13yo girl with back pain, headaches, jaw pain, acid erosion of teeth, ADD, gastric reflux, sleeps poorly….

So what’s the connection amongst all these things?  Is it possible there’s one condition/issue that is a primary driving force behind all of these that, if addressed, could make an amazing difference in a young girl’s life……for her entire life?  The answer is (of course, or I wouldn’t be asking such obvious leading questions, right?  LOL 🙂 )

YES!!!!

So what’s the driving force behind all these health-issues, and what can be done about it?

SLEEP APNEA!!!

Let’s list all those conditions out again and start connecting the dots:

• Lower back pain (no history of any accidents or trauma — this one is a bit of a stretch, but since there are no other contributing factors, and she’s been checked for scoliosis (curvature of the spine) and cleared, the fact that she’s been suffering from back pain is most likely due to the muscle spasm involved in the other issues, and perhaps she needs a new mattress for better lower back support.
• Long history of headaches (decreasing somewhat recently, but still significant for a girl only 13 years old) – quite a bit of research now indicates that both chronic tension and migraine headaches are connected to sleep disorders, and it makes sense – if you can’t breathe well at night and your brain gets less oxygen than it really needs, your brain/nervous system will get hypersensitized; any little trigger will make it go haywire, make muscles spasm like crazy, and result in headaches.
• Jaw pain/TMJ pain – Same as with the headaches; when the nervous system goes haywire, the muscles spasm like crazy, and your jaws will hurt; the joints get way too much pressure and pain can result, also the tissue in the joint gets scarred.
• Acid erosion of teeth, signs of wear/bruxism on teeth – Connected to both the last 2 items (jaw pain/TMJ pain and headaches) AND to the next one (gastric reflux/GERD), if the muscles are spasming like crazy and making your teeth grind, they will show signs of wearing down.  When acid from the stomach gets sucked up the esophagus during that snoring (it’s a vacuum, really) and put in the mouth, especially at night, it sits there for hours and eats away at the enamel just like soda does.
• Gastric reflux (very odd in a 13yo girl) – With sleep apnea, the throat gets closed off and you literaly stop breathing for short periods.  When your throat suddenly opens again, it’s like a vacuum suddenly releasing and acid gets sucked up your throat from your stomach.  VERY dangerous, and lots of research shows it can drastically increase your risk of Barrett’s Esophagitis, which can lead to throat cancer and is VERY VERY VERY NASTY!!!!
• ADD (Attention Deficit Disorder) – Again……decrease the oxygen level to the brain every night…..do you think your brain will function at normal levels?  Nope!  Common sense, really, and yes, the research is pointing in this direction.
• Poor sleeping – Just like anyone who can’t breathe well at night, do you think you’ll sleep well?  Nope!  You can sleep for 10 hours, but if you have trouble breathing well for 6 of those hours, how do you think you’ll feel in the morning?
• Asthma – The research on this is a little bit more in the initial stages from what I understand (could be further along and more definitive, though), but again it just makes sense.  After all, what is asthma but inflammation of the lungs, right?  Well, if you have some acid reflux at night, it’d be pretty easy to inhale just a little bit of that acid during the episodes of apnea, and imagine even a tiny bit of stomach acid getting into your lungs…..talk about irritated lungs!

So……..it really doesn’t seem like a stretch, does it?  You probably first thought…….no way!  But when looking at all of the different problems that this young lady faces at such a young age, there has to be something going on.  Given she has a pretty big tongue, big tonsils, and a very narrow throat, it was easy to determine she is at high risk for sleep apnea.

I can only hope that her mother listened and takes her for a thorough evaluation.  Besides keeping her teeth healthy, proper diagnosis, perhaps removal of her tonsils, an oral appliance, and some other possibilities for treatment, treatment could literally add years of healthy living!!!

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Heartburn and cavities (tooth decay), tooth erosion, and tooth wear, asthma, ADD/ADHD

Quite frequently I get very puzzled looks from patients when I ask them if they have heartburn or have ever been diagnosed with acid reflux.  First, they’re thinking, “Why in the world is my dentist asking if I have heartburn?” and secondly they’re thinking, “What in the world would heartburn have to do with my teeth?”  Thirdly, they get even more puzzled if I ask if they suffer from asthma or anything like ADD/ADHD.  So what’s the connection among all these conditions, and why am I, your dentist, asking these questions?

First, when it comes to the question about ADD/ADHD, please refer back to my recent post that followed up on NPR’s reporting on Sleep Apnea and Behavioral Issues.  There’s some great information in there for parents.

Secondly, when it comes to heartburn and teeth, think about this: Just what is heartburn? It’s also known as Acid Reflux, and when it gets severe, it’s known as Gastroesophogeal Reflux Disease, or GERD. It’s acid from your stomach, and what does acid from your stomach do?  The same thing that acid from any other source such as sodas, sucking on lemons or oranges, etc. – the acid literally eats away at the enamel of your teeth.  So yes…..if you have heartburn frequently, you are most likely also going to have many more cavities, see greatly increased/worsened wear on your teeth, probably will see increased gum inflammation.

So why do I also have ADD/ADHD and asthma in my post title?  Simple because heartburn/acid reflux/GERD may play a real role in both of these conditions as well, because they are also linked to sleep apnea.  While I could go into a lot of detail on the topic, there are others who have written it already, so I’m going to provide you the link to the Cleveland Clinic’s website relating to these topics (asthma & GERD), where you can read those extremely informative articles.

If you are concerned that you and/or your spouse or children suffer from these conditions, consider calling us for a consultation at 704-364-7069 or request an appointment through our website: Smiles by Payet Dentistry.

The Cleveland Clinic: Asthma & GERD