The benefits of regular visits to the dentist’s office go far beyond one’s teeth and gums. Although your dentist is not a medical doctor, your dentist is often the gatekeeper or first responder, if you will, to conditions in your mouth that indicate a more serious medical condition. Consider your dentist and your doctor two coaches on your healthcare team.
Ballclub #1: Sleep Apnea
The medical community recognizes so-called obstructive sleep apnea as a “chronic medical condition that can have serious medical consequences, reduce lifespans and impair quality of life,” explain doctors Stuart F. Quan and Wolfgang Schmidt-Nowara in the Journal of Clinical Sleep Medicine. People who have this condition can stop breathing during sleep and can suddenly fall asleep while performing tasks like driving. The condition also increases one’s risk for type-two diabetes, liver problems, heart problems, and more.
There are three types of sleep apnea: obstructive, central, and complex. With obstructive sleep apnea, throat muscles relax too much. While in central sleep apnea, it’s the brain that has issues, specifically sending signals to the muscles that regulate your breathing. Complex sleep apnea is the combination of both.
Why do dentists usually diagnose sleep apnea before doctors?
During your regular teeth cleanings, usually done by a hygienist, there comes a point when the dentist comes in to perform an exam. You may have thought he or she was merely checking the hygienist’s work and taking a look at any X-rays taken. Well, your dentist was also conducting an evaluation of your entire oral cavity, looking for oral or craniofacial abnormalities or other anatomical factors that may be impacting your health or quality of life.
What’s the dentist looking for when it comes to sleep apnea? A large tongue, a retrusive jaw, enlarged tonsils, and symptoms of TMJ (lockjaw) to name several. Dentists may also look for airway obstruction, neck circumference issues, and severe overjet (overbite).
What can your doctor and dentist do about sleep apnea?
For many patients, the standard therapy is CPAP. The acronym stands for a Continuous Positive Air Pressure device. The device gently pushes air into the mouth and nose during sleep through a mask, keeping your airway open and preventing it from collapsing during sleep. Similar air pressure devices are available that can differentiate the amount of air pressure and/or regulate the air pressure to match your natural breathing patterns. These are typically prescribed by physicians and set up by sleep specialists.
For some patients, a physician may recommend more basic changes in lifestyle (diet, weight loss, exercise, etc.) to mitigate sleep apnea. Reducing alcohol consumption, especially before bedtime, may also provide therapeutic and preventive value, doctors say. Finally, changing one’s sleeping position is also recommended. Researchers say that roughly half of sleep apnea sufferers sleep in a horizontal position, face and torso up.
In some cases, your physician working with your dentist may recommend an oral appliance for treating your sleep apnea condition. Numerous oral appliances are available today. They typically move the mandible, tongue and soft palate forward to increase airway space and reduce the risk of airway collapse. Oral appliances should be custom-fitted by a dentist, the medical community recommends.
Sleep Apnea and Kids
Children can battle with sleep apnea, too. Your doctor will work with you to find the most appropriate treatment, and sometimes that involves CPAP or oral appliances. But in the case of kids, other options may do the trick.
Medications such as topical nasal steroids have been shown to ease sleep apnea symptoms in kids with mild symptoms. Removal of the tonsils and adenoids might be the solution for other children with moderate to severe sleep apnea. Typically, your doctor will refer your child to a pediatric ear, nose and throat specialist to discuss removing the tonsils and adenoids, which may improve obstructive sleep apnea by opening the airway.
Ballclub #2: Autoimmune Disease
Autoimmune disorders are becoming increasingly common, and it is presumed to be a combination of genetics and environment causing them. Specifically, an autoimmune disorder is when the body mistakes a naturally-occurring substance in the body as something foreign, thus attacking it. Patients with autoimmune disease often experience opportunistic and secondary infections. These can be common in the mouth, so dentists have become the frontline for identifying issues.
Common issues a dentist may see:
- Tooth decay
- Periodontal disease
- Dry mouth
- Oral thrush
- Mouth lesions
Common diseases and conditions a dentist may see:
- Sjögren’s syndrome—an inflammatory disease that targets the glands that help your body make moisture. This affects your ability to produce saliva, causing dry mouth.
- Crohn’s disease—a disease that affects the intestines, but up to 29% of people with Crohn’s have it in their mouth, where symptoms such as mouth ulcers and swelling of the gums and lips occur.
- Systemic lupus erythematosus—a disease that damages body parts, including skin, joints, kidneys, and the mouth (specifically, mouth ulcers). According to the Office On Women’s Health, it mostly develops in young women but can happen to anyone, at any age.
- Oral lichen planus—a rash that affects the skin and any lining, including oral and esophageal. Still rare and not conclusively caused by autoimmune disease, people experiencing it have painful patches and peeling inside the mouth. It is most common in women over 50.
- Psoriasis—an autoimmune disease of the skin, which in rare cases can affect the mouth, including the lips, gums, tongue, and cheek. Symptoms include redness, burning, bleeding, difficulty chewing and difficulty swallowing food.
Whichever “ballclub” you may be battling, your dentist will always be playing on your team. The ballgame commences two times a year, at your regularly scheduled dentist appointment. See you there.