Can a dentist help you with your bad dreams?

Surprised? Thought dentistry was only about drilling and fillings?  

Known medically as sleep apnea, dentists are the first doctors to identify such an issue.

Definition of sleep apneaA shortness or gasping for breath that recurs multiple times during sleep and is caused especially due to obstruction of the airway or a disturbance in the brain's respiratory centre

Apnea is a Greek word meaning want of breath

It causes snoring, sleep disturbances, daytime sleepiness, bad breath, gum swelling, dry mouth, bad dreams, increased risk of heart diseases, high blood pressure and stroke.

The more common type being obstructive sleep apnea, induces breathing from mouth, resulting in dryness in the mouth and a bad “morning breath”.

 These symptoms being just the tip of the iceberg, sleep apnea can also be cause due to dental issues and anatomical changes in the mouth.

What causes the obstruction in the airway during sleeping?

The muscles of the upper air passage relax during sleep. This increases the chances of collapse. With the sleeping position itself increasing the chances of blockade of the upper airway, certain structural and organic factors cause sleep apnea.

General body factors that cause sleep apnea

·         Obesity: An increased body weight with the BMI of greater than 30 results in increased risk of sleep apnea. This is because the fat present around the neck further compresses the already partially collapsed airway, resulting in choking.

·         Swelling: Swelling of the upper air passage, which might be a short term swelling due to flu or sore throat, or a long term swelling results in obstruction of the pathway of air flow which is more pronounced at night, resulting in sleep apnea

Dental related factors that cause sleep apnea

 Since the upper air passage passes through the back of the mouth, structural abnormalities in the mouth contribute to blocking the airway.

·         Large tongue:  A larger than normal tongue, either due to some allergic reaction or a short term swelling, to a structurally large tongue present since birth can contribute to the obstruction of the airway during sleep.

·         Small lower jaw:  It has a relatively common occurrence of around 8%-10% of the population. While sleeping the lower jaw retracts and falls back due to the relaxation of the muscles. A smaller lower jaw causes greater constriction of the airway passage than a normal sized jaw

·         Loss of multiple teeth: Loss of teeth in the age of 25 – 64 years increases the risk of developing sleep apnea*. This is due to loss of bone height in the area of tooth loss. Also there is weakening of muscles that help in chewing with each tooth lost. As the number of teeth lost increases the chances of developing sleep apnea increases.

·         Gum diseases: The worrisome part of this is that around 70% of the world population is affected by gum diseases. With this being a risk factor for developing sleep apnea, attention to gum diseases is required not only from a dental point of view, but for the wellbeing of the entire body.  

What are the damages caused due to sleep apnea?

Due to the obstruction of the airway repetitively during sleep there is a feeling of choking or gasping for air, that might disturb one’s sleep. This would result in

·         Day time sleepiness

·         Tiredness

·         Bad dreams

With long standing sleep apnea, the oxygen levels in the blood decrease, resulting in

·         increased blood pressure

·         increased chances of stroke.  

Dental issues caused by sleep apnea

 If you are experiencing “bad breath” despite good oral hygiene, it might be the first sign of sleep apnea

It is important not to ignore bad breath because along with it being a social stigma, bad breath also signifies the underlying conditions in the mouth or even the rest of the body

If you have been brushing and flossing properly and still face bad breath get it evaluated.

The first symptoms of sleep apnea are seen in the mouth and include

·         Jaw pain

·         Headaches in the morning on waking up

·         Pain in the neck or shoulders

·         Swelling in the gums

·         Tooth sensitivity that has originated suddenly

·         A dry mouth on waking up

·         A very pungent “morning breath”

·         An increased incidence of tooth cavities, despite proper brushing

The symptoms of sleep apnea are presented in the mouth because when there is obstruction in the upper airway, involuntarily people try to breath from the mouth to compensate for the lack of air. This results in the saliva drying up. The saliva acts as a protective barrier in the mouth, preventing the growth of bacterial colonies. With the saliva drying off the bacteria can divide easily resulting in the bad breath and increased tooth cavities.

The rise of sudden sensitivity due to sleep apnea is due to the reason that sleep apnea is generally associated with grinding of teeth in the night known as “bruxism”

What is the treatment of sleep apnea?

 The principal cause of sleep apnea is obesity that compresses the already compromised airway.

After the complete proper evaluation, a team of doctors with different specialities including a sleep specialist is required.

The dentist along with being the first one to diagnose sleep apnea also plays a major role in the treatment with the construction of mouth guards and devices that help in positioning the lower jaw in a manner that helps in keeping the airway open.

Stop feeling conscious about you bad breath.  TREAT THE UNDERLYING REASON INSTEAD

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