As dentists, Dr. Robert J. Williams, DDS, and Dr. Robert C. Williams, DDS, FAGD, recognize that they are in a unique position to help screen for and educate patients about systemic health conditions such as diabetes, cardiovascular disease, and oral cancer. Because many people visit their dentist more regularly than their physician, dental professionals often have opportunities to identify early signs of health concerns that may otherwise go unnoticed.
In addition, Drs. Williams and their team of dental hygienists and assistants are trained to recognize signs of airway issues and sleep-disordered breathing, including snoring and sleep apnea. The oral cavity frequently provides important clues that can indicate these conditions. Common signs may include nighttime grinding or clenching (bruxism), TMJ pain, airway obstruction, tongue thrusting, and bite-related issues.
Their goal is to help every patient achieve optimal health and well-being. As part of that commitment, they take the time to educate patients about these conditions and explain the important connections between oral health and overall health, empowering patients to make informed decisions about their care.
Request an AppointmentWhat Is Sleep Disordered Breathing?
Sleep disordered breathing describes a group of sleep breathing issues involving:
- Abnormal respiratory patterns such as loud or chronic snoring, apnea, and/or hypopneas
- Insufficient ventilation during sleep, stemming from systemic disease or anatomical issues which may cause narrowing of the breathing passages
An apnea is when a person stops breathing for at least 10 seconds, before “waking up” to take a breath. A hypopnea is when a person’s breathing becomes shallow for 10 seconds or more. Their blood levels of oxygen may drop, but they don’t actually stop breathing completely.
Experts agree that things like mouth breathing, light snoring, noisy or effortful breathing, fitful sleep, multiple awakenings at night, insomnia, bed wetting, etc. are also signs that a person may have a sleep breathing problem.
When breathing is impaired, you may not be getting sufficient oxygen to your brain and tissues while you sleep, or your body may be making compensations night after night to open the airway, which can leave you exhausted in the morning. This nightly battle may manifest in many different health concerns, such as high blood pressure, migraines, gastrointestinal disorders, autoimmune diseases, and depression and anxiety to name a few, which are often overlooked as having a basis in a lack of quality sleep.
Causes And Diagnosis
There are many reasons a person may develop sleep apnea, and similar sleep disorders, at any stage of life. Some of the most common are weight gain, large tonsils or adenoids, respiratory problems like asthma, allergies, COPD, nasal obstruction, a narrow palate leading to reduced room for the tongue and smaller nasal passages, and loss of tone in the airway and tongue muscles.
If you or your doctor suspect that you have a sleep breathing issue, he or she may order you a sleep study, which can either be done at home (Home Sleep Test), or in a laboratory overnight (Polysomnogram). If you, or your doctor, aren’t totally convinced enough to order a test for you or a family member, you can also track your sleep at home with free Apps like SnoreLab, or with devices like the Apple Watch or FitBit. Videoing a sleeping child or spouse at night can also be very revealing. This data can give you and your doctor more information to see if a more in-depth test is needed.
Sleep studies, particularly those done in a lab overnight, will tell you if you are suffering from one of many sleep disorders. Some common diagnoses patients receive are:
- Sleep Apnea: Characterized by loud snoring, choking noises, and pauses in breathing leading to oxygen deprivation.
- Upper Airway Resistance Syndrome (UARS): This sleep disorder is characterized by narrowing of the airway rather than a cessation in breathing like in sleep apnea.
- Insomnia: Described as problems falling or staying asleep.
Restless Leg Syndrome (RLS), Narcolepsy, and REM Sleep Behavior Disorder are also common diagnoses from a sleep study.
If you suspect that you or a family member may be experiencing a sleep disorder, we encourage you to discuss your concerns with your physician and with Dr. Robert J. Williams, DDS, or Dr. Robert C. Williams, DDS, FAGD, at your next dental visit.
Signs In The Mouth
Over the last several years, a growing body of research has demonstrated that many dental concerns may have airway-related issues as an underlying cause. Conditions such as temporomandibular joint disorder (TMJ/TMD), orthodontic problems, narrow jaws, excessive tooth wear, clenching and grinding, cavities, dry mouth, and gum disease can all be associated with sleep-disordered breathing.
Dr. Robert J. Williams, DDS, and Dr. Robert C. Williams, DDS, FAGD, along with their clinical team, are trained to evaluate the upper airway—including the mouth, jaw, nasal passages, tongue, and throat—to help identify potential airway concerns. When appropriate, they work closely with medical and dental specialists to ensure patients receive comprehensive care for sleep-related breathing disorders.
Some oral signs that Drs. Williams and their team evaluate include:
- Tooth wear caused by bruxism (clenching and grinding) or airway-related acid reflux
- Effects of chronic mouth breathing, such as red, swollen gums and recurrent tooth decay
- Enlarged tonsils or narrowing of the airway at the back of the throat
- Jaw discomfort, clicking, or popping when opening and closing the mouth
- Tongue-tie and lip-tie restrictions
- Signs of restricted tongue space or improper tongue posture
- Bite irregularities that may contribute to airway dysfunction
Dental Treatment Options For Sleep Apnea
A poor bite, missing teeth, misaligned or narrow jaws and other dental abnormalities can further cause breathing problems. Depending on the particular issue, your dentist, orthodontist, or oral surgeon can correct them.
Treatments include:
- Night Guard: Worn during sleep, this device can help prevent tooth grinding, as well as temporarily opening the bite to give the tongue more space, which can improve milder sleep breathing issues at night.
- Mandibular Advancement Device (AKA snoreguard): This removable nighttime device temporarily moves the lower jaw forward to help open the airway, particularly for patients with obstructive sleep apnea. It may be worn during sleep with or without CPAP therapy and can also help improve snoring and bruxism. Napa Valley Sleep Solutions offers several custom oral appliance options, including the SomnoDent Avant®, which is designed to support the lower jaw in a forward position to help maintain an open airway during sleep. Oral appliance therapy may also be covered by medical insurance when a patient has a sleep apnea diagnosis from a sleep study.
- Palatal Expander: Attached to the teeth, or in some cases the palate itself, this device can widen the upper jaw and may be used to address certain orthodontic and airway concerns.
- Tongue and Lip Tie Release: Dr. Robert Williams, DDS and his hygienists have taken specialized training to identify functional issues with tongue range of motion caused by tongue ties.
- Jaw Surgery: In severe cases of sleep apnea, jaw surgery known as Maxillomandibular Advancement (MMA) may be an option.
Myofunctional Therapy
Our office is one of the few in the area with hygienists on our team who are trained in myofunctional therapy.
Myofunctional therapy consists of a system of techniques and exercises to strengthen the muscles of the lips, tongue, airway, and chewing and swallowing, enabling them to support effective nasal breathing during the day and night, which can reduce symptoms of bruxism, snoring, and sleep apnea.
Particularly in small children, it can be very effective in helping to guide jaw and facial growth. Myofunctional therapy can also be used along or in conjunction with orthodontics, tongue and lip tie release, and jaw surgery at any age.
If you think you have sleep breathing issues, discuss them with Dr. Robert Williams, DDS at your next visit. It’s important to your quality of life to correct breathing problems as early as possible, and we will work with you to make sure you receive effective treatment.