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The Relationship Between Sleep Apnea and Bruxism

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Sleep apnea and sleep bruxism are two health conditions that typically occur during sleep. Although they represent different nocturnal activities, scientific research indicates they may be connected. In fact, a 2009 report from the American College of Chest Physicians (ACCP) reveals a high prevalence of sleep bruxism in people with obstructive sleep apnea (OSA).

Sleep Bruxism

Sleep bruxism is characterized by nighttime teeth grinding, gnashing or clenching. People with this condition unconsciously grind their teeth during sleep. Many are unaware of their problem.

Mild bruxism rarely requires medical treatment. On the other hand, frequent or severe cases may cause headache, earache, face or jaw pain, tooth damage and other problems.

Stress, anxiety, anger and frustration are contributors to nocturnal teeth grinding. Additional factors include smoking, taking illegal drugs and drinking alcohol or caffeinated beverages.

Sleep Apnea

Sleep apnea is a sleep disorder with potentially dangerous complications. It involves repeated stops and starts in breathing. People with this condition usually snore loudly during sleep and feel tired when they awake.

There are two main types of sleep apnea: obstructive sleep apnea and central sleep apnea. OSA, the more common form, occurs when throat muscles relax during sleep. The other form involves problems with the brain signals that control breathing. Complex sleep apnea, a less common form, combines the two.

Sleep apnea results from a narrow or blocked airway. The inability to breathe arouses the sleeper and reopens the airway. Most people do not remember awakening, although the process may repeat several times throughout the night. Obesity, high blood pressure, advanced age, medications, alcohol consumption and smoking may increase the risk of OSA.

The Connection between Bruxism and Sleep Apnea

The relationship between sleep bruxism and sleep apnea usually stems from an arousal response. When an apnea event ends, various oral phenomena may occur: snoring, mumbling, gasping, grunting and teeth grinding.

Stress, anxiety and caffeine ingestion are additional explanations. Studies link high anxiety levels to bruxism, and sleep apnea itself may cause anxiety. Additionally, the daytime sleepiness caused by apnea may lead to high levels of caffeine consumption which, in turn, is linked to a high risk of bruxism.

When bruxism is associated with OSA, certain therapies may treat both problems. Continuous positive airway pressure (CPAP) keeps a sleeper’s airway open to allow for normal breathing. It has also been shown to decrease sleep bruxism.  CPAP machines can be combined together in a custom configuration with a patient’s night guard to protect against both problems.

How Long Does an Orthodontic Treatment Take?

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The length of time an orthodontic treatment takes depends on the individual patient. An average comprehensive treatment takes around 18 months, but cases vary widely, and sometimes a limited solution can be reached more quickly than a comprehensive one. The length of an orthodontic treatment will depend largely on the extent of the misalignment of the teeth and bite as well as many other factors such as skeletal jaw discrepancies, periodontal disease, missing teeth, excessive tooth wear, TMJ/TMD problems, etc.

A wide variety of issues may be responsible for orthodontic problems. Some of these include thumb sucking, breathing through the mouth, and traumatic injuries.  The most important factor, however, is genetics, so you can thank Mom and Dad for your crooked teeth!

Am I Too Old for Braces?

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Straightening of misaligned teeth not only improves the appearance of a person’s smile but also contributes to long term dental health. Bite correction can also maximize comfort and minimize wear on teeth, jaw joints and chewing muscles over time.

Am I Too Old for Braces?

Traditionally, braces have been associated with adolescence, but more than half of the patients receiving orthodontic treatment in the 21st century are adults. Old myths about age limits for orthodontic treatment still persist, but even senior citizens can benefit from braces. Orthodontics using modern materials and advanced applications provide more choices for adults concerned about the appearance of braces and the length of time for treatment. Regardless of age, it’s never too late to create a more appealing and healthier smile.

Orthodontic Appliances

The most common type of braces, metal-wire and bracket braces, utilize stainless steel. Clear braces using plastic and ceramic are also widely used and minimize the appearance of braces. For patients with allergies to nickel, titanium or gold-plated stainless steel may be used. Modern advances in orthodontics have created several choices, such as Invisalign® and other removable clear aligner systems.

Costs and Time

Orthodontic treatment may take from several months to several years depending on the patient’s needs and the treatment plan and appliances chosen for correction. The type of treatment prescribed along with length and complexity of treatment determine the total cost. In some cases, a patient’s dental insurance may pay for a significant portion of the cost of treatment.

The History of Orthodontic Braces

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Human beings have felt strongly about the value of a good smile for thousands of years. Even mummies from ancient cultures have been discovered with bands wrapped around their teeth from early attempts at orthodontics. In the thousands of years since then, orthodontic technology has made astounding advances, but the practice’s historic roots were amazingly simple.

Ancient Greece and Rome

As early as 500 B.C., Greek philosophers Aristotle and Hippocrates considered different methods of straightening teeth, but it is the Etruscans who are credited with first using appliances to perfect the smiles of its citizens. Later, the Romans developed crude gold wire bindings for the manipulation of teeth. The Roman philosopher Pliny the Elder suggested filing the teeth to create a uniform look, which remained common until the 1700s.

Braces Begin to Transform

In 1728, Pierre Fauchard, known as the “Father of Orthodontia,” wrote a book titled “The Surgeon Dentist“ that included a chapter devoted entirely to methods of straightening teeth. He advocated the use of what he called a bandeau. This device, a small strip of metal that was bound to the teeth using ties, was used to expand the arch of the mouth and modify the alignment of teeth. Later, in 1757, the French dentist Ettienne Bourdet published a book called “The Dentist’s Art,“ with its own chapter covering the alignment of teeth using appliances. Bourdet is credited with perfecting the bandeau and is the first dentist known to have extracted teeth to prevent overcrowding.

