The Link Between Oral Health and Sleep Apnea

What is Sleep Apnea?

Sleep apnea is a potentially life-threatening sleep disorder characterized by interrupted breathing while asleep. This can lead to a lack of adequate oxygen, which causes individuals to repeatedly waken and gasp for air. If untreated, sleep apnea can lead to several serious health conditions, such as heart disease, stroke, and diabetes.

The Connection Between Sleep Apnea and Dentistry

Sleep apnea can significantly impact your oral health. Individuals with sleep apnea are at a higher risk of developing oral issues including dry mouth, tooth decay, teeth grinding, temporomandibular joint disorder, jaw pain, tooth sensitivity, bad breath, mouth sores, and gum disease. Your dental professional can be a valuable resource in helping you manage sleep apnea and its oral side effects.

TMJ

Research has suggested a potential link between sleep apnea and TMJ. Reports have found this association to be a two-way link. That is, in some cases TMJ may lead to sleep apnea, and in other cases sleep apnea may contribute to TMJ problems. Your healthcare providers can help with diagnosis and management of both TMJ and sleep apnea.

Bruxism

Bruxism, also known as teeth grinding, is common for some individuals when sleeping. Teeth grinding may occur in someone suffering from sleep apnea due to attempts to open the airway so that they can breathe. Teeth grinding can cause significant wear to teeth and cause other oral issues over time if not treated.

Overbite

An improper overbite can lead to many health issues, and that includes sleep apnea. Due to improper positioning of the jaws, individuals may experience mouth breathing, snoring, and airway collapse.

Mouth Breathing

Some studies have shown a possible link between mouth breathing and worsening of obstructive sleep apnea. Mouth breathing can not only increase your risk of developing oral infection and tooth decay, but also increase airway collapse and nasal blockage.

Dry Mouth

As patients with sleep apnea attempt to reopen their airway to breath better during sleep, this can lead to dry mouth. Consequently, individuals with dry mouth are more likely to experience tooth decay, bad breath, oral infections like gum disease, and other oral issues.

Periodontitis

Periodontitis is a severe form of gum disease that is linked to several health conditions including sleep apnea. Research suggests that sleep apnea may worsen symptoms of gum disease, which can lead to harmful oral bacterial overgrowth and potential tooth loss.

Sleep Apnea in Children

• According to the National Library of Medicine, approximately 1-5% children have obstructive sleep apnea.
• The American Academy of Pediatrics (AAP) reports that obstructive sleep apnea is commonly underdiagnosed.
• Common causes of obstructive sleep apnea in children include enlarged tonsils and adenoids, obesity, family history of obstructive sleep apnea, and certain medical conditions like Down syndrome or cerebral palsy.
• For diagnosis, a medical doctor may ask questions using a sleep apnea questionnaire or suggest a sleep study known as a polysomnography.
• Treatment for childhood sleep apnea can range from tonsil and adenoid removal, mouth and throat exercises, orthodontics, continuous positive airway pressure (CPAP), allergy treatment, or simply close monitoring with frequent follow-ups and education on quality sleep habits.

Dental Treatments for Sleep Apnea

Continuous Positive Air Pressure (CPAP)

Continuous positive air pressure (CPAP) is a common treatment option that is designed to improve breathing during sleep. Air is supplied through the nose at a constant pressure to keep the airway open while sleeping.

Bi-Level Positive Airway Pressure (BiPAP)

Bilevel airway pressure (BiPAP) serves a similar purpose as CPAP device in providing air to keep the airway open, but uses a two-pressure system. BiPAPs provide one level of air pressure during inhalation and a different pressure setting for exhalation.

Oral Appliances

Oral appliances may be recommended as treatment for mild and moderate cases of sleep apnea. Oral appliances for sleep apnea are often designed to shift the jaw to allow for better airflow.

Oral Surgery

Upper airway surgery may be recommended to treat sleep apnea. It may also require removal of the tonsils, or parts of the soft palate or throat.

Adjusting Jaw Position

Repositioning the jaws into proper positions can prevent airway obstruction and resolve sleep apnea. This procedure, often referred to as maxillomandibular advancement, is often performed with the help of an orthodontist and oral surgeon.

Nerve Stimulation

In individuals with an improper tongue position, treatment with nerve stimulation can help control tongue movement to prevent airway collapse.

Clearing Blocked Airways

Blocked airways may be cleared with the help of tissue removal. This surgery, also referred to as uvulopalatopharyngoplasty involves removing tissue near the throat area to help reduce symptoms of sleep apnea.

Creating a New Air Passage

In cases of severe sleep apnea, a tracheostomy may be recommended to help create a new air passage to allow you to breathe.

Reducing Tissue Size

Another common procedure to treat sleep apnea is to shrink the tissue towards the back of the throat to help open the upper airway.

Dental Implants

In some cases, individuals may benefit from surgical implant placement in the soft palate, which helps limit vibration that causes snoring and other symptoms of obstructive sleep apnea.

Positional Therapy

Positional therapy involves using certain devices to help prevent individuals from sleeping on their backs. Some devices may use vibrations, or make it uncomfortable for you to shift on such as a tennis ball, special pillow, or backpack.

Oral Care Tips for Sleep Apnea Patients

Brush & Floss Daily

Maintaining good oral health is necessary to counteract the negative oral side effects of sleep apnea. Make sure to brush your teeth at least twice a day and floss at least one a day.

Adjusting Lifestyle Habits

Certain lifestyle choices can help treat your sleep apnea. This can include regular exercise, healthy eating, implementing a regular sleep schedule, sleeping on the side of the body, limiting alcohol, and quitting smoking.

Avoid Beverages

Avoid alcohol use, which can relax airway muscles and worsen sleep apnea.

Quit Smoking

Quitting smoking can help improve your overall health and well-being. According to research, smokers are 3X more likely to have obstructive sleep apnea than those who do not smoke. Smoking can cause swelling and fluid buildup in the airway.

Visit the Dentist Regularly

Visiting the dentist for routine check-ups is necessary can play a major role in maintaining your health. Dentists can be a valuable resource for managing sleep apnea and oral conditions associated with the condition. Your dentist can detect signs of sleep apnea and get you on track to having better sleep and a healthier smile.

Conclusion

Sleep apnea affects many people and can impact more than just your quality of sleep. Sleep apnea causes interrupted airflow during sleep, leading to lack of adequate oxygen, fatigue, and many oral problems like jaw pain, teeth grinding, dry mouth, gum disease, and more. Dental professionals can offer additional help in the management of sleep apnea. If you are experiencing symptoms of sleep apnea, schedule an appointment with your medical and dental professionals for more information and possible evaluation.