Question: My dentist has told me that I clench and grind, and I also snore. Is there a connection between the two?
David Wilhite says:
The problem frequently begins in childhood with allergies and enlarged tonsils. This sets off a whole cascade of events.
The allergies and enlarged tonsils result in a constriction of the airway. The constriction causes the child to breathe through the mouth as opposed to the nose. Now, the tongue assumes a lower position in the mouth to assist the mouth breathing. Without the tongue in the roof of the mouth, the upper jaw does not develop properly and stays too narrow and too highly vaulted. Thus, it takes up space for the nasal airway, further compounding the difficulty of nasal breathing. Under normal conditions, breathing through the nose filters and humidifies the air, removing allergens so that they don’t pass into the lungs.
The increased exposure to allergens inflames the tissues of the throat, enlarges the tonsils, and increases the level of inflammation in the body. Thus, the airway is narrowed and causes snoring– which can lead to sleep apnea even in children as young as 2-3 years old. Therefore any child who snores or grinds their teeth needs to be evaluated for sleep apnea.
Many patients with apnea also clench and grind to open their airway so that they can breathe. Unfortunately, clenching does not completely solve the problem of a constricted airway.
A high percentage of the patients with sleep apnea have acid reflux and vice versa. After an apneic event, the first breath is usually a gasp that brings stomach acid up into the throat or mouth.
Sleep apnea also leads to an accumulation of stress hormones, mainly cortisol, and this leads to more clenching and grinding.