How Untreated Sleep Disorders Can Impact Oral Health

At Sninski and Schmitt Family Dentistry, we take a comprehensive approach to your oral health. Doing so can give us the whole picture of your sleep, diet, and oral hygiene practices. In this article, we explore how untreated sleep disorders can impact your oral health.

The Connection Between Sleep and Oral Health

According to the biomedical report titled “Oral health and sleep disorders: A systemic review and meta-analysis” found in Spandidos Publications, “sleep disturbances can significantly impact oral health.” Temporary or chronic poor sleep quality and/or quantity can affect formation of oral structures and the development of oral disease. A thorough dental examination that includes extraoral and intraoral exams can indicate possible sleep disorders. Oral indicators of open mouth posture and poor sleep quality can include gingivitis, periodontal disease, dry mouth (xerostomia), high caries risk, poor plaque control, poor saliva control, or missing teeth.

The Importance of Screenings and Examinations

Screenings and regular dental examinations play an important role in identifying and diagnosing sleep disorders as well as preventing and/or treating oral issues that result from lack of proper sleep. Determining whether there is a sleep disorder at play improves not only overall health and well-being but also can impact dental treatment outcomes and oral health long term.

Extraoral Exam

The extraoral exam includes examination of the head and neck for any abnormalities in shape, size, color of the skin, muscle tone, or bony structure development. Facial features that alert a health care provider there may be a sleep quality concern can include flaccid skin tone, recessed skin, short upper lip, open lip posture, open bite, chronic dry lips or excessively wet lips, dried food at the commissures of the lips, long and narrow face, and dark circles under the eyes.

Intraoral Exam

The intraoral exam includes examination of the hard and soft tissues inside the mouth, including the gingiva, tongue, buccal mucosa, hard and soft palates, dentition, and oropharyngeal area. Research shows that poor tongue placement leading to sleep quality concerns can be traced back to infancy and the infant’s ability to nasal breathe, suck, and swallow. Open mouth breathing and tongue placement is directly related to the formation of the maxilla, sinuses, nasal cavity, and palate. All of these oral structures have a direct effect on the ability to breathe, chew, and swallow properly.

Sleep Disorders that Directly Affect Oral Health

Untreated sleep disorders such as obstructive sleep apnea, sleep bruxism, insomnia, and restless legs syndrome directly affect oral health.

Obstructive Sleep Apnea

Obstructive sleep apnea is a sleep disorder characterized by repeated episodes of partial or complete blockage of the upper airway during sleep. There are several possible causes for sleep apnea:

• Relaxation of soft tissues in the upper airway, for example, the tongue and tonsils
• Obesity
• Narrow or enlarged airway
• Certain medical conditions such as hypothyroidism, neuromuscular disorders  

Sleep Apnea symptoms include:

• Loud snoring
• Daytime fatigue
• Difficulty concentrating
• Restlessness during sleep
• Witnessed apneas by a bed partner
• Morning headaches

Sleep apnea affects oral health in several ways:

• Dry Mouth: Most people with sleep apnea breathe through their mouths during sleep, leading to dry mouth. Dry mouth can increase the risk of cavities, gum disease, and bad breath. Dry mouth can also make it difficult to eat, speak, and swallow.
• Teeth Grinding: Bruxism can be caused by sleep apnea. Bruxism can damage teeth, cause jaw pain, and contribute to temporomandibular joint (TMJ) disorders.
• Jaw Problems: Sleep apnea can cause jaw misalignment, which can lead to TMJ disorders.
• Other Oral Health Issues: Inflammation can contribute to gum disease, mouth sores, palate and dental changes, alterations in taste sensation.

Sleep Bruxism

Sleep bruxism is when you grind your teeth during sleep. This can negatively affect your oral health by causing worn down tooth enamel, chipped teeth, cracked teeth, or gum recession. 

These are some ways sleep bruxism impacts oral health:

• Tooth Wear: The constant grinding action wears down the enamel on your teeth, exposing the sensitive dentin layer, causing pain and sensitivity especially to temperature changes.
• Chipped or Cracked Teeth: Excessive force from grinding can cause teeth to chip or crack, requiring restorative dental work.
• Gum Recession: Grinding your teeth can irritate the gums, causing them to recede and expose more of the tooth root, which increases sensitivity and potential for gum disease.
• Jaw Pain: The repeated clenching and grinding associated with bruxism can lead to pain and discomfort in the jaw muscles, often accompanied by headaches and facial pain.
• TMJ: Severe bruxism can put stress on the temporomandibular joint (TMJ), causing clicking, popping sounds, and jaw joint dysfunction.
• Damaged Dental Work: Existing fillings, crowns, or other dental restorations can be compromised or damaged due to the force of teeth grinding.

