Worn Down Teeth May Be a Sign of Something Sinister That Happens During Sleep…

Worn down teeth can be a troubling indication of underlying dental issues. Over time, teeth may become flattened, showing signs of wear such as exposed dentine or scooped-out surfaces. These changes can lead to heightened sensitivity, difficulty chewing, and discomfort in the jaw muscles upon awakening. While tooth wear can be due to a variety of factors, one often-overlooked cause is sleep bruxism — an involuntary grinding of teeth during sleep, which is closely linked to obstructive sleep apnoea (OSA) or sleep-disordered breathing. If you're noticing worn teeth or experiencing jaw pain, it could be a signal that something more sinister is happening during the night.

Common Causes

While bruxism is one of the more dangerous causes of worn teeth, it’s important to remember that several other factors can contribute to tooth wear. Acidic foods, poor oral hygiene, misaligned teeth, and even environmental factors like stress or jaw clenching during the day can all lead to enamel erosion and tooth damage. However, when tooth wear is associated with sleep bruxism (ask your partner if you grind your teeth during sleep), and the bruxism is accompanied with signs such as daytime sleepiness, chest aches upon waking, or even snoring, it may be time to investigate further.

Be careful of sweet or acidic beverages!

Recent Findings on Sleep Bruxism and Worn Teeth

Recent research has revealed a concerning connection between sleep bruxism and obstructive sleep apnoea (OSA), or sleep-disordered breathing. Studies suggest that worn down teeth may be related to airway obstruction during sleep. When the airway becomes blocked or obstructed (“strangled”) during sleep, the body triggers a response to restore airflow. This response happens to be teeth grinding or bruxism, which in turn, helps to open up the airway. While this may serve to alleviate airway restriction, the excessive pressure exerted on the teeth during grinding can lead to significant enamel wear and damage.

I came across a video by an Otorhinolaryngologist (conventionally known as Ear, Nose, Throat specialist or ENT for short) which demonstrated how the grinding of teeth can result in the opening of the airway, showcasing the connection between bruxism and airway obstruction. This insight helps explain why some individuals who suffer from sleep apnoea experience more intense bruxism, leading to rapid tooth wear and the need for restorative dental treatment.

Given the link between bruxism and sleep apnoea, it’s essential that individuals suffering from these symptoms work with both dental and medical professionals. A combined approach between an ENT specialist and a dental surgeon is key to addressing the root cause of the problem and protecting both the airway and the teeth.

The ENT specialist with whom I work closely has a wonderful saying: the nose and the mouth are closely linked, the nose is upstairs, while the mouth is downstairs. Both are supposed to work in harmony.

The Bottom Line

If you’re noticing worn-down teeth, jaw pain, or disrupted sleep, it’s important to consider the possibility that sleep bruxism, linked to sleep-disordered breathing or obstructive sleep apnoea, could be a cause. Restorative dental treatment, such as crowns or bite guards, may be necessary to repair worn teeth, but identifying and managing sleep-related bruxism is key to preventing future tooth wear and maintaining overall oral health.

Dental professionals are often the first to identify these disorders even though we do not treat the nasal airways. After all, we see you at least twice a year. By seeking a thorough evaluation from your dentist, you can address the underlying issue before it leads to further damage and complications.

Early intervention can help protect your smile and address any underlying health issues, ensuring a healthy and functional mouth (and breathing system) for years to come.