We often take sleep for granted until we are not getting enough.
Your body ideally sleeps in 90 minute cycles that progresses from light to deep sleep. We must reach this deep level of sleep to enable your body to recover. Your brain takes over and your body is calm. This is where detoxification occurs and your energy is restored. If you are unable to reach this deep level of sleep, you may wake up feeling exhausted.
What does this have to do with dentistry?
The quality of our sleep is directly related to your mouth. At Dental Wellness one of the first assessments we do is a checklist to determine the quality of the sleep you are getting now. The process for breathing at night is a combination of nasal and oral breathing. While Nasal is preferred, we find many people are mouth breathers.
Nasal breathing vs mouth breathing
As a child, a mouth breather will classically have crowded teeth, steep or narrow palate, a poorly developed upper mid face and will be a noisy sleeper. Bed-wetting can also be a common symptom of mouth breathing due to overstimulation of the nervous system.
The dental solution for crowded teeth in the past was extraction of unwanted teeth and braces to align what is left. This can exacerbate an already narrow arch or palate to be even more encroached.
When you are asleep your tongue should live in the broad space of your palate. If the space in the roof of your mouth is too narrow to allow the tongue to lie comfortably flat, then the tongue will fill this space and is more likely to produce partial obstruction of oral airway. This leads to poor breathing habits.
The negative impact of poor breathing habits
Without good nasal breathing, your jaw instinctively wants to move forward to pull the tongue away from the airway. If you have had orthodontics with extraction you may find your bite is more locked. The muscles that engage to push your lower jaw forward can create a large stress on the head and neck leading to chronic head and neck pain and often show signs of heavy clenching and wear on the front teeth. At night when you are potentially, partially or fully obstructing your airway your body goes under great stress. Your pulse and blood pressure increase as your oxygen saturation decreases. When your body responds to the reduced oxygen your adrenal glands produce adrenaline to get the body breathing again throughout the night stimulating the diaphragm to contract and force you to take a gasp of air. This may lead to nighttime acidic reflux, which can result in acidic erosion of your back teeth.
The result – an endless cycle of exhaustion
When this cycle of poor nocturnal oxygenation occurs your nervous system is stimulated and it is this that prevents you getting the deep recovery stage of sleep. Patients waking exhausted and suffering from adrenal stress should be assessed for potential sleep issues. A GP referral for a home sleep study is often recommended.
How can dental wellness help in this situation?
There are a range of solutions we have to help our patients achieve an optimal night’s sleep. They range from simple techniques to more complex ones depending on the individual. Some of these include:
1) A simple soft mouth guard to be worn at night.
This takes some stress away from the head and neck while protecting your teeth from further damage.
2) Magnesium chloride crystals in a warm bath before bed.
This calms the nervous system and stimulates the body’s ability to get to the recovery stage of sleep – it also supports your adrenals.
3) Nutritional guidance to eliminate common food allergens.
This supports the body’s regulation of inflammation and detoxification. A multimineral with a therapeutic dose of magnesium is also a common proposed supplement taken before bedtime.
4) Bite Assessments to check the health of jaw joints and chewing function.
A worn set of teeth can be a sign of major nighttime activity. As a result of over closure of your bite, stresses on your head, neck and breathing apparatus are increased. A full rehabilitation of your dental situation will have a potential profound improvement in your head and neck stress but more importantly on your airway, breathing and quality and quantity of sleep.
5) Snoring appliance options.
If a sleep study confirms obstructive airway, options can be provided Sleep Physicians for a CPAP machine to force air into you at night while sleeping or a MAS (Mandibular Advancement Splint). The MAS is made by your dentist to hold your lower jaw in a forward position to pull your tongue away from the airway thereby reducing snoring and opening the airway. An ear, nose and throat specialist may need to assess your nasal and sinus health.
In conjunction with nutritional supplements and breathing exercises, the dental wellness team can contribute greatly to the quality of your sleep and your general wellbeing.