Watch Your Mouth!

How Seeing Your Dentist Regularly will Have You Smiling Like a Rock Star & Might Just Save Your Life.

Did you know the average patient spends about seven minutes every two years with their doctor? That may not be enough time to notice changes in our patients’ lives.

As a practicing dentist for the last twenty one years, I usually see patients twice a year, for ten to fifteen minutes at each visit. It seems six months is a nice increment of time to notice physical changes. Plus, our hygienists and assistants are thorough with updating medical history and doing simple things like taking a patients’ blood pressure.

So how does a dentist and dental team save lives?

By addressing the whole patient and not just their teeth and gums. Especially in working with patients to help diagnose Obstructive Sleep Apnea. Sleep apnea has many signs that show up on a simple oral screening and exam. Some of these signs patients can notice themselves. Here is a list of signs and symptoms:

  1. Excessive Tooth Wear — Patients who have sleep apnea will snore for a while (sometimes until they stop breathing completely for a few seconds) and then clench for a while to open their airway and breathe from the nose to get good oxygenated air to the lungs. Sometimes patients will clench their teeth together so hard and so long that ditching or erosion occurs at the gumline where the enamel is the thinnest. This is a process called abfraction. Many times patients will have been incorrectly told that they are brushing too hard or asked if they are using a hard bristled brush. Sometimes the wear becomes so significant that it causes sensitivity to temperature, chewing or sometimes even sweets. Enamel is the hardest organic substance in our bodies and therefore it doesn’t wear down much. When this hard substance presses together (as in opposing teeth), the nerve inside the tooth becomes inflamed and irritated, causing sensitivity.
  2. Lack of Sleep — When is the last time you felt really rested? A patient who has apnea seems to almost never feel completely rested and ready for the day. Many cannot remember their last good night of sleep. These patients will look tired (dark circles or baggy tissue under their eyes). Also these folks tend to be light sleepers or people who cannot go back to sleep once they wake up. Patients with apnea therefore are often tired at work, behind the wheel, or fall asleep at strange times during the day whenever they get still or quiet.
  3. High Blood Pressure — How many people do you know in your family who have been taking blood pressure medication for years because of “genetic” hypertension? Or just happen to have blood pressure issues of any kind? Certainly hypertension is an issue and can be treated with medication, but if a patient has apnea, we are just treating a symptom of the greater problem. Hypertension can occur in folks who’ve never had it before when their apnea has reached a point that their “fight or flight” or autonomic nervous system is cranking up their adrenaline levels during sleep apnea events literally to wake the person so he or she will breathe.
  4. Headaches — Headaches are many times caused by lack of oxygen to the brain. Apnea patients are by definition without necessary oxygen many times each night.
  5. Snoring — Your partner hears you snoring (or even stop breathing). In my case my wife (who could sleep through an F5 Tornado) was hearing me snore until I stopped breathing and it scared her. If you sleep alone: Is your mouth dry often? Do you wake up feeling as if your tongue is plastered to your palate? Have you had an increase in cavities or had to have more dental work done of late? Dry mouth from snoring can make our saliva ropey and ineffective at lubricating our teeth and we consistently see more cavities in our patients with dry mouth.
  6. Obesity — (Physician heal thyself. I’m currently way overweight and working on this). We continue to hear more and more about how obese we are as a nation. As an Arkansas resident, my state is the third fattest in the country with a whopping 67 percent of us overweight. I often joke that my epitaph will read…”here lies Dr. Leeds, dead of biscuits”. Google Jim Gaffigans’ discussion of biscuits and gravy if you need help understanding that. This is just simple science. If we have more fatty tissue around our head and neck area, this is more tissue that can put pressure on our airway to close it off (especially when we are lying down). So if you are a big person like me and have a 17 inch neck or greater, you’re a candidate for OSA. One thing to note here: skinny folk can have apnea as well and will almost always exhibit several of the other signs listed above.

So, how do we find out for sure if a patient has Obstructive Sleep Apnea? We refer them to their primary care doctor and advise a sleep study. Luckily for me, my wife heard me even during her amazing REM sleep. I quickly saw my MD buds and had a sleep study arranged. During my study, it was discovered that I had mild apnea and needed a CPAP machine. The first night I put on the machine, I slept four and a half hours and it felt like I’d slept a month. I cannot begin to describe how good it feels to get productive sleep when you’ve not had it for a long time. I use a nasal pillow insert which is very comfortable, my mask is as easy to put on as a baseball cap and I’m asleep literally within 30 seconds of putting it on every night.

So watch your mouths out there everyone. See your dental health professionals on time and keep up the routine maintenance. Good oral health care could save you.

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