consequences of sleep apnea

Dental Side Effects of Sleep Apnea

Several different types of sleeping disorders can affect a person’s rest. Obstructive sleep apnea (OSA) is one of the most common forms of sleep-disordered breathing that we see in Raleigh.


Besides fatigue, weight gain, mood changes, and high blood pressure, sleep apnea can also impact your smile. In fact, if you’re not quite sure that you have a sleeping disorder at all, dental symptoms offer some of the most obvious warning signs.


During your dental exam at Raleigh Dental Arts, we’ll screen for symptoms of sleep apnea such as a large neck circumference and high blood pressure. But other oral symptoms, like the one listed below, are fairly common in people who have unmanaged sleeping disorders.



Bruxism Linked to Sleep Apnea


Chronic clenching and grinding your teeth is a condition that we refer to as “bruxism.” People with sleep apnea tend to suffer from bruxism without even realizing it. It’s a natural side effect of oxygen deprivation while you sleep. If your airway is blocked off and you’re not inhaling enough air, your brain tells your jaw to clench your mouth tightly together and close off the airway even more.


All of that instinctive clenching includes grinding the teeth together, too. Your family might even be able to hear your teeth grinding against one another between your other symptoms (snoring, gasping, etc.)


Teeth grinding while you sleep is not normal or healthy. It’s a commonly overlooked symptom of sleep apnea. While the health of your teeth may be the first thing on your mind, it’s a red flag that you could also be at risk for a stroke or cardiovascular attack.



A Scalloped Tongue


When you stick out your tongue and look along the sides and tip, what do you see? Is there a smooth transition from the top of your tongue to the bottom as the tissues change? Or do you notice a visible “line” or scalloping along the sides and front?


Having a scalloped tongue or white lines along the sides of it usually means you’re biting and chewing your tongue, causing those parts of your skin to toughen up and form a sort of callous. It’s fairly common in people who suffer from bruxism while they sleep to also have sleep apnea. While it’s not a definitive diagnosis, it’s still a strong enough warning to catch your attention and take the next steps.



Broken Fillings and Crowns


Heavy teeth grinding places excessive pressure on your dental work. Fillings, crowns, bridges, and other restorations are durable, but they’re not meant to withstand heavy bruxism on an everyday basis.


One of the first things you might start to notice if you have bruxism from sleep apnea is broken down teeth and dental work. Fillings may crack teeth in half or slivers of your crowns may break completely off, leaving a misshaped restoration behind.



Flattened, Worn Teeth


Tooth enamel is the hardest thing in your entire body. But it isn’t invincible. When you take teeth and grind them against each other on an extended basis, the tooth-on-tooth wear will ultimately result in your enamel wearing itself down.


People who clench and grind their teeth because of sleep apnea tend to show signs of flattened biting surfaces, especially along their back teeth. The edges of their biting surfaces may even feel sharp when they run their tongue over them. As the enamel wears down and reduces the natural height of the teeth, it can also alter the normal function and positioning of your TMJ joint.


Most individuals with flattened enamel should be screened for sleep apnea to rule out some type of a sleeping disorder.





People with sleep apnea frequently complain of headaches and migraines. There are a couple of different reasons why they can happen.


First of all is oxygen and sleep deprivation. Even if you’re “sleeping” at night, an inadequate amount of quality, deep, REM sleep where your body is fully rested will still leave you sleep deprived. Your body and brain cannot function that way on a day-to-day basis. So, when you’re fatigued and feeling overwhelmed, you develop headaches. In fact, you might already wake up with a headache first thing in the morning because of all the oxygen deprivation you experienced overnight.


The second is strain to specific muscles. There are multiple muscles that reach throughout your forehead, temples, scalp, neck, and shoulders, all of which tie back to your TMJ and jaw. If you’re clenching and grinding your teeth all night long, you’re essentially exercising those muscles for hours on end. It’s easy to see why they may feel sore and achy the next day, giving off symptoms of headaches.



