Sleep Apnea at the Dentist

A scientist examines the wear and tear on stalagmites and stalactites to read the stories of natural history. Likewise, a dentist peering into your mouth can read your sleep story from the grooves in your top and bottom teeth.

In fact, your dentist may realize you have a sleep disorder before your primary care physician does. That's because if you're like most patients, you see your dentist more often than any other medical provider. You also spend more time in direct contact with him or her during an average visit.

Since 1995, dentists have been recommending patients for sleep studies based on their assessment of risk factors for obstructive sleep apnea (OSA). More recently, members of the American Academy of Dental Sleep Medicine (AADSM) began using oral appliance therapy to treat sleep problems.

The Stories Your Teeth Tell

What do your teeth tell a dentist about your sleep habits? During a routine dental exam, the dentist checks for signs of bruxism (teeth grinding). These signs include damage to cheeks or underlying bones, grooves on teeth, or unusually smooth teeth. You may already know if you have bruxism because you wake up with a headache, a cramped jaw, or a stiff neck from grinding your teeth during the night.

Many factors can cause bruxism, but since 25% of people with sleep apnea grind their teeth at night, it's a sign to a dentist to inquire about the quality of your time in dreamland. There are two theories about why sleep apnea and teeth grinding are related:

1. Sleep events or arousals--those awakenings during the night to catch your breath--flood the body with stress hormones. Many people deal with these hormones by clenching their jaw and grinding.

2. The brain counters a collapsing airway by signalling the jaw to tighten. This response helps strengthen the soft walls of the throat, preventing further erosion of the air passages.

Could be either or both, but in any case, it’s not great for your body.

How Your Dentist Can Help You Sleep Better

Dentists examine the anatomy of your mouth and nasal passages for signs you may be at risk of or suffering from sleep apnea. They're looking for unusually shaped or small air passages leading from the mouth into the nasopharynx (that’s the back of your nose above your soft palate). These passages can easily collapse or otherwise obstruct airflow causing sleep disorders.

Dentists can help control snoring and OSA both by recommending at-risk patients for sleep tests and by using alternate treatments like oral appliance therapy. This new kind of therapy is a dental alternative to CPAP machines in which dentists custom build a mouth guard that helps keep airways open.

According to the AADSM,

"It fits like a sports mouthguard or orthodontic retainer. A custom-fit oral sleep appliance is an effective treatment that prevents the airway from collapsing by supporting the jaw in a forward position."

People who can’t use CPAP machines or who have only a few sleep episodes per night (as opposed to a few per hour) may want to inquire about oral appliance therapy. Listening to your dentist can be a great way to prevent wear and tear on teeth--and help your mouth start to tell a more relaxing bedtime story.