Articles about sleep apnea and TMJ pain can be found throughout literature with hundreds of scientific studies. There is a connection. Interestingly, the Center for Disease Control (CDC), released clear and concise information regarding sleep apnea, stating that sleep apnea has become a national epidemic. Some studies show that 85% of sleep apnea patients remain undiagnosed.
Sleep apnea is very often related to underdevelopment of the jaws. Almost all treatment is geared towards managing the issues: dental sleep appliances, CPAP machines. It should be about fixing broken foundations to develop the proper airway system. Once the foundation is stable, moving teeth back into alignment in the correct place in the face is not complex.
There is true connection between airway, the jaw joints, muscles, neck, and anterior nasal complex. This may seem confusing, however, they all interact and work together.
Teeth that meet together in the wrong place in the head can cause many issues including narrowed airway space, this in turn can cause patients to exhibit forward head posture so as to allow them to get more oxygen intake, which in turn affects the posture of the neck and jaw joints as well as the development of the upper and lower jaws. Some patients may brux or grind their teeth in an attempt to open their airway as well as to try and find a more comfortable and correctly positioned bite for their teeth. This is by no means simple to explain, however, all these issues should be addressed when treating patients with TMJ and/or sleep apnea.
Even though a clicking/non-clicking joint can be asymptomatic, non tender to palpation and a normal range of motion, it may yet be the culprit that produces headaches, neck pain and sleep apnea.
Sadly, most treatment is focused on controlling sleep apnea by means of dental appliances or CPAP treatment especially in children. Very few professionals actually try to evaluate the true cause of these issues. You can have a good occlusion (the way the teeth meet together) with gross malfunction of the jaws. Simply stated the teeth meet together correctly but are in the wrong place in the face.
Mouth breathing, lack of nasal breathing, orthodontic treatment retracting the teeth backwards can all cause a narrow airway by forcing the jaws backwards. This is easy to see on a 3D scan (see photo above).
Addressing the development of the anterior nasal complex and correcting, by non-surgical means and correcting associated mouth breathing issues too could significantly decrease this sleep apnea epidemic. The usual course of treatment is orthodontics to straighten teeth and/or a sleep appliance or CPAP to keep the airway open or force air into the chest.
Patients who have worn their teeth down by through bruxism or grinding, most often have their teeth built to the same bad bite position that caused them to ruin their teeth. It is much better to consider correcting this and restoring their teeth to the best possible position which should in turn open their airway as well. This treatment should be a functional cosmetic dental approach.
Perhaps it is much easier to classify all this as midface deficiency that through allergies, mouth breathing, orthodontic retraction of teeth does not allow the face to develop properly. These issues can be treated and this does help the development of the airway in children and adults. Learning to diagnose and treat these TMJ and sleep issues is most often better for ones health than simply managing it.
In fact, this full face development not only allows us to have better airway and breathing but also creates more beautiful facial esthetics. All treatment should protect or enhance the airway.
If you have any questions about TMJ treatment or Sleep Apnea, please contact our office, Ronald W. Konig DDS, FAGD, LVIF, FIAPA, 713-248-8868