Not Sleeping? See the Dentist

SLEEP…a hot topic for sure. We all know the importance of sleep and how the lack of quality sleep can create physical, mental, and emotional problems. We hear it in the media all the time, which makes it even more stressful — anxiety-producing, even — for people not getting a good night’s sleep.  The question, then, becomes is it a sleep hygiene issue or a medical condition like sleep apnea — or a combination of both?

Sleep hygiene, defined as “the habits and practices that are conducive to sleeping well on a regular basis,” is often a major fail for adults. We understand that infants need sleep, and create a soothing, consist, quiet bedtime routine to meet this need.  But we forget, in our busy lives, that for adults this need for sleep is just as important.


You may be all-too-familiar with the effects of not sleeping. Many of my patients report having symptoms that range from feeling fatigued despite hours of sleep, brain fog, waking in the middle of the night to use the restroom, irritability, daytime headaches, heavy snoring, GERD, weight gain, headaches, dry mouth, and jaw pain. You can see how this would negatively affect one’s life!

So how do we establish good sleep hygiene?

Our bedrooms should be an electronic free-zone, used for sleeping. Yes, that means no smart phones, iPads, tablet, computers, etc — even TVs should be kept elsewhere. It is also helpful to avoid spicy foods, napping, and stimulants like caffeine (including chocolate!) late in the day.  Get your cardio in early, unless it is a yoga, light walking, or meditation to help you wind down.

If you are still having problems sleeping, there may be a medical component, for example sleep apnea, that should be evaluated…and you can start at your routine dental exam.

How does a dentist play a role in identifying and treating sleep apnea?  During an exam, I look for several indicators that likely signal a problem: a narrow palate, crowded teeth, visual access to the tonsils, scalloping of the tongue, enlarged neck, bony growths on the upper and lower gums, and evidence of teeth grinding or bruxism.  We also offer in-office 3D ICAT imagining, which allows us to view and measure a patient’s airway.  If the airway is compromised, I will refer a patient for a sleep study to diagnose sleep apnea.


The most common way to treat sleep apnea is by using a CPAP machine, which provides a steady stream of pressurized air through a mask during sleep. However, many patients don’t like to use this cumbersome machine, leaving them untreated (and not well rested!). I prefer to use an oral appliance, a device that gently holds the lower jaw in a forward and downward position, relaxing the joint and physically opening the airway to increase throat diameter and thus breathing.  I have found success using a combination therapy — a CPAP machine and oral appliance — for severe apnea, and an oral appliance only for mild to moderate apnea.


My patients who use the oral appliance feel better cognitively and physically.  It is a game-changer to get a good night’s rest, and my patients reap the benefits that go along with healthy sleep!

Look for my next post on dental health and my approach to overall health and wellness, in the meantime, be well.

If you or your sleep partner struggle to get restful sleep, please call DC Smiles/TMJ & Sleep Therapy Center of the Greater Washington Area at 703.299.4614 to schedule an evaluation with me. 

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