How are you sleeping? Your dentist wants to know
By Katie Dastoli, RDH
If a survey was conducted in a room full of adults asking them how they are sleeping, it is likely that the majority would respond, “not so well.” In fact, one of the most common health complaints heard in doctors’ offices around the country is fatigue.
While there are numerous health issues and disorders that can lead to this chronic symptom, there is one that is starting to pop up more often in discussion at the dentist, and that is sleep apnea.
“Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts,” according to the Mayo Clinic. There are three main types of sleep apnea, with the most common being obstructive sleep apnea, which occurs “when the throat muscles relax.”
Many patients are often surprised to learn there is a link between their oral health and their quality of sleep, but the proof is in their mouths.
It is important to recognize that dentists are educated in anatomy beyond the mouth and possess the knowledge to properly observe and assess for common signs of a sleep disorder. As reported by the American Dental Association, “when conducting a standard evaluation of the patient’s oral cavity, dentists are ideally positioned to identify oral or craniofacial abnormalities or other anatomical factors,” that could result in sleep apnea.
Some easily observable signs discovered during the dental exam include a large tongue or enlarged tonsils and certain jaw relationships. Additional examples of evidence include worn, cracked or chipped teeth as a result of bruxism (grinding/clenching the teeth together) and dry mouth due to mouth breathing.
Additionally, symptoms of sleep apnea that can be uncovered during a thorough discussion with your dentist are jaw pain, pain throughout the head, neck, and shoulders; problems chewing, jaw joints that make clicking or grinding sounds and history of locked jaw. Your dentist may also ask if you are experiencing any of the following: Loud snoring, episodes in which you stop breathing during sleep, gasping for air during sleep, waking up with a dry mouth, morning headaches, insomnia, hypersomnia and even difficulty paying attention.
How can your dentist help?
Most often, the first step is a recommendation to follow up with your primary care provider to discuss interest in a sleep study or a consultation with a sleep medicine professional. Meanwhile, back in the dental chair, there are a number of dental appliances that some dental offices will customize for their patients. Most devices are meant to be worn during sleeping hours to keep the teeth from occluding in an effort to protect the teeth, while others are more complex, such as mandibular advancement appliances, which are made to keep the airway open while you sleep by bringing the lower jaw forward and keeping the tongue from blocking the throat.
Oral appliance therapy is not for everybody. One form of therapy that is starting to garner more attention in the dental field is myofunctional therapy, which helps to correct the root causes of sleep issues, like underdeveloped jaws and airways. Myofunctional therapy is not just for adults — children with sleep issues can benefit from it, too. The theory behind this form of therapy is that it can “encourage the development of the jaw to improve breathing, make room for teeth, and more.” For children, it often utilizes a combination of both exercises and orthodontics.
Myofunctional therapy is still a fairly new focus for those in the field of dentistry, and unfortunately, myofunctional practitioners are not easy to find.
Many dentists realize that more collaboration with other professionals such as orthodontists, speech pathologists and sleep specialists is needed in order to provide more access to care for patients. Patients’ overall health, not just their oral health is of great importance. Sleep apnea, if left untreated, can lead to a myriad of serious health issues.
So, if you feel you’re not getting enough sleep these days, the reason might be right under your nose. It’s a matter that should be brought to your dentist’s attention sooner rather than later.
In other words, don’t sleep on it.
Katie Dastoli is a registered dental hygienist at Cochrane Dental Associates in Northampton, Mass.