Sleep Disorder Breathing in Adults – Do you suffer from a lack of oxygen?
In the last newsletter, I discussed Sleep Disorder Breathing (Sleep Disordered Breathing – Uncovering Health Issues in Your Child) in children and adolescents, and the potential problems associated with this disorder. Well, what happens if the Sleep Disorder Breathing is not corrected, or is not properly corrected, and now you are an adult?
In a high percentage of cases, as an adult, your SDB will continue and you will develop TMD problems and/or a restricted airway. As you age these problems can progress to the point of diagnosed sleep apnea. Most of us know someone who needs to sleep with an oxygen machine (CPAP) because of their sleep apnea. People with sleep apnea have a higher incidence of stroke, cardiovascular disease, hypertension, cancer and dementia!
A good supply of oxygen is critical.

When your airway is restricted it is a big problem.

When the jaws are not fully developed in width and when your upper jaw (maxilla) is too narrow and too far back in relationship to your skull, the lower jaw (mandible) is trapped in a retruded position, and so is your tongue. 
It is your retruded tongue that restricts your airway. My friend, Dr. Felix Liao, calls this a “six-foot tiger, three-foot cage” (He has an excellent book with this title, Six-Foot Tiger, Three-Foot Cage: Take Charge of Your Health by Taking Charge of Your Mouth ).

There are some signs that can provide a clue. Put a pinky finger in each ear with the pad of the finger pointing forward. Open and close your mouth. If there is tenderness, or clicking, or any non-smooth sensation as you open and close, this is an indication that your mandible is too far back.

Some other important signs of a restricted airway are:

  •  not waking up refreshed
  •  clenching or grinding your teeth
  •  waking up in the middle of the night startled or gasping
  •  acid reflux
  •  teeth fracturing
  •  teeth imprints on the sides of your tongue
  •  generalized recession of your gums or indentations of the teeth at the gum line (abfractions)

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  •  sensitive teeth
  • bladder urgency
  • daytime sleepiness
  •  heart disease
  •  hypertension
  •  poor profile
  • head forward of your shoulder
  •  chronic neck and shoulder problems
  • snoring
  • tongue-tie            

Today we are fortunate in having 3D X-ray scans that allow us to measure your airway opening and to measure the volume of airway space.

The Orthopedic Perspective
There is a lot of advertising in the dental industry about creating a perfect smile, straightening teeth without braces or braces for only 6 months, veneering teeth and whitening of teeth. There is no doubt that a great smile is important; however, understand that before you have your teeth straightened (whether as a child or as an adult) to help create that perfect smile, the issue I am discussing goes beyond orthodontics. In my experience, most orthodontists are good at straightening teeth, but miss the big picture. What I am talking about here is treating from an orthopedic perspective. By this I mean determining the proper position of the maxilla to the rest of the skull. Once we know this, then we know where to place the mandible. In the preponderance of cases, the maxilla needs to be more forward. This can be accomplished with removable orthopedic appliances. It is not rocket science, but it is critical for one’s overall wellbeing. It is upsetting to me when an orthodontist creates a “three-foot cage.”
Orthopedic Perspective vs Orthodontic Perspective

22-year-old Cynthia recently came into my office with a number of concerns. Cynthia was not happy with her profile, she suffered from headaches and from other health issues as well.

The cause of her less than desirable profile, and her headaches, stemmed from her orthodontic treatment. An orthodontist had removed the two permanent teeth behind Cynthia’s eye teeth because she had “buck teeth.” He then brought the buck teeth back. The problem was not that her upper teeth were out too far, the problem was her lower jaw was trapped back because her upper jaw was too narrow, like trying to put your foot into a shoe that has a too narrow toe box and is two sizes too small. Fortunately, the problem can be corrected. 

Your mouth is the gateway to your health. As dentists, we can cause a tremendous amount of harm (mercury fillings, root canals, orthodontics, etc.); on the other hand, we can do more to help improve and maintain health than any other profession. Choose your dentist wisely!
© 2017, Mark A. Breiner, DDS 

The information presented is for educational purposes only. Please consult a qualified dentist or health practitioner for diagnosis and treatment.

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