Whistler Dental

Last week-end Dr. McKenzie and his wife Janis attended a meeting about Dentistry and sleep. As more information becomes available, it is becoming evident that Dentistry is central to sleep, and Sleep is central to Dentistry.  The link between the two is the airway and the TMJ and Bruxism.

I'll try to keep this as simple as possible.  When a person is falling to sleep they pass thru a number of different stages before arriving in REM sleep.  REM sleep is where everyone needs to get every night.  The exact amount of REM sleep needed by each individual is different, however REM sleep is essential to good health.  During REM sleep all the myriad restorative functions occur that make a person feel well rested the next day.  It is akin to re-charging a battery.  Re-charging a persons battery is essential to survival.

During REM sleep the persons body is very relaxed.  So relaxed that it is paralysed.  During this intense relaxation many peoples airways become too relaxed and thus their breathing ability is compromised.  Often this is accompnied by very loud snoring.  The snoring is the soft palate and the uvula flapping as the velocity of the air flowing thru the airway is increased.  The velocity is increased simply by the diameter of the airway being decreased due to the lack of tone in the muscles.  As the airway becomes compromised the level of oxygen in the blood starts to fall.  Most peoples day-time waking blood oxygen saturation is over 95%.  This is essential for the health of our bodies amd especially our brains !  Our brains are our most oxygen dependant tissues in our body.  It is not un-common for many ordinary healthy people who think that they have no problems,  to have oxygen saturation levels of under 90% while they are sleeping. 

This leads to a very fitfull  fragmented sleep.  As the oxygen level starts to fall the body compensates by increasing the rate of respiration.  That is the heart beating faster, and the person breathing faster.  NEXT THE PATIENTS BLOOD PRESSURE STARTS TO SOAR.  Next, the person starts to grind/clench his/her teeth.  This is known as bruxism.  As the patient is bruxing he is moving his lower jaw around into all sorts of bizarre positions  while putting incredible forces on his/her teeth.  The patient is doing this to help stiffen/open the airway.  And to top it off another common feature is acid reflux or GERD.  This struggle usually results in the person awaking with a very characteristic loud snort.  This results in the person having a very poor sleep.

When this typical patient is bruxing,  he/she is destroying their teeth.  As this struggle to breath is going on the are damaging their teeth and many other body systems such as the cardiovascular.  The extreme manifestation of this struggle is called Sleep Apnea and is a VERY serious medical disorder which always needs treating.  This is a new emerging field in Medicine and Dentistry.  The medical aspect is hard on the entire cardiovascular system.  Not just the heart, but also the endometrium which is the lining of all the blood vessels. Changes happen here which will pre-dispose a person to stroke.  The dental aspect is bruxism which leads to broken down teeth and distressed TMJ joints.  They are all  intimately inter-related.  It is very hard to distinguish which came first, the chicken or the egg?