Sleep Disordered Breathing
Sleep disordered breathing refers to 3 slightly different conditions.
#1. is simple snoring which may or may not be a problem.
#2. upper airway resistance syndrome and
#3. obstructive sleep apnea.
These 3 airway problems are closely related and differ only in severity. Sleep Disorders are slowly being recognized as major factors in human illness and premature death.
For many snoring does not involve a serious medical disorder. However, snoring can often be a warning sign of a serious health problem where the airway closes during sleep and may even become life – threatening. Snoring is caused by the uvula and the soft palate vibrating due to the passage of air over them as the patient inhales. This is usually more pronounced if the patient is lying on his/her back. It also becomes more severe as the person snoring falls deeper into sleep as his throat relaxes. It is even further exacerbated if the patient has consumed alcohol before bed-time. As the airflow is disrupted the amount of oxygen absorbed into the blood stream in the lungs is reduced. The more severe the snoring, the more reduced the blood oxygen level. In a hospital setting alarms go off when the blood oxygen level drops below 90%. As the oxygen level drops many people respond by grinding or clenching their teeth. This grinding/clenching also know as bruxism, is a MAJOR factor damaging peoples teeth today. People grind and clench to reposition their mandibles so as to open the airway. This happens far more often than society is acknowledging at the moment. Every Dentist sees examples of the results of this bruxism in their practices every single day. It is one of the major factors in the breakdown of peoples dentitions today. The stress on the cardiovascular system from having to struggle harder to raise the oxygen level is huge. It may be a major pre-disposing factor in cardiovascular disease. This low oxygen level is also damaging to any tissue which relies heavily on a high oxygen level…mainly the brain and the retina’s.
The tongue also plays a major role in obstructive sleep apnea. The tongue has a tendency to fall back into the airway when sleeping. When a patients bite/occlusion is worn the mouth becomes smaller, the volume of air becomes less, and relatively speaking the tongue appears to be bigger. The tongue is not bigger, but relative to the rest of the mouth it becomes a larger obstruction in the airway. Also as the bite/occlusion breaks down the lower jaw tends to be positioned more to the back pushing the back of the tongue into the back of the throat thus closing the airway.
Indications of poor sleep include:
- Daytime sleepiness
- Headache or jaw soreness
- Dozing easily when reading, watching TV, or driving
- Anxiety with breathlessness
How Does My Dentist Know That I Grind My Teeth?
Cardinal signs of Bruxism (teeth grinding)
- the dentist will often observe a wear pattern in the front teeth, usually centered around the canine (eye tooth). This wear pattern will usually match up with the bottom teeth only when the jaw is protruded into some very un-natural position. It is often a position that the patient will have a hard time believing that he ever goes to This is NOT from chewing.
- the dentist will often observe abfractions. These appear as notches in the side of teeth aqt the gum-line. Many years ago a Dentist may have told you that this was from tooth brush abrasion. This is not true. It is now known that these lesions in the side of the teeth occur due to stress. Only from the degree of stress that is placed on teeth when people brux of grind. Whe people brus/grind it is to open their airway and breath better. This is often done with a lot of force…far more force than teeth are engineered to withstand. This force is a lateral force and it causes the tooth to flex, causing the hard brittle enamel to pop off. When these types of lesions are newer, they are very distinct and sharp however as time goes by they do get smoothed out by the tooth -brush. This will make the tooth look longer as the gum level gets higher. The tooth is actually getting shorter and the airway smaller.
- the dentist will often observe dental pooling. Dentinal pooling is a dental term used to describe the erosion of enamel off of the top surface of the teeth. It usually appears in the 1st molars first and then moves forward. The acid is from acid reflux which is another side-effect of what is going on when the oxygen level is low, and the heart is pounding, and the blood-pressure is soaring, and the intra-abdominal pressure is high causing stomach acids to flow back up into the mouth. Acid -reflux is a very common problem and is very evident in some peoples mouths. Another term for this acid reflux is GERD. GERD is an acronym for Gastrointestinal/Esphogeal/Reflus/Disease. This could sometimes be mistaken for Bullemia, but the Bullemic acid erosion pattern is different.
- a very common sign of Bruxism is broken teeth. When a person is Bruxing his/her teeth, they will break anything! Not only will they break teeth, but they will break crowns, bridges, or pretty much anything that any Dentist may ever construct. When a patient is sound asleep and having a hard time breathing…don’t get in between their teeth. It could be hazardous!
How Do I Know If I Grind My Teeth or If I Have A Sleep Disorder?
These two problems are often opposite sides of the same coin. Bruxism can lead to worn/broken/missing teeth. Which can lead to worn diseased TMJ joints which can lead to airway/sleep problems OR An airway/sleep problems can lead to bruxism, can lead to worn/broken/missing teeth, can lead to TMJ problems !! Signs of both are:
- Headaches(migraines, tension headaches)
- Vertigo or dizziness and nausea
- TMJ pain, clicking and popping sounds in the TMJ’s when opening and closing.
- Worn/broken/missing teeth
- Neck and back pain
- Tiredness/fatigue and irritability
- Eye pain
- Excessive daytime sleepiness, especially while watching a movie or driving
- Falling asleep while stopped at a red light
- Poor memory
- Acid reflux, GERD
If you have any of these signs please call us to book a complimentary consult appointment.
- Treatment – Oral Airway Appliance
- Diagnosis – To determine if you are a sleep appliance candidate our office performs a complete dental history, screening exam and diagnostic tests as well as referring out to a sleep specialist for a medical assessment and a sleep study when indicated.
If you or someone you love experience sleep problems, we can help. Call today for further details.