What Does Gum Disease Have to Do with Oral Appliance Therapy for Sleep Apnea?

Oral appliance therapy is a terrific option for many people with obstructive sleep apnea. It can be as effective as CPAP but a lot more comfortable and convenient. You don’t have to sleep with a mask tethered to a machine. You don’t have to plug into an outlet or worry about having back-up power in the event of an outage.

You simply wear a lightweight appliance as you sleep to hold your jaw in an optimal position, keeping your airway free and clear through the night. You can breathe easy and sleep easy.

Oral appliance therapy isn’t always an option, though. For instance, if you don’t have enough teeth to support the appliance, this treatment may not be possible (though it is possible to fit an appliance over well-fitted dentures). This is also sometimes the case if you have advanced periodontal (gum) disease.

Gum disease is an infection marked by chronic inflammation. As it progresses, the infection starts to destroy both the soft gum tissues and the underlying bone that supports your teeth. As support is lost, the teeth loosen in their sockets.

When teeth are in this precarious state, OSA appliance therapy can actually make things worse. It may need to be delayed until periodontal conditions have improved.

A good amount of that improvement comes from periodontal therapy. The standard treatment is a procedure called scaling and root planing (SRP), but many people call a “deep cleaning.” SRP involves cleaning thoroughly below the gumline, where harmful bacteria can thrive. An ultrasonic scaler is typically used to help loosen plaque and break up oral biofilms. Tools like lasers and ozone may also be employed to help disinfect the tissues.

Ramping up your home care can also help you improve the health of your gums. That means making sure you floss daily. If you don’t like floss or have trouble with it, you can use a water flosser or interdental brushes instead. Some studies have found interdental brushes to be even more effective than floss! Use those brushes to simultaneously apply ozonated oil, and the benefits can be even greater.

And then there’s diet.

In fact, multiple studies have shown that even if you don’t change a thing about your oral hygiene, shifting to a less processed, anti-inflammatory diet can lead to significant improvements in gum health. This means eating far fewer sugary foods and other highly refined carbs and eating more nutrient-dense real food, particularly foods rich in omega-3 fatty acids, fiber, and antioxidants such as vitamin C, vitamin D, and CoQ10.

In fact, just reducing your intake of added sugars alone can make a difference, as confirmed by a recent review of the science.

Its authors sifted through nearly 1800 studies to find 9 that met their criteria for inclusion, such as a record of gingival measurements like inflammation and bleeding. Some looked at plaque scores, as well. Their analysis found “that reduced free-sugar consumption was significantly associated with reduced gingival inflammation.”

No surprise that plaque levels were lower, as well. Sugar, after all, is the preferred food of the bacteria that cause tooth decay. Cut the sugar, and you effectively starve them, keeping them from gaining so much of a foothold.

The reduced gingival inflammation also makes sense, since sugar is well known to fuel chronic inflammation. Cut the sugar and other refined carbs, which are digested as sugar, and you reduce the inflammatory aspect of your diet a whole lot.

And that brings us to a large new study out of Korea which looked at the relationship between inflammatory diets and periodontitis. Participants completed questionnaires about their food intake, and that data was used to determine how inflammatory their diet was. This was compared with gum disease diagnoses.

Analyzing all the data, the researchers found that there was “a significantly increased risk of incident periodontitis in individuals consuming high E-DII (more pro-inflammatory) diets in the total population.”

That type of diet is one that contains a lot of sugars, refined grains and other carbs, processed meats, excessive alcohol, and hyper-processed foods. (For the last, think of fast foods, ready-made meals, and other foods that contain one or more ingredients that you wouldn’t find in the average home kitchen.)

An anti-inflammatory diet, on the other hand, includes lots of fresh vegetables and fruit, and foods like beans and other legumes, oily fish, whole grains, and healthy fats.

The Mediterranean diet is a great example of what an anti-inflammatory diet looks like – and a delicious way to support healthy teeth and gums, so if you do need appliance therapy, periodontal disease won’t be a barrier to getting the apnea treatment you prefer.

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