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Sleep Apnea and Impaired Oral Function: How Dentistry Relates to Heart Disease, Stroke, and Diabetes
Arthur M. Strauss, DDS
. http://www.amstraussdds.com


The body prioritizes for its survival, as illustrated in the CPR (cardio-pulmonary-resuscitation) sequence of airway (A), breathing (B) and circulation (C). This sequence is active all the time, managing body balance and survival through the autonomic nervous system (ANS).

This article will focus on the relationship between heart disease, stroke and diabetes, and obstructive sleep apnea and impaired oral function.

The jaws, teeth, cheeks and lips make up the mouth and influence the posture, position and contour of the tongue, the back of which serves as the front wall of the throat. Consider their effect upon the tongue as one upon a blind person living in a cave (the mouth), the size and shape of which is altered from jaw movement and dental changes. The tongue is the only dynamic part of the throat (the airway), thus controlling its size and shape.  The rest of the throat is essentially immobile or minimally mobile.

As the tongue moves in and out of the throat when we speak, swallow and breathe, changing it shape, it controls the aerodynamics of speech, enunciation, as well as, our access to air.

Apnea, Greek for without wind (breath), is the result of an obstructed (narrowed or blocked) airway and is a 24-hour problem that impacts airflow. To survive, the body reacts by compensating to keep the airway adequately opened through:

An increased state of “fight or flight” as in an adrenaline response via ANS.

Postural changes, often characterized by forward head posture, and changes throughout the body including muscles and joints.

Clenching and grinding of the teeth, which leads to most TMJ symptoms (temporomandibular joint).

How the body compensates varies based on the environment, and whether the person is awake (obstructive apnea) or asleep (obstructive sleep apnea). These compensations have secondary impacts everywhere.

The adrenaline response of a rapid heart rate, increased breathing rate, elevated blood pressure and apnea induced negative pressure in the head, neck, throat, stomach and chest can impact those who have or are at risk for heart disease or stroke.

Weight gain and diabetes may result due to the increased demand for blood sugar to meet muscle demands in order to maintain the adrenaline response a compromised body posture and clenching teeth.

Clearly, “impaired oral function” in dentistry can cause more than restless nights. It can serve as the origin of heart disease, stroke and diabetes.