Insomnia

Lack of sleep can affect your dental health in several ways. When you suffer from a poor quality of sleep, your body’s ability to naturally repair itself is severely affected, you have a weakened immune system, and increased stress levels. These can lead to poor oral hygiene practices and increased inflammation in the gums, making your mouth more susceptible to infections and damage.

How insomnia can impact oral health:

• Reduced Saliva Production: You produce less saliva when you don’t sleep well, which naturally cleanses your mouth and neutralizes acids, therefore leading to a higher risk of cavities and tooth decay.
• Inflammation: Lack of sleep can create inflammation that can severely affect your gum health and cause periodontal disease, leading to tooth loss.
• Weakened Immune System: Sleep deprivation can weaken your immune response so that it is more difficult for your body to fight off bacteria that contribute to gum disease.
• Increased Stress and Teeth Grinding: Stress associated with insomnia often leads to bruxism (teeth grinding), which can wear down tooth enamel and cause jaw pain.
• Dry Mouth (Xerostomia): Lack of sleep can exacerbate dry mouth, further increasing the risk of cavities and gum disease.
• Poor Oral Hygiene Practices: When you suffer from insomnia and lack proper sleep, you feel tired, which can make you less likely to maintain a proper oral hygiene routine, leading to plaque buildup and gum inflammation.

Restless Legs Syndrome

Restless Legs Syndrome (RLS) disrupts sleep, therefore negatively impacting oral health. RLS can cause similar symptoms as sleep apnea and insomnia such as bruxism, dry mouth, and reduced saliva production.

• Sleep Disruption: The primary way RLS impacts oral health is by disrupting sleep due to the uncomfortable sensations in the legs, leading to less restorative sleep and increased likelihood of teeth grinding during sleep.
• Buxism (Teeth Grinding): Poor sleep quality associated with RLS can trigger teeth grinding, which can wear down tooth enamel, chip teeth, and cause jaw pain.
• Dry Mouth (Xerostomia): Some medications used to treat RLS can have a side effect of dry mouth, which can increase the risk of cavities and discomfort.
• Reduced Saliva Production: Decreased saliva production due to dry mouth can also make it harder to clean the mouth naturally, potentially leading to increased bacteria build-up.

Acid Reflux and Sleep Disturbances

There is a strong connection between disturbed sleep and gastroesophageal reflux disease (GERD), which may be bidirectional. Too much acid being in contact with teeth, whether with acid reflux or eating too many acidic foods, hurts teeth. Sleep disorders may induce GERD while gastrointestinal (GI) disturbances may also provoke or worsen sleep. Nighttime reflux can lead to sleep disturbance and sleep disturbance may further aggravate GERD. All of this can facilitate the occurrence of complicated GERD and decreased quality of life. The interplay between sleep problems and GERD is complex, and there is relatively limited data on the issue. Too 

Key points about how acid reflux impacts oral health:

1. Tooth Enamel Erosion: Stomach acid is highly acidic and can dissolve tooth enamel, causing visible pits, grooves, and a worn-down appearance on the teeth.
2. Increased Sensitivity: As the enamel wears away, the dentin layer underneath becomes exposed, leading to increased sensitivity to hot and cold foods and drinks.
3. Discoloration: Enamel loss can reveal the yellowish dentin layer, causing teeth to appear discolored.
4. Gum Inflammation: Acid reflux can irritate the gums, potentially leading to gum inflammation and increased risk of gum disease.
5. Bad Breath: Stomach acid in the mouth can contribute to bad breath due to the presence of bacteria.

Contact Sninski & Schmitt Family Dentistry to Schedule Your Next Dental Checkup

Our professional team, during a regular dental checkup, can determine if there are issues that may be stemming from a sleep disorder. Sninski & Schmitt Family Dentistry is currently accepting new patients. Reach us at our Holly Springs dentist office at 919-600-6262 and our dentist in Cary office at 919-467-2203. Or, you can also complete our contact form to schedule an appointment.