At the Michigan Head & Neck Institute, we treat both temporomandibular joint disorders (TMDs, also called TMJ) and obstructive sleep apnea (OSA). This is not merely random or a combination of convenience; we’ve chosen it because these two disorders are closely related. How closely related? Research shows that about 75% of people with TMD have symptoms that suggest sleep-disordered breathing (a category that includes both snoring and OSA). In addition, people with OSA symptoms, such as loud snoring, are nearly four times more likely to have chronic TMD.
In other words, people with OSA are likely to have TMD and vice versa. Treatment of either condition should involve awareness of the other to ensure people get great results for both treatments. At the Michigan Head & Neck Institute, we understand the close relationship between these conditions and know how to manage them simultaneously to deliver outstanding results.
Jaw Structure Contributes to OSA and TMD
A critical connection between these conditions is your jaw structure. The size and shape of your maxilla (upper jaw) and mandible (lower jaw) are closely related to the size and shape of your upper airway. If you have large jaws, your upper airway will likely be large. If you have small jaws, your upper airway is likely to be smaller, making it more prone to collapse, which causes OSA. A retrognathic jaw- a mandible positioned toward the back- can also contribute to upper airway collapse because the jaw isn’t providing proper support to the soft tissues of the airway.
Small jaws and retrognathic jaw also affect the way you chew. To chew with these particular jaw structures, you are constantly moving your jaw and exerting your jaw muscles in ways that can contribute to the development of TMD. TMD can originate from the temporomandibular joint (the jaw joint) or any of the numerous structures connected to it, especially the muscles. The jaw muscles and their partners stretch from the shoulders to the top of the head, so TMD can commonly cause wide-ranging symptoms, including neck pain and headaches.
With this common cause, it’s no wonder that the two conditions are commonly comorbid. However, do the diseases contribute to each other? This is a more complicated question.
Sleep Bruxism, OSA, and TMD
Sleep bruxism occurs when you involuntarily clench and grind your teeth at night. Of course, clenching and grinding are different experiences and can come from other causes. But are they linked to OSA and TMD?
There is some evidence that teeth clenching is related to OSA. Some studies show that people often clench their teeth after apneic events. This can be interpreted as an attempt by the body to anchor the jaw in a more favorable position to hold the airway open. However, there is no evidence that treatment of OSA with CPAP stops sleep bruxism, which casts doubt on the cause-and-effect relationship between these conditions. Treatment of OSA with an oral appliance can help manage sleep bruxism.
Bruxism is considered both a contributing cause and an effect of TMD. TMD treatment is highly effective at managing sleep bruxism.
Potential Bite Complications of OSA Treatment
Treating OSA is potentially life-saving. In addition, it can dramatically improve your quality of life by helping you have more energy, fewer headaches, and better overall health. If you are diagnosed with OSA, it’s essential to find a treatment option that works for you.
However, ensuring that the treatment option doesn’t cause bite problems is also important. Unfortunately, evidence suggests most sleep apnea treatment options can impact your bite. Strapping a CPAP mask to your face every night can deform the jaw, leading to crooked teeth and bite problems. Similarly, oral appliance therapy can impact your bite, leading to consequences ranging from cosmetically crooked teeth to temporomandibular disorders.
To avoid the worst complications, you should work with a dentist thoroughly trained in TMJ and sleep therapy.
Can TMD Treatment Lead to OSA?
TMD is not a life-threatening condition like OSA. However, TMJ disorders can significantly impact your quality of life. They can cause chronic pain, disruptive tinnitus, and impaired jaw function. People with TMD may have trouble speaking, chewing, and swallowing, which can make it hard for them to live a normal, comfortable life. The chronic pain and dysfunction of TMD can lead to severe depression. People with serious TMD need treatment.
However, it’s important to approach TMD treatment intelligently. Just as OSA treatment can impact your bite, bite treatment can potentially lead to sleep-breathing problems. For many, TMJ treatment means wearing a bite splint that repositions the jaw. Repositioning the jaw also changes the shape of the airway. A poorly fitted bite splint can cause loud snoring, apneas, and sleep problems.
When choosing a TMD dentist, choose one who also understands the ramifications of treatment on your airway so you can avoid OSA as a complication of TMD treatment.
Comprehensive Care for OSA and TMD in Detroit
If you are looking for a dentist in Detroit to treat either OSA or TMD, choose one skilled in treating both conditions. The conditions are so closely related that you may have more than one. Even if you don’t, poorly designed OSA treatment can aggravate your TMJ, while TMD treatment can contribute to OSA.
If you are looking for a Detroit dentist skilled in OSA and TMD treatment, contact the Michigan Head & Neck Institute today.