The Roots of Modern Orthodontics Emerge

In the late 19th century, Norman W. Kinsley and Edward H. Angle pioneered ideas on misalignment of teeth and formed the principles upon which modern orthodontic treatment is based. Using long-term pressure and regular adjustments, dentists of the early 1900s refined orthodontic practices to create methods similar to those in use today. Early bands and wires were made of precious metals such as gold, platinum and silver. Steel was not commonly used for braces until the 1950s.

Recent Decades

In the 1970s, new brackets were invented that bonded directly to the teeth, but these brackets did not become popular until the next decade. Throughout the 1980s and 1990s, orthodontic technology rapidly progressed. One of the biggest breakthroughs was wires made of nickel-titanium alloy, a technology developed by NASA. These wires, which are used to apply a gentler force over a longer period of time than stainless steel wires, are still used today.

The next major breakthrough was Invisalign, a method for straightening the teeth without the use of braces.  We will cover the evolution of Invisalign in a later post.

Today, it is truly amazing how far the field of orthodontic braces has come since its beginnings thousands of years ago. As new technologies continue to emerge, the field will likely offer consumers even more convenience and options in the future. One thing that will never change, however, is the immeasurable value of an attractive smile and a functional bite.

You’re Not the Only One: Celebrities That Have Worn Braces

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Millions of people wear braces every year, including celebrities. These braces align the teeth, improve the function and comfort of your bite, give you a great smile and make your teeth easier to clean. If you think that you might look different or dorky when you wear braces, you should take a look at some of these famous people who wore their braces proudly.

Male Celebrities

One of the most famous men who wore braces is actor Tom Cruise. Cruise appeared in movies like Top Gun and Mission Impossible before he decided to fix his crooked teeth. The actor was 39 when he first stepped out wearing braces. He wore the braces while filming and working on his next movies. He might have inspired actor Nicholas Cage to visit to the orthodontist too. The actor who starred in Con Air and Leaving Las Vegas got his braces in 2003. His new smile helped him land the title role in Ghost Rider. Danny Glover of Lethal Weapon also decided to change his smile by using braces. The actor revealed his braces in 2006, and he continued working on movies while wearing them. Glover chose clear braces, which reduced the visibility of the braces.

Famous Females

Lyndsey Fonesca starred on a television soap opera, but she later decided to straighten her teeth with braces. The actress revealed her braces at the Daytime Emmy Awards, and she later earned roles in Hot Tub Time Machine and How I Met Your Mother. Actress Dakota Fanning made a name for herself as a child actress. In 2006, she revealed that she also wore braces by showing off her smile on a publicity tour for one of her movies. Fanning came back to Hollywood after getting the braces off with starring roles in the Twilight franchise and The Runaways. Madonna’s daughter and rising fashion designer Lourdes Leon also wears braces. Leon flashed her braces on the red carpet.

Just for Fun

When No Doubt found fame and fortune in the late 1990s, many fans noticed that singer Gwen Stefani wore braces. Instead of the invisible braces popular with most celebrities, Stefani chose the old-fashioned stainless steel variety. Stefani wore the braces during publicity tours, photo shoots and concerts. Recently, Stefani revealed that she didn’t need to wear the braces, but she thought they were a fun accessory.

Stefani is not the only celebrity who wore braces for publicity. Model Cindy Crawford wore braces when she was a child, and the model later wore a fake pair of braces when shooting a commercial for Pepsi. America Ferrera never needed braces until she landed a role on Ugly Betty. The producers wanted the Betty character to look out of place in the high fashion world, so the producers added metal braces to the wardrobe. These celebrities helped make braces look fashionable.

Do You Have TMJ?

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TMJ disorders affect the joints on both sides of your face, where your skull and jawbone meet. These disorders are often extremely painful and require treatment; most cases can be treated non-surgically.

The symptoms associated with TMJ include jaw joint pain, problems chewing food, pain in or near your ear and pain in the muscles of the face, temples, neck and even shoulders. People with TMJ may also have recurrent headaches, locking jaws and an uncomfortable or uneven bite. If you suffer from any of these symptoms, along with clicking of the jaw joint, you may have TMJ and should be evaluated by a dentist or orthodontist for a diagnosis and treatment plan.

TMJ disorders are often caused by damage to the disc inside the joint, which can be due to misaligned bite or a variety of other causes. If the disc in the jaw joints moves out of alignment, TMJ symptoms may also occur. People who grind or clinch their teeth while they sleep are at an increased risk of developing a TMJ disorder. Women who are between the ages of 30 and 50 are most likely to develop this problem. Those who were born with a deformation of the jaw joint or those who suffer from rheumatoid arthritis, fibromyalgia or chronic fatigue syndrome are also at increased risk of potential TMJ problems.

You dentist or orthodontist will perform a physical evaluation to determine if you have a TMJ disorder. It may also be necessary to obtain an X-ray, CT scan or MRI of your jaw joint to confirm the diagnosis. Symptoms sometimes disappear on their own with no treatment. If your symptoms are persistent or severe, your doctor may prescribe medications for the pain, muscle relaxation or reduction of inflammation. You may also require a bite splint (or “night guard”), which is typically worn at night to protect the joints, muscles and teeth during grinding activity. If you have missing teeth or a misaligned bite surface, orthodontic tooth movement may be necessary. TMJ surgery is only performed as a last resort, when all other treatment methods have failed to relieve your pain.