Is sleep disturbance the real problem? The interconnectedness of sleep, breathing and dentistry
STEAMBOAT SPRINGS — Several years ago, Dr. Jeffrey Harrison had an epiphany: by identifying and addressing airway and breathing issues, he could help his patients in ways far beyond fixing their teeth. A different approach to dentistry — and a focus on getting a good night’s rest — could even save lives.
When two of Harrison’s patients died due to issues related to nighttime breathing, he decided to change everything he was doing. He gave them great smiles, but he didn’t diagnose the breathing problems or why they had ground down their teeth, he said.
“I wasn’t taught to recognize that — just to fix teeth,” Harrison said.
With 25 years experience as an oral healthcare professional, Harrison now focuses solely on helping his patients get better sleep.
In 2017, Harrison opened Sleeping Giant Sleep Solutions in Steamboat Springs. He moved to the Yampa Valley in 2016 after 22 years spent operating Colorado Laser Dentistry in Colorado Springs. Harrison has also spent a significant amount of his career giving lectures across the country and globe.
About two weeks ago, upon reading a local news article about working to address the root causes of behavioral and mental health in young people, Harrison saw a glaring omission: the role of sleep.
Wanting to contribute his experience, expertise and concern, Harrison drafted a letter in response.
“Over the past few years, it became wildly apparent to me that, as a dentist, I was focusing on the wrong thing,” Harrison wrote. “My training was based on fixing disease, not preventing it from happening.”
The impacts of sleep deprivation, both on mental and physical health are wide-ranging, profound and potentially severe, Harrison described. And sleep-disordered breathing is often to blame.
“When sleep deprived, your body struggles to extract glucose from the blood stream, and your brain is unable to think straight. This then impacts your rational thinking, willpower, self-control, productivity and interactions with peers,” he wrote.
In his work with young patients, Harrison said he found sleep issues to be at the root cause of poor academic performance and some behavioral problems.
“When kids don’t, won’t or can’t go to sleep, wake frequently in the night or have difficulty going back to sleep, there are daytime consequences —behaviorally, physically and mentally,” he wrote. “The effects can be subtle or very obvious, and these compound over time. Some kids become tired but wired while others become lethargic and poorly coordinated. Some may appear to be OK but are, in fact, operating way below their ability level.”
And it isn’t just how you behave or feel the next day, Harrison said. Over time, sleep disorders can build and compound.
Research is now connecting “sleep fragmentation and disturbed sleep” Harrison wrote, to several types of cancer, diabetes, schizophrenia, heart attacks, stroke and Alzheimer’s disease.
Harrison is a big advocate of collaborative medicine and returning dental health to general health.
“No single person can provide the comprehensive care needed,” Harrison said. “Collaboration cures.”
Decades ago dental and medical medicine separated, he explained. “Like somehow the mouth was not attached to the rest of the body.”
Today, Harrison said he is seeing those worlds move back together.
“We know the outcome of a patient’s dental care is reliant on the outcome of a patient’s health care,” he said. And vice versa. “You can’t do one without the other.”
So, how does dentistry relate to how you breathe when you sleep?
It’s primarily about airway obstruction, Harrison said, which can relate to teeth and jaw development and positioning, swallowing, the tongue, lips and everything else related to the mouth, nose and throat.
Snoring is a big sign something might be wrong, Harrison said. As is bed-wetting in kids.
There are a lot of people walking around who don’t know they have sleep and nighttime breathing problems, he said. And the older they are, the harder it is to fix.
One in four adults have sleep apnea, and nine out of 10 children display incorrect signs of breathing during sleep, according to statistics.
One of the best-known treatments for obstructive sleep apnea is CPAP — Continuous Positive Airway Pressure — therapy.
But orthodontic/orthopedic appliances, like night guards, can also be very effective treatment, Harrison said.
Many sleep and breathing disorders start early in life, he said. And the earlier they can be caught, the better. It’s vital to get kids in a good sleeping pattern by the time they are 5, he said. That’s why Harrison advocates for HealthStart — a free child assessment program that begins with a detailed questionnaire.
In addition to questions about a child’s sleep and breathing habits, the assessment also focuses on speech.
While it can seem cute for a kid to say “wabbit” instead of “rabbit” or “pasghetti” instead of “spaghetti,” those mispronunciations can also be a sign of sleep and dental issues, he said.
Harrison also works with moms on breastfeeding and addressing babies born with tongue-tie, a condition present at birth that restricts the tongue’s range of motion.
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