Patients diagnosed with obstructive sleep apnea (OSA) that choose CPAP therapy often feel like their lives have been changed after having deep, restorative sleep for the first time in years. However, after they’ve used their CPAP machine for some time, they may notice several downsides to the CPAP machine that they hadn’t anticipated. This can partially be caused by improper use of the device, as 83% of CPAP users don’t follow protocols recommended by their doctors, while others end up giving up on the device entirely after a while due to the cleaning and maintenance upkeep required.
What is OSA? What’s a CPAP?
Obstructive Sleep Apnea, also called OSA, is a condition that affects almost 22 million people in the US every year. The disorder causes people to draw in shallow breaths while they’re sleeping, sometimes failing to breathe altogether temporarily. This event usually causes the person to wake up, occasionally up to 30 times in an hour. The disjointed and interrupted sleep cycle of those with OSA can cause a long list of other health issues in the body, such as high blood pressure, heart attack, and depression, just to name a few.
A CPAP machine is a device that can help treat OSA by providing the wearer with a continuous stream of oxygen as they sleep. The pressure of the mask helps keep the airway open that’s usually narrowed by the relaxation of the muscle and flesh at the back of the throat. As a result, those who use the CPAP machine will get more restful nights of sleep as their breathing is no longer disrupted. However, while CPAP machines can significantly improve the lives of many with OSA and are perfectly safe when used as directed, they also have some drawbacks that can affect oral health, among many other things.
Some patients have reported that their teeth have shifted since they started CPAP therapy for OSA. The effect was studied and attributed to the positive airway pressure pushed into the mouth by the machine through the tube and mask attached to the face during sleep. The elevated pressure inside the mouth helps keep the airway open, but it also pushes teeth around as well. The movement of these teeth can also have an impact on changes in the dental arch which can impact bite position and jaw placement.
Not only can the CPAP machine push teeth around with air pressure after prolonged use, but the instrument may also cause a change in face shape and jaw placement. Many patients have reported the device’s impact on facial structure. In addition, a study found that patients’ jaws were also moving along with teeth shifting, causing malocclusion that negatively affects the way jaws align while at rest. This side-effect can actually make OSA worse over time because patients’ lower jaws can begin shifting backward, once again narrowing the airway.
When teeth shift and bite patterns change, it will cause the CPAP wearer some tooth pain. The impact teeth endure during routine activities such as chewing and talking can cause inflammation in the dental nerve. As these shifts and changes happen, it can also cause people to begin grinding or clenching their teeth while they sleep as the jaw struggles to align itself from the air pressure of the device.
It’s pretty common for patients who wear CPAP machines to experience dry mouth. Cases range anywhere from mild to severe, but the impact dry mouth has on dental health is more important than the annoying discomfort. When CPAP wearers breathe through their mouths at night with their machine, it dries up much of the saliva that’s needed to lubricate the tongue, teeth, and gums. This disrupts the base pH levels that are ideal for the mouth to maintain good oral health, and acidity will occur, causing tooth enamel and gums issues due to an increase in cavity-causing bacteria.
Acidity in the mouth for a prolonged period of time can quickly cause tooth decay. The low pH levels in the mouth caused by dry mouth from CPAP machine usage can eat away at tooth enamel, making teeth much more susceptible to decay, including cavities. In addition, leftover food particles or thick residual liquids from sugary drinks can stick to teeth that are already vulnerable, created even more acidity. This can lead to many more issues, such as increased plaque, mouth sores, and gum disease.
Dry mouth, acidity, and poor dental hygiene create the perfect storm for progressing gum disease. This is why CPAP patients are highly encouraged to keep up with their dental check-ups and attend cleanings every six months as a preventative measure—brushing twice a day and flossing once a day is the minimum to keep these CPAP side-effects at bay.
Alternative Options to CPAP Machine
While CPAP machines work for many, they aren’t the solution for everyone. Depending on the severity of the patient’s OSA, there are several other solutions to consider:
Weight loss: many OSA sufferers can cure the condition by losing 10% of their body weight. The extra flesh in the back of the throat can be caused by excess fat, especially in the neck area. Having a thick neck is also a telltale sign of sleep apnea and puts people at higher risk.
Oral appliance: some people with milder cases of OSA prefer to use an oral device fitted to their mouths. There are over 100 FDA-approved oral appliances available that can help hold the lower jaw in place at night, opening the airway that is usually obstructed while sleeping.
Surgery: there are various kinds of surgeries available for people who have moderate to severe OSA. Depending on each patient’s specific needs, the surgeries can be as minimal as laser therapy to reduce the thickness of the flesh in the back of the throat to something more serious like a tonsillectomy.
Speak with your dentist today if you have concerns about obstructive sleep apnea, so they can help get you on your way to a proper diagnosis and better health.