“How could that be? When I snore, I sleep with my mouth open!” … says, everyone. And in fact, they are right but they are also wrong. Teeth clenching still occurs episodically during the night, for some people more often, for others less. The cumulated effects over years can lead to damaging tooth wear associated with a bite sinking effect, tooth movements, enamel/porcelain fractures, teeth cracking and yellowing…
The latest studies analyzed in depth the connection between snoring and clenching/grinding. Independently from each other, researchers from all over the world discovered that episodes of low oxygen levels in the bloodstream – due to less air reaching the lungs – causes the brain and heart to go in “panic mode” followed by:
- Heart rate accelerates to compensate for less brain oxygenation
- Brain “wakes up” from deep sleep to a more superficial state
- U.A.R.S. – Upper Airways Resistance Syndrome – due to the difficulty in breathing (snoring), chest pressure becomes negative by comparison with the abdominal pressure causing an acidic reflux from the stomach in the esophagus
- As an automatic reflex to compensate for the lack of oxygen, we slightly wake up (toss and turn), raise the head off the pillow and clench the teeth together
- Clenching is a reflex in bringing the lower jaw forward together with the tongue so the airways get opened for more air.
It has been also found that many people who are snoring are also suffering from L.P.R. – Laryngopharyngeal Reflex or the Silent G.E.R.D.. This is a form of acidic and non-acidic (pepsin) reflux that does not respond very well to medication and is constantly “burning” the larynx and/or pharynx, past the upper esophageal sphincter. These tissues are not designed to withstand such acidic aggression and they get inflamed, the throat membranes swell up restricting even more the airflow and also increase the risk for throat cancer. Few signs of L.P.R. are:
- Voice hoarseness in the morning
- The need of constantly “clearing the throat” (mucus excessively produced by the body to defend against stomach acids reaching the throat)
- Restless sleep or insomnia – low sleep quality due to the difficulty of reaching and remaining long enough in the deep, regenerative sleep state (sympathetic vs parasympathetic healing sleep)
- Jaw muscles tired and teeth sensitivity/looseness
How can a dentist discover these issues?!
Simple, we often see excessive enamel wear on the front teeth but not so much in the back teeth. The lower jaw is pushed forward in a reflex attempt to open the throat for air, bringing the front teeth way more often in contact. Normally, teeth come in contact just 20 minutes a day and this is when we swallow. Having them in contact more than that, especially in a forward position (edge to edge) and while experiencing episodes of snoring possibly associated with restless sleep, could be the signs of your body trying to cope with a developing problem. Maybe it hasn’t developed yet in an Obstructive Sleep Apnoea (O.S.A.), which is a much more serious condition, but the risk is definitely increasing.
If not properly diagnosed, any attempts to cosmetically repair the worn front teeth will most likely end up with repeated restoration failure. Simply put, the teeth are not the issue but just the victim of a complex problem, otherwise treatable based on a correct diagnosis.
What to do?
Tell your dentist about any episodes of snoring, restless sleep, jaw muscle tension and/or heartburn. There are technologies nowadays that can be used to determine the true cause of problems. One of them is a portable sleep/breathing monitor that I even tried myself and I often prescribe to my patients. It proved to be very useful in finding the right bite/jaw position for optimum breathing and a regenerative deep sleep. Correlating the findings with the jaw muscles tension led to a long-lasting dental treatment and also prevented more serious issues.
Dr.-medic stom., D.D.S. (USA)