One of the strangest things I have encountered as a dentist and as a human being are the things that people take personally. Especially when it is about their health and/or something they literally have NO CONTROL OVER. But, honestly, it happens every day in the general dental office- a patient gets personally offended by the hygienist or dentist suggesting that they might snore OR that they clench their teeth! The response is often “what, no I don’t?” or some other “I can’t believe you are suggesting I might do that” response. I still can’t figure out why. Even outside the office, suggesting or telling someone that they were snoring will often be met with a flat out denial. (But just so you know, you don’t know what you do while you’re asleep because…..well, you’re asleep). Believe it or not, when you sit in my office, and I look in your mouth I can see tell tale signs of sleep apnea/snoring & clenching/grinding AND it does not make you a bad person if you do either thing.
So, what exactly am I looking for in your mouth that may suggest that you could have sleep apnea?
#1- A small mouth or large tongue that falls back into your airway space when you’re laying back in the dental chair can sometimes indicate that your airway may be even smaller at night. If you are awake and your tongue blocks your airway, I generally know that when you lose your muscle tone at night you’re having an even worse problem.
#2- Scalloped tongue/cheeks. Oftentimes, if you aren’t breathing well at night because your tongue is falling back into the throat, your tongue will push back. It is not uncommon for me to see patients that have obstructive sleep apnea also have this pattern on their tongue.
#3- If you have trouble breathing during a dental procedure. People that have trouble breathing through their nose or breathing in general when laying flat on their back during a dental appointment often experience difficulty breathing at night. There are some patient’s where I can hear an audible snoring sound just by positioning them flat to have a dental procedure done.
#4- Worn down teeth. This is a hot topic right now in my world because there is a lot of debate about whether clenching/tooth wear is a sign of sleep apnea. Significantly worn down teeth tells me something is happening that is not “normal” and paired with other signs/symptoms I will at least suspect there could be some disordered sleep breathing.
The American Dental Association has issued a position statement that says that dentists are encouraged to be on the frontline of screening for sleep disordered breathing. In the course of your regular dental visit, your dentist is looking for a lot of different things besides just gingivitis and cavities! They are looking for serious medical issues as well- oral cancer, pathology, high blood pressure, and hopefully signs/symptoms of Obstructive Sleep Apnea. Patients see their dentist oftentimes more frequently than their primary care docs. And we DEFINITELY look in your mouth for longer, oftentimes in more detail, and when you are laying down on your back. I bet your primary care doctor has never looked in your mouth while you were not sitting up. Because obstructive sleep apnea can manifest itself in the mouth, it makes sense that the dentist that looks in your mouth the most would be the provider to look for these signs and symptoms. If your dentist does suggest or ask about snoring, DON’T TAKE IT PERSONALLY. We are just trying to help you be optimally healthy, I promise, it is not a criticism or something to be embarrassed about. And if you’ve been in denial, it is time to recognize that you cannot control what you do while you are asleep! I’ve never met anyone that chooses to snore or clench their teeth while they’re asleep. In fact, I’ve never met anyone that had a choice one way or the other. The good news is, we can help you fix it! And acceptance of a problem is the first step to correcting it.
If you’ve ever been curious about your snoring, one thing you can do is download an app called Snore Lab. It will give you an idea of whether or not you’re snoring and how loud it is. Check it out, you might be surprised what you find out! I would love to know below why you think people take it personally when a dentist asks about snoring or clenching your teeth! Leave a comment and let me know.