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Ever wonder why some OSA patients struggle with treatment despite your best efforts? Today we're diving into a hidden culprit you might not expect: the surprising connection between oral acidity, GERD, and sleep apnea.

These insights could change how you approach treatment for your most challenging cases.

In Today’s Edition:

• How GERD and Oral Acidity Affect OSA

• Industry Events

5-minute read👇

Clinical Corner

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Key Takeaways🔑

The Acid Connection: How GERD and Oral Acidity Affect More Than Just Your Smile

Building on the idea that centrally-acting medications can lead to dry mouth, which lowers oral pH and promotes acidity, this piece could explain how these acidic conditions make the mouth more vulnerable to erosion, periodontal disease, and even systemic inflammation. Citing Dr. Jonathan Aviv’s The Acid Watcher Diet, you could discuss how dietary and lifestyle adjustments, such as low-acid foods and alkaline water, help combat this effect. Lowering oral acidity through such interventions not only protects dental health but may reduce GERD symptoms that contribute to upper airway inflammation and aggravate SRBDs, including obstructive sleep apnea (OSA)​.​

Several studies underscore the bidirectional relationship between GERD and OSA: acid reflux can trigger inflammation and airway narrowing, which disrupts breathing during sleep, while OSA’s intermittent low oxygen levels exacerbate GERD symptoms. This inflammatory cycle affects not just oral health but also cardiovascular and respiratory systems, highlighting the importance of a whole-patient approach. In particular, the chronic exposure of the esophagus and airway to acidic stomach contents increases the risk of conditions like Barrett’s esophagus and respiratory inflammation, which may further disturb sleep and complicate OSA management

By exploring the oral-systemic impacts of acidity, your newsletter could emphasize how dentists can guide patients with GERD toward preventive dietary changes, proper oral hygiene, and lifestyle modifications that reduce acid exposure and inflammation. Such comprehensive care can address both dental and systemic health, showcasing the critical role that dentistry plays beyond the teeth. This approach would make a profound impact on readers and provide actionable insights they could immediately begin sharing with their patients.

Several selective serotonin reuptake inhibitors (SSRIs) are linked to reduced saliva flow, which can result in dry mouth (xerostomia) for patients. Common SSRIs that exhibit this effect include fluoxetine, sertraline, and paroxetine. These medications are known to have anticholinergic properties, which inhibit the action of acetylcholine, a neurotransmitter involved in stimulating salivary flow. Though less severe than tricyclic antidepressants, SSRIs still contribute significantly to decreased salivary production, increasing the risk of dry mouth and associated oral issues such as dental caries and periodontal disease, particularly in older patients who may be more sensitive to these side effects.

Patients on SSRIs experiencing xerostomia often benefit from additional dental care to mitigate dry mouth’s impact on oral health. Encouraging hydration, using artificial saliva substitutes, and incorporating fluoride treatments are common strategies to help preserve enamel and prevent decay in individuals with decreased salivary flow. Dentists may also advise patients to avoid acidic or sugary snacks and beverages that can exacerbate dry mouth symptoms and accelerate enamel demineralization (Daly, 2016; Physiology International, 2020)​

References:

Einhorn, O.M., Georgiou, K., & Tompa, A. (2020). Salivary dysfunction caused by medication usage. Physiology International, 107(2), 195-208. https://doi.org/10.1556/2060.2020.00019

Daly C. Oral and dental effects of antidepressants. Aust Prescr 2016;39:84.https://doi.org/10.18773/austprescr.2016.035

Article - Acid Reflux and Sleep Apnea: Exploring the Connection and Impact on Sleep

Article - The Connection Between Gastric Reflux, Obstructive Sleep Apnea, & Diet

Article - Does GERD Cause Sleep Apnea? Exploring the Connection Between GERD and Sleep Apnea

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