How Does Oral Health Affect Your Sleep?

Dr David Cowhig BDS(Lond)FACNEM(Dent)ACAAM trained at Kings College London 30 years ago and has continued to work as a general dentist for all of that time. He has been a Fellow of ACNEM (Australasian College of Nutritional and Environmental Medicine) for 20 years, and became Board Certified in Anti Ageing Medicine with A5M three years ago. He has worked in Brisbane for 20 years and is married with three children. Passionate about whole body health (us too!), he finds it an exciting time to be a holistic dentist. This week, we asked him to talk to us about two topics people don't normally associate as related - oral health... and our sleep! Read on to find how the two are actually more interconnected than you think.
People often ask me “what has sleep got to do with dentistry?” Well - the truth is, if your sleep is poor then there is a high risk that you will have dental issues... And if your dental health is poor, it may result in the quality of your sleep being poor. 

General dentists are beginning to take patients sleep and breathing into account and often send their patients to physicians for sleep studies, who hand over the treatment management to doctors prescribing CPAP machines (FYI - these are machines that force air into a face/nose mask to supply air at night bypassing obstruction and physiology).

From childhood

Holistic dentists look at the sleep issue in a slightly different way. From birth onwards, the development of the upper jaw is dependant on the breathing patterns of the child. If they do struggle to breathe through their nose, they develop a mouth breathing habit that has a pretty nasty effect on the development of the upper jaw. If it's not addressed early with dietary elimination of dairy (or any other allergens) and nasal breathing encouragement, the upper jaw becomes very narrow, with a steep arch. This means that often the child has dark circles under their eyes, their teeth are crowded, and front teeth are protruding. The removal of premolars and braces CAN help align the teeth - but create an even smaller space for the tongue. The lower jaw is a single bone and finds itself in a compressed space also stressing the TMJ (that's the jaw joint for those playing at home). 

The consequences of mouth breathers...

So! Now you are an adult... and you still have issues with breathing through your nose. If you mouth breathe when you're asleep, this stimulates the Central Nervous system to go into fight or flight (Sympathetic) mode rather than calm healing (Parasympathetic) mode like nose breathers. This results in clenching of your teeth and bruxism leading to sensitive cracked teeth. High blood pressure and reflux are also related, as your body is in stress mode often waking in the night needing to visit the bathroom as the urinary system has also been turned on. Without healthy amounts of parasympathetic sleep the body loses it ability to regulate your leptin levels and so then the ultimate undesirable, weight gain, is unavoidable. 

Clenching and grinding

Did you have teeth removed or orthodontics as a child? If yes, you're more likely to suffer from clenching and grinding. When you clench and grind your Sympathetic system is being turned on and increase blood pressure, stress and nocturnal waking with bathroom visits. When we ask about grinding and clenching we are assessing as biological dentists how much stress your airway is under when you are asleep. How can we help this situation other than referring for a CPAP?

CPAP alternatives

A detailed assessment of your airway and condition of your tonsillar tissue is essential and referral to an ENT to make sure your nasal passage is healthy and aligned. Your holistic dentist will strive to find the position where your lower jaw wants to be which is often down and more forward so the TMJ is in comfort. This will result in your tongue moving away from the airway and reducing the resistance to nasal breathing. This can be improved further with a MAS (mandibular advancement splint) but a healthy TMJ is essential for this not to cause neck problems. 
A soft mouthguard can reduce the nasal airway resistance in simple cases. Hard polycarbonate upper splints can improve nasal breathing and also protect the teeth from further stress. I have referred to nasal breathing in this article on quite a few times - that's because it really is the key to not only dental health, but overall health and longevity.
 There are Nitric Oxide receptors in the nose that allow for reduction of blood pressure. Nasal, shallow breathing increases your cellular oxygen supply and also stimulates the cranial nerve called the Vagus that is responsible for gut flora, digestion, respiration and detoxification. Poor nasal breathing leads to mouth breathing and a dry mouth - and the risk of periodontal disease which in itself is linked to heart disease, diabetes, arthritis and even some cancers. 

Root canals

Nobody wants a root canal carried out in their mouth. The three main causes are trauma, tooth decay and cracked teeth. Endodontics is a speciality created to keep your teeth in your head. The issue with root canal is the risk to your health if a low grade infection remains in your jaw releasing endotoxins into surrounding blood supply potentially creating a chronic whole body infection and challenge to your health and longevity. It is impossible to permanently sterilise a dead tooth so biological dentists take this more seriously. If you have a root canal treated tooth it is worth getting regular checks to assess the health of the roots and bone at the end of tooth. Digital X-rays and now 3D Conebeam CT confirm these infections.
If you have had multiple root canals due to cracked teeth, I'd suggest a sleep assessment as you may be clenching and grinding in the night as your airway is restricted.

In summary...

So, whether you are struggling as an adult with restless broken sleep and adrenal fatigue, or you have young infants who have their mouths open at night struggling to get to that restful sleep - it is a good idea to see you holistic dentist to get an assessment and help improve your quality and quantity of sleep. 
If you're near the leafy suburb of The Gap in Brisbane, Dental Wellness has been the first choice for holistic dentist for over 20 years. Their Dentists and Oral Health Therapists all work with a holistic philosophy and can guide your whole family towards health and longevity by creating your personal safer, healthy beautiful smiles. Head to to download the infographic giving five tips to save money, reduce pain and boost your health before you visit your dentist.