Your Mouth Tells a Story: Functional Dentistry Connects Oral Health to Sleep Apnea and Heart Disease
The focus of functional medicine—whole person health care—easily expands to include dentists trained in oral systemic health. Currently embraced by a small percentage of today’s farsighted dentists and doctors, this relatively new field of prevention and wellness views the mouth as a key portal when considering the status of the whole body. Similar to the way doctors of Oriental medicine assess the heart’s pulse to help diagnose health issues throughout the body, these systemic health dentists consider the gums, tongue, teeth and throat to be key signals of overall health.
American Academy for Oral Systemic Health (AAOSH) Executive Director Bobbie Delsasso was a periodontal hygienist for more than 30 years before becoming a consultant and public speaker on the larger perspective. “I taught patients about the importance of good nutrition and alerted them to consult their physician regarding what their mouth health might indicate about their body’s health,” she says. While the academy educates dental professionals to understand the internal workings of nutrition and what the mouth reveals about overall well-being, “Less than 6 percent of physicians even learn adequate basics of nutrition in medical schools,” she notes.
Cardiovascular Health Links
Beyond nutrition, academy curricula for dentists now include such titles as Arteriology and Vascular Inflammation – The Oral/Systemic Connection, based on a course designed for medical professionals by physician Bradley Bale and Amy Doneen, an advanced registered nurse practitioner, co-founders of the Bale/Doneen Method for the prevention of heart attack, stroke and diabetes. Mike Milligan, a doctor of dental medicine, founder of Eastland Dental Center, in Bloomington, Illinois, and AAOSH president, explains that heart attack and stroke are triggered by an inflammatory process which can be initiated or exacerbated by periodontal disease and abscessed teeth.
Thomas Nabors, a doctor of dental surgery and an authority in molecular analysis and genetic risk assessment for periodontal diseases, provides clinical proof that supports the growing association between medicine and dentistry. “Since our inaugural AAOSH conference [in 2010], Bradley, Amy and Tom have continued to provide the current science and clinical backdrop to the oral/systemic connection to cardiovascular wellness,” says Milligan.
Respiratory Health Links
Other vital advances in oral systemic health involve treating airway concerns such as snoring and sleep apnea. “Snoring is typically caused by muscles and tissues relaxing in the throat and mouth, resulting in decreased space in the airway passage and vibration of tissues. Eventually, individuals can develop sleep apnea, which can also result in hypertension and other problems,” advises Milligan.
In sleep apnea, the sleeper’s breathing pauses often or produces hypopnea, slowed or shallow breathing for 10 or more seconds at a time. Fewer than five episodes per hour is normal, with five to 15 considered mild apnea, 15 to 30 moderate and more than 30 severe.
Although 20 percent of Americans may have sleep apnea—typically associated with insomnia, tiredness and less oxygen in the body—95 percent of affected individuals go undiagnosed. To help, Milligan suggests that before going to bed we lower the thermostat in the bedroom and avoid drinking alcohol, smoking, watching television or working on a computer.
Improved breathing helps assuage snoring, sleep apnea, asthma, hay fever and nasal congestion. Milligan cites Patrick McKeown’s work, explained in his book The Oxygen Advantage. An authority on the Buteyko Breathing Method, McKeown explains how improved breathing dramatically improves oxygenation, releases more energy and supports lifelong health and well-being.
Muscle retraining using orofacial myofunctional therapy can help prevent sleep apnea and also abate temporomandibular joint disorders. This new field is concerned with orofacial functional patterns and postures when teeth are apart, their status 95 percent of each day and night. It also retrains muscles to keep the tongue at the roof of the mouth and the lips together to prevent breathing through the mouth, correct swallowing function and eliminate poor oral habits such as thumb sucking.
Three mechanical treatments for sleep apnea include mandibular advancement oral devices used to move the lower jaw forward, a continuous positive airway pressure machine to aid airway functioning, or surgery, which is the last resort. “The real opportunity for catching and preventing this is with children 5 to 10 years old, when their jaws are developing,” says Milligan.
He further cites links discovered between the mouth and brain. “Oral spirochetes, which normally live in the mouth, have been found in the brains of Alzheimer’s patients. Dr. Judith Miklossy, from the International Association for Alzheimer’s, spoke at an AAOSH conference about the link between oral bacteria and dementia, and Garth Ehrlich, Ph.D., professor of microbiology, immunology and otolaryngology at Drexel University College of Medicine, addressed rheumatoid arthritis and certain types of cancers.
All of these links are more than enough reasons why good oral hygiene is essential to good health,” says Milligan.