SLEEP apnea is commonly associated with loud snoring, pauses in breathing during sleep and daytime fatigue.
But the condition can also have consequences for oral health, making the dentist’s office an important place to identify possible warning signs.
The most common form is obstructive sleep apnea (commonly called OSA), which occurs when the upper airway repeatedly becomes blocked or narrowed during sleep. These interruptions can happen many times during a night, reducing normal airflow and disrupting sleep.
One of the most noticeable oral effects associated with sleep apnea is dry mouth.
People with obstructive sleep apnea may breathe through their mouths during sleep, particularly when the airway is obstructed. Sleeping with the mouth open can reduce saliva and leave the mouth unusually dry upon waking.
Saliva plays an important role in protecting the teeth. It helps wash away food particles, neutralize acids and provide minerals that help maintain tooth enamel.
When saliva production or its protective effect is reduced, the risk of tooth decay can increase. Dry mouth can also contribute to bad breath, difficulty swallowing and irritation of oral tissues.
People who regularly wake with a dry mouth may therefore benefit from discussing the symptom with both a dentist and a physician.
Another oral-health issue associated with sleep-disordered breathing is bruxism, or teeth grinding and clenching.
Some studies have found an association between sleep bruxism and obstructive sleep apnea. Repeated grinding can cause tooth wear, sensitivity, jaw discomfort and damage to dental restorations.
However, the relationship is complex. Not everyone with sleep apnea grinds their teeth, and teeth grinding alone does not establish that someone has sleep apnea.
Dry mouth and changes in oral conditions can contribute to an increased risk of cavities and gum problems. If a person already has poor plaque control, reduced saliva may make maintaining oral health more difficult.
Signs such as frequent cavities, persistent dry mouth, gum inflammation and tooth wear may prompt a dentist to ask questions about sleep, snoring and breathing.
Dentists do not diagnose every case of sleep apnea, but they can sometimes recognize symptoms that warrant further medical evaluation.
The most important symptoms of obstructive sleep apnea often occur during sleep or during the day.
Loud, persistent snoring, witnessed pauses in breathing, gasping or choking during sleep and excessive daytime sleepiness are common warning signs. Morning headaches and difficulty concentrating may also occur.
Because untreated sleep apnea can have significant health consequences, people with these symptoms should seek evaluation from an appropriate healthcare professional.
Treatment depends on the type and severity of sleep apnea. For many people with obstructive sleep apnea, continuous positive airway pressure is a commonly used treatment. Other approaches can include oral appliances prescribed by appropriately trained dental professionals, positional therapy, weight management when appropriate, and—in selected cases—surgery.
A dentist may play a role in treatment by providing or managing a custom oral appliance designed to help keep the airway open during sleep.
Good oral hygiene remains important regardless of whether a person has sleep apnea. Brushing twice daily with fluoride toothpaste, cleaning between the teeth and attending regular dental examinations can help protect against cavities and gum disease.
Sleep apnea therefore extends beyond snoring and disturbed sleep.
The condition can affect the mouth through dry mouth, tooth grinding and other changes in oral health. Recognizing these connections can help patients and dental professionals identify possible sleep problems and encourage appropriate medical evaluation.
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Dr. Joseph D. Lim, Ed. D., is the former Associate Dean of the College of Dentistry, University of the East; former Dean, College of Dentistry, National University; Past President and Honorary Fellow of the Asian Oral Implant Academy; Honorary Fellow of the Japan College of Oral Implantologists; Honorary Life Member of the Thai Association of Dental Implantology; and Founding Chairman of the Philippine College of Oral Implantologists. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515.
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Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI, graduated Doctor of Dental Medicine, University of the Philippines, College of Dentistry, Manila, 2011; Bachelor of Science in Marketing Management, De la Salle University, Manila, 2002; and Master of Science (MSc.) in Oral Implantology, Goethe University, Frankfurt, Germany, 2019. He is an Associate Professor; Fellow, International Congress of Oral Implantologists; and Fellow, Philippine College of Oral Implantologists. For questions on dental health, e-mail limdentalcenter@gmail.com./PN
