The Silent Killer

Barbara Tritz
· August 18, 2014 ·

4 minutes

Today’s post is part II – following up on sleep apnea in adults.  Why is a dental hygienist writing about a “medical problem”?  As a dental hygienist, I see many signs in the mouth/throat that alert me to a potential  issue with sleep apnea- even before my patients are aware (or maybe it’s really because they don’t want to acknowledge) they may have a problem.  Let me give you a little background on sleep apnea and what signs I look for while examining my patients.  There’s lots of information on the internet so you can explore this further.  If you have any questions I am happy to answer any emails.
There are two kinds of sleep apnea- central sleep apnea and obstructive sleep apnea. Central sleep apnea results from the brain “forgetting”  to tell your body to breath at night.  While a rare condition, it definitely needs attention and is beyond the scope of this article.  Today we’ll focus on obstructive sleep apnea- when your throat closes off while you sleep.
Obstructive sleep apnea is truly a silent killer.  As I noted in last week’s post on children with sleep apnea, upwards of 10% of children have it!  If left untreated, these children grow up into adults with sleep apnea and many medical issues.   This figure increases with adulthood to 25% of adults having sleep apnea, and for those  over 65 years of age the number increases even further to between 30 to 60%!   22 million people in the US have it and don’t know it!
At least 80% of peple experiencing obstructive sleep apnea go undiagnosed. Experts estimate that 9% of women and 24% of men are affected. Cleveland Clinic HealthHubHere’s a sample of some more statistics to start your day.  If you have sleep apnea you are:
     2.5 times more likely to have high blood pressure
     3.9 times more likely to have congestive heart failure
     2 times more likely to die in your sleep
     2 times more likely to die of a heart attack or stroke
     40% greater chance of suffering from depression

How’s that for sobering? My post entitled When You Let Plaque Attack discusses heart attacks, strokes and the connection to gum disease and tooth decay.  The book I quoted from:  Beat The Heart Attack Gene  by Amy Doneen and Brad Bales also discusses the connection between sleep apnea and cardiovascular disease in depth.  I encourage you to read it and then find physician that takes this well rounded approach to health.   Prevention is key.  If your cardiologist has not sent you for a sleep study, find out why not.  Sleep apnea also can contribute to diabetes, weight gain, cancer, and traffic accidents to mention but a few health considerations.

My goal is to live a long HEALTHY life, and  I snore. Yikes!  I decided to get myself healthy and learn as much as possible about this stealthy killer, and help my patients be healthy too.  I started investigating and learning about sleep apnea.   You may think you sleep well, but you may not be!  Take the Epworth Sleepiness Scale, the Stop Bang Questionnaire or the Berlin Questionnaire to start screening and hand those results to your doctor.   If your sleep partner says you snore- again, for their sake and yours, go get screened!  Snoring may not necessarily be a sign of sleep apnea, but the only way to tell is to have a sleep study.  The dreaded sleep study- no one really wants to get one.  The thought of sleeping in a lab, hooked up to monitors turns may folks off.  There are now home sleep studies that can at least screen you.  Ask your doctor if you might qualify for that.

Some lesser known signs of sleep apnea:
     Repeated urination at night.  Do you have to “go” more than once a night?
     Morning Headaches.  Do you wake up with a headache or a migraine?
     Night sweats. Sleep apnea is a common cause of night sweats in men and non-menopausal women.
     Erectile dysfunction. Is there anything sleep apnea does not affect? No, not really! It touches all aspects of your health!
     Facial pain, clenching and grinding Your bite guard only protects your teeth, it does nothing to stop clenching and grinding, and sleep apnea.  It may well be making matters worse if it keeps you from opening your airway properly.
There are many other signs and symptoms to be aware of but these caught my eye as some signs that most people don’t associate with sleep apnea.

Sleep apnea clinical signs I look for when evaluating patients:

    When I went for my PSG, they said all I'd have to do was show up and sleep.  Little did I know...

  1. Neck circumference measurement- 16 inches for women (40.64 centimeters)   and 17 inches in men (43.18 centimeters)   
  2. Scalloped tongue   
  3. Enlarged tongue
  4. Grinding or clenching teeth 
  5. Abfractions (notching on the sides of teeth)
  6. High sensitivity to cold
  7. Tired jaw
  8. Dry mouth  or sore throat on waking 
  9. Bony growths on the lower jaw
  10. Big or long uvula (the thing that hangs down your throat)
  11. Enlarged tonsils
  12. Acid reflux/acid erosion
  13. Friedman score 
As you can see, there’s lots to look over and evaluate!  Your dental hygienist and your dentist may well save your life!  It’s up to you to follow through, get that physical and then a sleep study.   You may even get to reduce or stop your medications just by sleeping better, not to mention feeling rested and happy!
Where to go from here?  At our office we are always on the lookout and screen for sleep apnea. We work with a board certified sleep medicine doctor and have a sleep medicine dentist we refer to that makes dental appliances which open the airway the correct way.  Our sleep medicine dentist  is able to bill medical insurance and has many years experience in this area.  Selecting the correct therapy  – whether it is a CPAP (continuous positive air pressure) machine or a dental appliance to re-position the jaw/tongue is the gold standard of treatment for sleep apnea.  Do what works best for you!  It’s time to take care of yourself.

I wish you all sweet dreams and a great night’s sleep every night.

Til next week,



Hello, I'm Barbara Tritz

Unveiling the Stories Behind Dental Hygiene

Loving science, especially biology, from an early age, Barbara is a registered dental hygienist, certified biological hygienist, and orofacial myofunctional therapist. In 2019, she received the Hu-Friedy/ADHA Master Clinician Award from the American Dental Hygienist Association.

Share your thoughts below!


  1. apu mridha

    Enjoyed reading the post…….Thanks for sharing 🙂

  2. Barbara Tritz

    Good Morning Apu! So glad you enjoyed this post! Hope it was helpful.


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