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“I told her we could straighten her teeth, but the question was, why is this happening in the first place?” Dr. Danner

Sleep apnea was shifting her teeth

A young lady came to me because she wasn't pleased with how her smile was changing. She had braces as a child and her teeth generally looked straight, but she didn't like the space developing between two teeth. She wanted it fixed and thought braces or clear aligners would be the way to go.

I told her we could straighten her teeth, but the question was, why is this happening in the first place? I had a suspicion why, but needed to ask more questions. Do you sleep well? “Well, I fall asleep”. Do you get up a lot? “Yes, I get up a lot at night”. Do you wake up with headaches? “Yes, I do wake up with morning headaches. Do you get tired throughout the day? “Yeah, I do. I get pretty tired”.

I could see some wear patterns on her teeth while she spoke. Do you grind your teeth? “Yeah, I grind my teeth at night and then my face is sore in the morning, and sometimes during the day it gets even worse”.

Are you aware of snoring? “Yes”. If you're snoring, that means that there's not enough space for air to pass through. There's a good chance that while you're asleep, you’re waking up gasping. “Yes! I do gasp when I wake up. I feel like I’m choking!”.

This young lady came in with a dental problem, but we soon discovered she really had an airway problem. She had no idea.

Get Evaluated

It's important to have signs and symptoms of a potential sleep breathing disorder evaluated by a knowledgeable healthcare professional.

Sleep apnea was making her depressed and anxious

I had a young girl in the office last week. The concern that she and her mom had was that “her teeth looked really crooked”. She was embarrassed to smile. When we asked her to take a picture for her dental records, she said, “It feels really odd for me to smile because I don’t ever smile”.

She looked exhausted. I asked her if she was generally tired and experiencing morning headaches. She nodded her head yes. I informed her mom that I was beginning to suspect an airway problem. Mom then spoke up and said, “My daughter…she has issues with depression and she's very anxious. Is there a possibility that this could all be related to her airway?” I said absolutely.

Low quality sleep increases your risk of developing depression, anxiety, and even makes you more prone to Alzheimers.

This family found an answer they couldn't find anywhere else. This poor girl was struggling with an airway problem. She had no idea.

Sleep apnea was cracking her teeth

A patient called yesterday. She was having difficulty biting her teeth together. She was referred to us because she had already seen other specialists with no luck. She was desperate for an answer.

Her teeth were all worn down with multiple cracks. If you're clenching or grinding while you sleep, something’s going to give. Typically, it's the teeth that shift. They get crowded over each other, or they break fillings, dislodge crowns, or wear or crack teeth. When it comes to clenching and grinding, the facial muscles always win and the teeth always lose.

We explained to her that we could easily fix her teeth to make her comfortable, but unless she fixes the underlying problem, the problem will just return.

Clenching and grinding can be connected to sleep apnea when the body is struggling to breathe. This clenching and grinding can generate three times more force while we sleep. An airway problem was destroying this woman’s teeth and overall health. She had no idea.

Get Evaluated

It's important to have signs and symptoms of a potential sleep breathing disorder evaluated by a knowledgeable healthcare professional.

Sleep Apnea shortened my father’s life

As an airway-focused dentist, I help patients overcome the negative effects of sleep apnea everyday, but there was one patient I couldn’t help...my father.

My father snored like a train. He always woke up during the night and often struggled with daytime fatigue. My father was told he had mild sleep apnea. But my dad did not understand the importance of treatment and neither did the medical community at the time.

Back then, the medical community didn’t understand what we understand today. I have no doubt that my father’s sleep apnea shortened his life. I wish I could go back in time with the knowledge and skills I have now and help my father, but I can’t. Don’t ignore the signs and symptoms and let sleep apnea shorten your life too.

Diagnosing sleep apnea is an easy process

I love helping our patients discover and treat their sleep apnea because the process is very easy and the payoff is so big.

Our assessment process starts with a comprehensive questionnaire. This questionnaire asks very specific questions and helps you connect the dots of different things in your life that are pointing to the same thing. An underlying sleep disorder.

We next complete a thorough head, neck and intra-oral exam. We’re looking at everything. Part of the exam includes a 3-D CBCT scan of your jaws and intra-oral digital scans of your mouth and teeth.

We look at the tongue to see if there are scalloped borders or fissured lines on the surface. These are classic indicators that the tongue is stuck in a place with inadequate room (a restricted airway).

I remember one day looking at a patient's tongue and saying, “Those borders on the side of your tongue are quite scalloped. They mimic the shape of your teeth”. Her eyes got huge. She said, “I cannot believe that you can actually tell me why my tongue looks that way. I've been asking physicians and dentists for years and no one could give me an answer”.

Another sign we look for is the presence of lines on the inner cheeks that run parallel to the biting surfaces of the teeth. This may be an indication that there's a suctioning action happening as the body is struggling to get oxygen.

We also assess the relationship between the tongue and the roof of the mouth. Can we see in the throat or is it closed off? If we can't see anything back there, there’s a good chance the patient has an airway issue.

A major part of the assessment process is a home sleep study. We prescribe and typically dispense these from our office. One home sleep study kit we use simply attaches to your wrist or finger. That’s it!

We also have an in-house Myofunctional Therapist. She’s a specialist in determining what facial muscles are weak and need to be strengthened with simple exercises to maximize healthy breathing.

We’ll then take all that information and review it with our team, which includes, but not limited to, an airway driven dentist and a sleep medicine physician.

And finally, at a follow-up consultation appointment with the patient, we discuss all the team’s findings and review all possible treatment options.

You Don't have to be stuck with a CPAP machine

I typically recommend an oral appliance for all patients. A CPAP machine is always an option, but it’s not always the best choice. Oral appliances are designed to comfortably hold the jaw in a more forward position while you sleep to open the airway.

They work extremely well and are easy for the patient to deal with.

There are two types of oral sleep appliances. The first type controls sleep apnea, but must be used for the rest of the patient’s life. The second type controls sleep apnea too, but it also stimulates bone growth in the upper jaw to permanently open the airway after 12 to 24 months of use. At that point, the patient no longer has to use an oral appliance. It’s a permanent fix.

With all treatment options, we always follow up with a new assessment (new 3-D CBCT scan, new home sleep study, etc.) to verify that the oral sleep appliance is working. Before I even start the new assessment, patients often tell me, “I feel so good when I wake up in the morning. I slept all the way through the night. I’m not snoring anymore”. With the new 3-D scan we can also see that a small airway has grown larger. The results are phenomenal. 

Are you experiencing the signs and symptoms of sleep apnea? Come see us!

If you notice that your teeth are getting spaced apart. If you notice that your lower teeth are getting crowded over. If you find yourself biting your tongue or cheeks by accident and not really sure why. If you're waking up tired day after day and getting fatigued as the day goes on.

If there's soreness in your face or you’re experiencing morning headaches. If your sleeping partner cannot stand the snoring noise that you're making. If you know you wake up gasping and not sure why, then it's time to get some answers. Give us a call today.

Get Evaluated

It's important to have signs and symptoms of a potential sleep breathing disorder evaluated by a knowledgeable healthcare professional.

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