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The Silent Connection: Sleep Apnea, the Mouth, and the Heart
Michael Bennett DDS, PhD
Good morning. This is More Than Teeth. The newsletter that helps dental sleep professionals get 1% better every week.

Good morning.
Many patients are surprised to learn that their gums and their heart are on speaking terms. But science is catching up to what airway dentists have known for years: oral health is a mirror to systemic health. And nowhere is that more true—or more urgent—than in the relationship between sleep, the airway, and cardiovascular disease.
In Today’s Edition:
The Mouth-Heart Connection: How poor oral hygiene and sleep apnea team up to raise your risk for heart disease.
Why Your Dentist Might Save Your Life: The role of dental screenings in detecting obstructive sleep apnea (OSA).
Surprise! Dentistry at the NIH: Meet the little-known division of the NIH that’s funding cutting-edge oral and craniofacial research.
CE Opportunities/Events
5-minute read👇
Clinical Corner
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Key Takeaways🔑
OSA isn't just a sleep issue; it places the heart under chronic stress, increasing the risk of heart attack, stroke, and high blood pressure. OSA increases heart attack risk by an odds ratio of 23.3, higher than smoking or hypertension.
Inflammation from untreated periodontal disease may increase the risk of heart disease, especially when paired with undiagnosed OSA.
An stated in an article found in ScienceAlert, oral bacteria can enter the bloodstream and contribute to arterial plaque formation, potentially leading to atherosclerosis. This supports earlier findings from the Journal of Clinical Periodontology, which showed that periodontal therapy reduced systemic inflammation markers like CRP.
Dentists on the Front Lines of Heart Health
A recent expert article from ScienceAlert highlights how poor oral hygiene may contribute to inflammation that harms the heart. Bleeding gums, loose teeth, and oral bacteria aren’t just local problems—they can inflame blood vessels, disrupt circulation, and elevate your risk for heart attacks and strokes.
But there’s an even deeper connection most people (and even most physicians) aren’t aware of:
Obstructive Sleep Apnea (OSA) and the Heart: A Dangerous Duo
Obstructive sleep apnea—where the airway repeatedly collapses during sleep—has been shown to raise the risk of heart disease more than any other single factor. In fact, untreated OSA increases your risk of a heart attack 23-fold, more than smoking or hypertension.
When the airway collapses, oxygen levels drop. The brain wakes the body repeatedly—dozens or hundreds of times per night—causing chronic sympathetic nervous system activation (your body's "fight or flight" mode). This leads to:
Elevated blood pressure
Inflammatory overload
Insulin resistance
Cardiac arrhythmias
Vascular damage
And all this occurs silently, while you're sleeping.
You may not think of your dentist as part of your heart health team. But at More Than Teeth, we do more than polish smiles—we protect airways. We screen for the oral signs of OSA, like:
Scalloped or enlarged tongue
Bruxism (grinding)
Retrognathic jaw position
Periodontal inflammation
Mouth breathing patterns
We're proud to align with the American Dental Association's 2017 policy, which encourages all dentists to screen for sleep-related breathing disorders. This isn't just best practice—it's a public health necessity.
Dr Bennett’s Case Spotlight: Connecting the Dots Beyond the Cleaning
During a routine hygiene visit, I met a 25-year-old male who described himself as health-conscious: he runs 3 miles nearly every day, eats well, and takes his health seriously. Yet, something didn’t add up—he was already on hypertension medication.
That was my first clue.
His medical history also included a strong family background of snoring and obstructive sleep apnea (OSA). Clinically, I noted his scalloped and fissured tongue, and advanced enamel wear on his upper canines and lower incisors—signs often linked with sleep-related bruxism. He also admitted to feeling unrefreshed upon waking.
Rather than rush through the cleaning, I paused and asked a simple question:
"Have you ever wondered why you're on blood pressure meds at 25, even with such a healthy lifestyle?"
He nodded, visibly frustrated. That gave me the opening to explain that certain oral signs—combined with his symptoms, medication, and family history—strongly pointed toward a possible undiagnosed sleep disorder. I recommended a home sleep test and a follow-up review with a board-certified sleep physician.
We agreed to review the report together at his next appointment.
When he returned, the sleep study revealed moderately severe OSA. He chose to start PAP therapy right away. And you know what? He thanked us—for seeing the bigger picture. For going beyond the prophy and helping him uncover what could be the missing piece in his health journey.
What did this visit really deliver?
A higher perceived value.
A better chance for long-term healing.
And yes, fewer future dental problems from bruxism and dry-mouth-related decay.
🦷 Takeaway for Your Practice:
Don't underestimate the power of a few thoughtful questions. Our hygiene chairs are front-line opportunities for whole-body screening. When we connect oral signs to systemic implications, we redefine what “comprehensive care” means—for the patient, and for ourselves.
Did You Know? Dentistry Has a Seat at the NIH Table
Here’s a little-known but exciting fact: There is a division of the National Institutes of Health (NIH) entirely dedicated to dental, oral, and craniofacial research—the NIDCR. That’s right, our nation's premier medical research agency is investing heavily in studying the oral-systemic connection, including how airway and jaw development influence lifelong health.
This underscores a truth we live by: the mouth is not separate from the body. It is the gateway to whole-body healing.
Business of Sleep
📈Better businesses = more lives saved!
Screening for OSA isn’t just life-saving—it’s practice-building.
With heart disease now linked to poor oral hygiene and untreated sleep apnea, dental professionals have a clinical and ethical opportunity to lead in preventive care. But here’s the business case:
Over 80% of OSA cases remain undiagnosed. That’s a huge pool of patients already sitting in your chairs.
Medically necessary sleep appliance therapy is often covered by medical insurance, not dental, expanding your billing options.
Implementing OSA screening with tools like STOP-BANG and Epworth Sleepiness Scale can take less than 3 minutes per visit.
Bottom line: Screening for sleep apnea adds massive value—clinically, ethically, and financially—while positioning your practice as a leader in airway and systemic wellness.
Something Sweet
🍭Stuff so sweet you might get a cavity..
CE Opportunities / Events
Event | Dates | Location | Link |
---|---|---|---|
Introduction to Sleep and Airway Medicine | May 15-17, 2025 | Denver, CO | Click Here |
2025 AADSM Annual Meeting | May 16-18, 2025 | Las Vegas, Nevada | |
SLEEP 2025 | June 8-11, 2025 | Seattle, WA | |
Guided Growth & Development | June 12-14, 2025 | Denver, CO | Click Here |
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