“How have you been sleeping lately?” is a question that many patients expect from their primary care physician, NOT from their dentist. However, your sleeping habits may have more impact on your mouth than you realize. Sleep apnea is a disorder which affects more than 18 million Americans and the first sign of trouble is often indicated by symptoms which appear in your mouth and can be identified by your dentist.
• What is Sleep Apnea, Anyway? Sleep apnea involves the cessation of breathing during the night. Patients can be completely unaware of their own loss of breath and have no memory of waking up during the night or of experiencing disturbed sleep. Regardless of whether or not the patient is aware that he or she stops breathing, sleep apnea causes interrupted breathing up to 30 times per hour. Pauses in breathing can last for a few seconds or even a few minutes.
You may be wondering why an often undetected disorder like sleep apnea would be problematic. For starters, an interruption in your breath cycle causes your sleep to become disturbed as well. This means that patients with sleep apnea never get the benefit of a “good night’s sleep” and often feel drowsy, lethargic, and inattentive during the day. Patients with sleep apnea often report headaches, memory loss, irritability, and morning sinus pain. Sleep apnea is also linked to serious health problems such as high blood pressure, diabetes, and heart disease.
• What will my Dentist Look for? There are a number of signs your dentist can look for to help identify sleep apnea. Some symptoms associated with sleep apnea may cause physical changes within the mouth. The first signs of sleep apnea are often caused by bruxism, which is the medical term used to describe tooth grinding. If you grind your teeth while sleeping, your dentist may notice that the surface of your teeth have a particularly worn appearance.
In more extreme cases of bruxism, patients may actually crack their enamel or break a tooth. Bruxism can also lead to worn and bleeding gum tissue, which shouldn’t escape the attention of a dentist during an exam. Because bruxism is so damaging to tooth enamel, tooth grinders may also experience an increase in cavities, or more cavities than the average patient. Bacteria find their way into the crevices of a damaged tooth damaged by bruxism and begin to decay the enamel.
Other symptoms of sleep apnea that your dentist may notice include a small jaw, and an irritated tongue with ulcers or scalloped edges. Sometimes, a patient with sleep apnea will have a red or swollen throat. An irritated throat can be caused by the snoring associated with sleep apnea.
• What are my Treatment Options? If your dentist is concerned that sleep apnea is at the root of the issues you are experiencing, he or she will probably recommend a sleep study. During a sleep study, a specialist will track and record your bodily functions, such as brain activity and heart rate, while you sleep. Only a medical doctor is able to give an affirmative diagnosis of sleep apnea. For those diagnosed with sleep apnea, one treatment option is to use CPAP (positive airway pressure) therapy. CPAP therapy involves wearing a lightweight mask, which is connected by tubes to a machine, while sleeping. Another option for sleep apnea is to undergo a surgical procedure to alter the airways and promote more stable breathing during sleep. As an alternative to CPAP therapy or undergoing surgery, many patients seek out and utilize oral appliance therapy. In oral appliance therapy, a custom-fitted mouth guard, which keeps the airways open, is worn during sleep.
Have you experienced any of the signs of sleep apnea? If so, don’t hesitate to ask your dentist or primary care physician to take a closer look. Remember that your body is a highly integrated system; oral health affects overall health, and vice versa. We want to see you “get your smile on,” but we hope you’re getting appropriate shut-eye, too!
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