TMJ Disorder Symptoms


The excessive clenching and grinding of your teeth at night will also impact your temporomandibular joint (TMJ) or “jaw joint” as well as the muscles and ligaments that attach to it. Your TMJ needs to move thousands a day, including every time you speak, swallow, or go to eat something. If it’s experiencing overuse because of sleep apnea and bruxism, the joint itself will start to take a beating.


Some of the most common TMJ symptoms you might experience will include:


  • Popping, clicking, or grinding noises
  • Limited range of motion
  • Your jaw moving to one side when you open/close
  • Ear pain
  • Prominent jaw muscles
  • Joint pain and stiffness


In rare situations, your disc may even become dislocated or deteriorate. A full-mouth X-ray or CT scan can give our Raleigh dentist an insight into what your TMJ anatomy looks like to determine if any type of therapy is necessary.



Lines Inside Your Cheeks


Just like the scalloping along your tongue, the tissue on the other side of your teeth can take a beating too. In this case, we’re talking about your cheeks.


If you clench and grind your teeth excessively during the night, the inside of your cheeks may have a raised, visible line that runs along the inside near where your teeth bite together. The tissue may even have a white color to it, because of the keratin that builds up similar to a callous.


With a raised line inside your cheeks, it’s fairly common to continue biting on your cheeks during the daytime while you eat. These sort of areas tend to constantly get irritated. And when you bite down on them accidentally during a meal, they become swollen and get bitten even more frequently.



Sleep Apnea Screenings in Raleigh


If you suspect that you have sleep apnea or you’re experiencing at least 2-3 symptoms of a sleeping disorder, it’s time to plan a screening. At Raleigh Dental Arts, we review our patients’ medical histories and assess their oral symptoms to screen for a variety of health conditions, including sleep-disordered breathing.


Even if you’ve never had a sleep study before but you experience chronic snoring, we can arrange to have you take home a bedside sleep study machine where it monitors your sleeping patterns from the convenience of your own bedroom. Home sleep studies are easier than overnight clinical studies, at least for most people. Once the machine captures all of your sleep data it’s returned to a specialist to interpret the information and make an appropriate diagnosis if need be.


For people who experience symptoms of OSA, a screening is the first step toward improved heart health, better metabolism, and a good night’s rest. And getting screened is easier than you thought, especially with the help of our trained sleep dentistry team. We can perform your sleep screening at any time, or combine it with your routine six-month checkup!



Dental Sleep Apnea Appliances


Most people assume that treating sleep apnea will always involve a CPAP machine. However, the cumbersome nature of CPAP equipment is often off-putting enough that some individuals may never get a sleep study.


Fortunately, there’s an FDA-approved alternative sleep treatment that can replace CPAP equipment in some cases. Or even be used alongside it! We’re talking about a dental sleep apnea appliance or “mandibular advancement device.” As a medically proven sleep appliance, dental sleep aids that are fitted by a trained sleep dentistry provider can significantly increase oxygen flow. The natural manner of widening your airway and reducing the restriction of oxygen flow allows for improved sleep as early as the first night it’s used.


Although sleep specialists can prescribe an oral appliance, only a sleep dentist can fit and deliver the prosthesis (since it can affect your teeth and jaws.) Typically, people who have medical insurance can use their coverage to help pay for a dental appliance for sleep apnea the same way they would a CPAP machine.



Contact Raleigh Dental Arts Today


Raleigh Dental Arts offers sleep apnea screenings and referrals, as well as oral sleep appliance therapy. If you suspect that you have a sleeping disorder or are experiencing any of the symptoms mentioned above, contact our office to reserve an exam. A take-home sleep study may be the only thing standing between you and a better night’s rest. Call us today to get started.


Tarun Agarwal

Dr. Tarun Agarwal, DDS is considered one of the top dentists in the country. He is a recognized speaker, author, and dental leader. He has been featured on CBS, NBC, ABC, FOX, and News 14 Carolina. Dr. Agarwal has been awarded '40 under 40' Business Leaders by the Triangle Business Journal. He is regularly invited to teach other dentists around the world and recently built a training center within the practice dedicated to sharing his expertise. Most importantly he is a loving husband and dedicated father of three wonderful children. His biggest accolade was being voted 'Best Dad in the World' by 2 of his 3 kids.