, our dentists have a high level of training in the recognition of growth patterns that could lead to airway problems. We believe in interceptive treatment to stop those issues before they begin. The broad generalizations for orthodontic treatments that produce an optimal airway are expansion of the upper jaw and forward positioning of a retruded lower jaw. When we use orthodontic treatment to align the teeth into the best bite relationship, it naturally allows the lower teeth to come forward into a perfect, puzzle-piece fit with the upper teeth.
Call your nearest Premier Dental of Ohio location today to schedule a consultation with one of our wonderful dentists. We can answer any questions you have about obstructive sleep apnea and its effects on your teeth. We are happy to help our patients find solutions that work for them and lead to a better quality of sleep!
