Sleep Apnea and Pain Management Oral Systemic Balance

By Arthur M. Strauss, DDS

During Obstructive Sleep Apnea (OSA), the tongue and jaw muscles progressively relax as we move into deeper and deeper and more restful sleep. This leads to a partially, and often fully, blocked throat, choking us and initiating the “stress response.”

It has been shown that dental structures, including the size, shape, contours, and positions of the jaws and teeth, influence the posture and position of the tongue in relation to the throat when awake and asleep.

In prior articles, I have referenced how our body compensates for this structural relationship while awake and asleep through

Clenching and/or grinding teeth (more often during sleep)

Posture changes (poor posture while awake and postural changes while asleep)

Increased adrenaline secreted, as in the “fight or flight” response, increases muscle tone and activity to support the above actions, including breathing, circulation, and more

The “dental complex” has a major structural impact on the threshold that triggers the need for compensation, the amount of compensation, or effort needed to keep the body even and in balance.

This has been referred to as Oral Systemic Balance (OSB).

When an individual has symptoms that warrant a diagnosis of OSA, we consider the jaw-tongue-throat complex because it is very sensitive, like a hair trigger that fires off threatening signals to the brain to activate the “fight or flight” or “stress” response.

This is likely related to breathing and air supply and the body's immediate sense of a serious life-threatening situation.

A study published in February 2012 in Pain Medicine concluded that the way someone breathes decisively influences autonomic and pain processing, thereby identifying “deep slow breathing” (DSB) in concert with relaxation as an essential feature in the modulation of sympathetic arousal and pain perception.

Mindfulness meditation seems to reduce distractive and ruminative thinking as the essential feature in the modulation of sympathetic (“fight or flight”) arousal and pain perception.

Oral Systemic Balance focuses on improving the jaw-tongue-throat anatomical relationship to enhance ease of breathing, swallowing, and speaking. This raises the threshold that triggers the need for compensation, because it naturally facilitates DSB and air supply integrity.

The influence of dentistry upon ease of breathing and stability of the airway is far greater than previously suspected. Dentistry's influence controls our sensitivity to both physical and mental (thinking) relaxation and distractions that disturb the tongue position, airway integrity, airflow, and breathing. Dentistry impacts the “stress response,” thus reducing pain and increasing inner peace.