Did you know your teeth and mouth can provide valuable insights into your sleep quality? As a dentist, I’ve seen firsthand how understanding the relationship between oral health and sleep health can help people identify underlying sleep problems, like sleep apnea. From there, they can seek timely intervention to improve their sleep and overall health.

Here’s an overview of how oral health and sleep are connected, and how to take proactive steps to improve both.

Teeth grinding and sleep apnea

One of the most apparent connections between oral health and sleep apnea is teeth grinding, also known as bruxism. People with sleep apnea often grind or clench their teeth involuntarily as they sleep. This can result in worn-down enamel, tooth sensitivity, jaw pain, and dental damage.

Sleep apnea is a condition characterized by repeated interruptions in breathing during sleep. These interruptions are called apneas. They occur when a person’s airway becomes partially or completely blocked, and they can lead to temporary pauses in breathing, which can trigger involuntary jaw movements and bruxism episodes. The grinding is the body’s response to reopen a person’s airway and restore normal breathing.

Acid erosion and sleep apnea

Acid reflux and sleep apnea are two distinct conditions. But they often coexist or influence each other. Acid reflux is also known as gastroesophageal reflux (GERD), and it occurs when the stomach’s acidic content flows back into the esophagus. When this happens, it creates irritation and inflammation in a person’s airway. This causes the airway to narrow, making it more susceptible to obstruction during sleep.

Sleep apnea can also influence the occurrence and severity of acid reflux. During apnea episodes, the repeated cessation of breathing leads to negative pressure changes in the chest and abdomen. These changes promote the movement of stomach contents, including acid, into the esophagus.

Scalloping of the tongue and sleep apnea

Having a “scalloped tongue” means there are wavy or rippled indentations (resembling a pie crust) along the sides of your tongue. Most of the time, tongue scalloping is caused by swelling or inflammation, which can be brought on by sleep apnea or another type of sleep-disordered breathing.

When people have trouble breathing at night, they may subconsciously push their tongues against their teeth to open their airways—and this behavior can lead to tongue scalloping. A scalloped tongue can also occur when the jaw is narrow or constricted, thus leading to insufficient room for the tongue.

As many as 80 percent of people who have a scalloped tongue also have sleep apnea3, so it’s a marker you should pay attention to.

Mouth breathing and sleep apnea

Mouth breathing refers to the habit of breathing through the mouth instead of the nose. Occasional mouth breathing is normal, but chronic mouth breathing can lead to tooth decay, bleeding gums, and gum disease. Mouth breathing can also exacerbate the severity of sleep apnea.

When people breathe through their mouths, they bypass the nose’s natural filtering, warming, and humidifying functions. Consequently, the air entering the airway is colder, drier, and less filtered. This can lead to increased inflammation of the upper airway and contribute to airway obstruction.

Mouth breathing can also affect the position of the tongue and jaw, and this can lead to further airway obstruction during sleep. A lowered tongue position and lack of support from closed lips may cause the tongue to fall back more easily and partially block a person’s airway.

Dental abnormalities and sleep apnea

Certain dental abnormalities may indicate sleep apnea or a smaller airway, which can make people more prone to obstruction during sleep. These abnormalities include:

  • Crowded or misaligned teeth: Crowded or misaligned teeth can affect the oral cavity’s structure and lead to a narrower airway.
  • Narrow palate: A narrow palate refers to a smaller width of the roof of the mouth. This can reduce the available space for the tongue and other soft tissues and may contribute to airway obstruction during sleep.
  • Tongue tie: Also known as ankyloglossia, tongue tie is a condition in which the tissue connecting the tongue to the floor of the mouth is abnormally tight or short. This can restrict the tongue’s position and movement and impact breathing during sleep.
  • Crowded dental arch: A crowded dental arch refers to a narrow alignment of the upper or lower teeth. Similar to misaligned teeth, a crowded dental arch can affect the space available in the oral cavity and contribute to a smaller airway.
  • Enlarged tonsils and adenoids: Tonsils and adenoids are part of the immune system. They’re located in the back of the throat. And when they become enlarged, they can obstruct the airway during sleep.
  • Excess tissue in the back of the throat: Some people have excess soft tissue in the backs of their throats, which can partially block their airways during sleep.

The takeaway

Your teeth and mouth can provide valuable clues about your sleep quality and potential sleep disturbances, like sleep apnea. By paying attention to oral health issues and abnormalities, you can take proactive steps to identify and address underlying sleep problems.

Remember to consult with healthcare professionals, such as dentists or sleep specialists, who can provide accurate diagnoses and personalized treatment plans. With their expertise and a proactive approach to oral health, you can achieve better sleep and a healthier life.

Reference: Posted in MGBHealth (2023), Available at: https://www.mindbodygreen.com/articles/sleep-health-dental-health (Accessed: 13 September, 2024)