The Link Between Sleep Apnea & Your Oral Health

There have been numerous discussions about how our sleep relates to our oral health and how they could be linked to issues such as snoring, and insomnia. These can be signs of the sleep disorder called apnea. Sleep apnea can both contribute to oral health problems and can also be caused by dental problems. In this article, we take more of a deep dive into the link between sleep apnea and our oral health. 

What Is Sleep Apnea?

To begin, what is sleep apnea exactly? This is a very common sleep disorder affecting up to 25 million American adults today, according to the American Academy of Sleep Medicine. It has been characterized by apneas which are repeated interruptions in your breathing during sleep cycles. Apneas are caused by collapsed tissue within the airway which can be linked to weak airway muscles, being overweight, a large tongue, or other risk factors. Apneas make it so oxygen cannot reach the lungs. 

Therefore sleep apneas disrupt the sleep cycle, swallowing up your daytime energy, mental fortitude, and can eventually have long-term health effects. If apnea goes untreated it can be fatal due to the level of oxygen dropping in your system can increase blood pressure and cause strain to your heart. 

If you think you could be suffering from sleep apnea, common symptoms include: 

  • Frequent and loud snoring
  • Forgetfulness
  • Daytime fatigue and sleepiness
  • Reduced or absent breathing
  • Dry mouth and headaches upon waking
  • A decrease in concentration and focus 
  • Gasping for air during sleep 
  • Waking up often in the night 
  • Sexual dysfunction and/or decreased libido

In addition to the above, symptoms in women include anxiety, depression, insomnia, and various sleep issues such as frequent wakening. Children can experience asthma exacerbation, hyperactivity, bed-wetting, and academic performance problems.

There are some factors that put you at major risk of sleep apnea that you don't have very much control over such as being male or if you have a family history of sleep apnea or snoring. Being overweight is easily one of the largest risk factors of sleep apnea. 

  • Large tonsils or a large tongue 
  • Small jaw bone
  • Nasal or sinus problems
  • A large neck
  • Being over 40 years old 
  • Being a post-menopausal woman

Experiencing good, quality sleep helps keep you healthy in a number of ways but also reduces bad breath, mouth ulcers, and the development and progression of periodontal disease. Dental problems that are often associated with sleep apnea include TMJ (temporomandibular joint) disorders, teeth grinding disorders, and mouth breathing. 

TMJ

Evidence has pointed to TMJ disorders and sleep apnea going hand-in-hand. The TMJ connects to the lower jaw to the upper jaw so we all have two TMJ joints, one on each side. 

 

Symptoms of a TMJ disorder include:

  • Jaw pain
  • Pain throughout the head, neck, and shoulders
  • Problems chewing
  • Jaw joints that make clicking or grinding sounds
  • Locked jaw (the inability to open or close the mouth for a period of time)
A 2013 study reported that people who were more likely to have sleep apnea based on risk factors were also three times more likely to suffer from a TMJ disorder. The study also showed that people with two more signs of sleep apnea had a 73% higher risk for a TMJ disorder, disregarding their age, smoking history, weight, or race. 

Bruxism (Teeth Grinding or Jaw Clenching)

Grinding of the teeth and clenching of the jaw can happen at any time but frequently occurs while a person is sleeping. The technical term being Bruxism has negative effects on your sleep including waking up with headaches, neck and jaw pain.  Bruxism is considered a sleep-related disorder because it causes uncontrolled movement of the jaw during sleep. Many people may not even know they suffer from bruxism, but your dentist may discover evidence during a clean exam by identifying marks on your teeth. 

Other signs of bruxism your dentist may identify are loose teeth, eroded tooth surfaces, or cracked, chipped, or broken teeth. If they do find these, they may inquire if you've experienced any muscular pain in the head, neck, face, jaw, or shoulders along with dryness around the lips, mouth, and throat when waking.

Mouth Breathing

Sleep apnea forces a person to breathe through the mouth which results in dry mouth which can lead to tooth decay and other consequences such as plaque, mouth sores, gingivitis, and periodontal disease. 

Sleep Apnea in Children

Up to 4 percent of children between the ages of two and eight suffer from sleep apnea, according to The American Sleep Apnea Association. Childhood sleep apnea can pose a lot of serious health concerns including risks to oral health which is often overlooked. Sleep issues in kids typically involve mouth breathing, which can create serious problems for their teeth and gum health. 

Research has found a link between children's sleep issues and dental problems, including cavities and periodontal disease. Through dental exams, researchers discovered that kids with sleep disorders had three times the risk for cavities and also had deeper spaces, up to three times deeper that had been created by inflamed gums. They also had more gum bleeding, tooth sensitivity, and mouth sores. 

What To Keep An Eye Out For

Some symptoms of sleep apnea are specific to dental problems. Dental symptoms to look out for in both adults and children include:

  • clenching and grinding teeth during sleep, both loud and soft should be reason for concern 
  • tightness and pain in jaw joints
  • sore and raw spots from chewing the inside of one or both cheeks
  • dull headaches that start at the temples

Be sure to discuss the above symptoms with your dentist. They may suggest ways to alleviate them. Your medical doctor can determine if your symptoms are related to sleep apnea or another sleep disorder. 

Treatment

Your dentist may recommend being treated by your general practitioner or doctor depending on the problems you have associated with sleep apnea. Sleep apnea is typically diagnosed by a medical doctor who will provide the corrective treatment measures to take, such as a CPAP machine. 

Your dentist will then help you alleviate the dental symptoms through modifications in your daily behavior and routines, including improving sleep quality, managing dental health including orthodontic treatment, treatments for dry mouth, misaligned teeth, or a dental mouthpiece or manage grinding and clenching. 

Mouthpieces can be custom-made through dental or retail facilities and can range from pretty cheap depending on the quality to quite expensive but they certainly make a difference when you need one. Be sure to discuss the options with your dentist before purchasing. 

In Closing

Sleep disorders affect health in many ways and receiving consistent nightly sleep is important for feeling energized and balanced mentally and physically. If you are concerned you may have sleep apnea, talk to your doctor about getting tested to determine the root cause of your sleep problems. 


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