Sleep apnea, tooth decay, and surgical solutions

Sleep apnea affects and estimated 22 million Americans each year. It is estimated that another 80 percent of cases remain undiagnosed. While most people are familiar with treatment with a CPAP machine, some cases of sleep apnea are much more obstructive and require the skilled hand of an oral surgeon. Sleep apnea is hard on the body. Periodic episodes without oxygen stress the brain, the heart, and every one of the body’s systems. But did you know that sleep apnea also effects your oral health?

Sleep apnea causes mouth breathing due to poor airway. Oftentimes, this is evidenced by snoring. Scientists have now linked mouth breathing during sleep with increased levels of tooth decay. Why? Well, it has to do with saliva, acidity, and bacterial activation which are all impacted by breathing through the mouth (with or without snoring). The impetus of the study was a marked increase in dentists reporting patients complaining of dry mouth, especially during sleep or upon awakening. Oral dryness during sleep can be linked to sleep apnea and patients who rely on mouth breathing to make up for poor airway flow.

First, mouth breathing during sleep causes saliva to evaporate into the surrounding air. Think of how dry your mouth feels when you’ve got a cold and can’t breathe through your mouth due to congestion. This lack of moisture in the mouth isn’t just a problem with discomfort, however. Saliva is important both for moisture and for keeping the mouth’s acidity under control. Saliva contains base pH levels that protect tooth enamel and allow for a reduction in bacteria. Lack of saliva causes acidity levels to rise, creating an environment in the mouth where enamel is left unprotected.

A reduction in saliva can lead to increased acidity and result in tooth decay. Acidity in the mouth leads to loss of tooth enamel through erosion and tooth decay or caries cavities. When the mouth is acidic and there isn’t saliva to counterbalance the acidity, the enamel begins to slowly erode. Likewise, when bacteria in the mouth feast on food particles, they create acidity as a byproduct. That acidity causes tooth decay in the form of cavities.

Aside from the risks to oral health generally, sleep apnea is a sleep disorder that can cause many serious cardiovascular problems if left untreated. Obstructive sleep apnea occurs when the tongue blocks the back of the throat while you’re sleeping. This causes the person to stop breathing, decreasing the amount of oxygen available to the body. Many people are able to successfully alleviate the symptoms and issues associated with sleep apnea by using a CPAP machine that delivers pressurized oxygen through the nasal passage. However, some cases are more severe and will require oral surgery.

There are several surgical options to treat sleep apnea. Using oral surgery as a means of treatment is to reshape the palate, making blockage by the tongue much more difficult. One procedure, uvulo-platao-pharyngo-plasty, can be performed by a surgeon or laser assisted. This procedure reshapes the soft palate and throat. While it sounds intimidating, this procedure has a favorable recovery rate with few complications.

Another option is use of a radio-frequency probe to tighten the soft palate alleviating the cause and symptoms of sleep apnea.This less invasive option is sometimes an interim step before requiring more invasive surgery, but can provide the relief needed in mild- to moderate- sleep apnea cases.

For more complex cases where the alignment of the jaw must be corrected orthognathic surgery might be the best course of action. If symptoms cannot be alleviated with an oral appliance that repositions the jaw while you sleep, your oral surgeon may recommend this invasive surgery that will permanently reposition the jaw.

If you’re suffering from sleep apnea and the symptoms it causes, give Dr. Sedaros a call. He uses state of the art technology to diagnose your condition and will only perform treatments based on your individual needs. If you have questions about how this disorder is affecting your sleeping and waking hours ask your doctor about your options today. It’s imperative that sleep apnea is treated early, before permanent damage is caused to the teeth, the cardiovascular system, and the heart.