Orthodontist highlights compromises to the human airway (Part 3)
Many health conditions can compromise the human airway. Dr. Barry
Raphael, an orthodontist with 33 years of experience, discussed
hypocapnia and breathing disordered sleep in a session of the Airway
Focused Dentistry Mini-Residency. The course was co-developed by Dr.
Raphael and Dana Point dentist, Dr. Mark A. Cruz.
Hypocapnia
Think of the body as a bottle of soda, filled with carbon
dioxide in the blood. Carbon dioxide gives a person a certain amount of
“fizz.” Imagine if the bottle of soda was left open overnight. It
becomes flat. Likewise, when a person leaves his or her mouth open all
night, the base level of carbon dioxide lowers. Hypocapnia involves having less than an optimal level of carbon dioxide in the body.
This condition causes spasms of smooth muscle tubes in an
attempt to reduce the loss of carbon dioxide. A person experiences
shortness of breath as is experienced with asthma. Hypocapnia also
causes spasms in all other smooth muscle tubes in the body.
When carbon dioxide levels are low, oxygen is not
distributed to the tissues properly. This can lead to rapid fatigue in
the muscles, poor memory, headaches, and many other issues. It is just
as dangerous to over-breathe as it is to overeat, Dr. Raphael said.
Breathing Disordered Sleep
Breathing disordered sleep includes snoring, Upper Airway Resistance Syndrome (UARS) and Obstructive Sleep Apnea Syndrome (OSAS). Daytime
symptoms include hyperactivity, behavior and learning difficulties, and
compromised somatic growth. Risk factors of breathing disordered sleep
include swollen tonsils and adenoids, crossbite (narrow palate), and a
convex facial profile.
Symptoms and signs of OSAS include:
A physical examination will reveal the person is underweight or overweight, tonsillar hypertrophy, a high-arched palate, failure to thrive, hypertension, a narrow face, or short jaws. Risk factors of sleep disordered breathing and OSAS include the size and condition of the airway and the flow of air through the airway. Sleep apnea occurs due to craniofacial morphology and obesity.
Bruxism
Bruxism is tooth grinding and clenching during sleep. It is
associated with caffeine, heavy alcohol use, anxiety and psychological
stress, sleep apnea, and reflux. Its secondary effects include tooth
wear and fracture, hypersensitivity, and temporomandibular derangement
and pain.
Understanding these conditions can better help dentists, as
well as orthodontists, treat patients. Drs. Cruz and Raphael are
committed to educating doctors of multiple disciplines in hopes of
improving medicine.