I recently spent the day in a class about bruxism. That’s tooth grinding, or gnashing of teeth. I fully expected this to be a rehash of many of the things I’ve learned over the years. But instead, it offered a new perspective on a number of dental issues and how they relate to medical and developmental issues.
We’ve known for many years now the toll that sleep apnea takes on our bodies. Obstructive sleep apnea (OSA) is a cessation of breathing at night due to collapse of the airway. This starves the body of oxygen and leads to poor sleep, excessive tiredness during the day, poor memory, anxiety, depression, weight gain, heart arrhythmias, heart attack, and stroke.
Upper Airway Resistance Syndrome (UARS) is a less severe airway restriction that causes many of the same symptoms as OSA. The airway is not completely blocked, so there is no apnea and oxygen levels don’t drop as low as they do in OSA. But in UARS, the body has to exert more effort to breathe and, as a result, deep sleep and REM sleep are interrupted resulting in poor memory, daytime sleepiness, anxiety and depression. UARS also can cause gastric reflux due to excessive forces in the abdomen required to continue breathing with the airway restriction. Unfortunately, the diagnosis of UARS is more subtle, and when a sleep study is done, they may only be looking for OSA.
Do you grind your teeth at night? This could be an attempt by your body to keep the airway open.
The body may try to prevent airway collapse by stimulating muscle activity during sleep which can result in nighttime grinding noises. The extra muscle activity at night can cause excessive tooth wear, sore muscles, or TMJ pains.
Sleep apnea in children is pretty uncommon, but UARS seems to be much more prevalent. Children with UARS can experience bruxism or tooth grinding which may cause poor sleep. In children, the interruption of deep sleep, and resulting poor memory can lead to poor performance in school. Long term, it can lead to cognitive impairment, orthodontic problems and skeletal development issues. Children may benefit from earlier orthodontics or surgical removal of tonsils to enlarge the airway.
For adults with OSA, a CPAP machine is often used as treatment. It pushes air through a face mask making it easier to breath when the airway tries to close. This device would work for people suffering with UARS also, but these machines can be uncomfortable and make deep sleep difficult for some. Another potential solution in some adults is a jaw surgery that corrects a dental malocclusion and opens the airway. In some cases, a dental appliance that positions the jaw forward may be enough to correct the problem.
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