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The Sleep We Think We’re Getting
Where Dentistry Meets Whole-Body Health Michael Bennett, DDS, PhD & Cathy Bennett, MS
Good morning. This is More Than Teeth. The newsletter that helps dental sleep professionals get 1% better every week.
“I’m fine.”
Those two words are among the most common in medicine, and the most misleading.
For many people, “fine” means functional, not flourishing. It means surviving on habits their body has quietly adapted to, not realizing how far from true restoration they’ve drifted.
This month, we share the story of an 88-year-old man whose heart and airway reminded us all that sleep is not a luxury; it’s biology’s first repair system.
As dental professionals, we stand at the intersection where structure, breath, and healing meet. What we see in the mouth may be the first clue that the body has forgotten how to rest.

In Today’s Edition
Case Study: What one 88-year-old’s heart failure revealed about hidden sleep apnea.
Mindset Shift: “My sleep is fine” —how to honor patients’ perspectives while guiding discovery.
Clinical Integration: How digital lab collaboration accelerates healing.
Free Resource: Download the Chairside Dialogue Reference Sheet, featuring five natural ways to discuss sleep quality.
5-minute read👇
Clinical Corner
From the operatory to the heart of the matter — here’s what to remember this week.
Key Takeaways🔑
1. “Normal sleep” may just mean “familiar sleep.”
Patients can’t compare their rest to something they’ve never experienced. Our role is to awaken curiosity, not impose concern.
2. Oxygen is medicine.
The same hypoxia that stiffens arteries and impairs urination often starts at night, unseen. Restorative sleep restores vascular flexibility, renal function, and digestive rhythm.
3. The mouth tells the story.
Attrition, missing teeth, dry mucosa, or a scalloped tongue aren’t just dental issues; they’re systemic vital signs.
4. Language matters.
Empathy + analogy opens hearts faster than data alone. (“Your body’s like a team, sleep is the coach.”)
5. Dentistry’s five-minute miracle.
A two-minute screen and a one-minute conversation can uncover decades of missed healing potential.
The Clinical Walkthrough
“My sleep is fine.”
That’s what my 88-year-old father-in-law said for years.
He lived a full life of service and strength, marked by a deep commitment to community, family, and faith.
But what if the only sleep we’ve ever known… isn’t truly restorative?
This month’s reflection combines family, physiology, and the power of dental advocacy; a reminder that every day in our chair is an opportunity to save a life through sleep.
A Case that Reframed Everything
He drove himself to the ER because of swollen legs, a bloated abdomen, and the inability to urinate.
The diagnosis: congestive heart failure and 90% coronary blockage.
After an emergency angioplasty and new medications, his heart finally stabilized.
But no one, not a cardiologist, not a urologist, had asked the most basic question:
“How’s your sleep?”
When I finally screened him, the data were startling:
-60 apneas per hour
-Oxygen dropping to 73%
Within a week of starting bilevel PAP therapy, everything began to change:
-Restful mornings
-Normal urination and bowel function
-Enough energy to go for a walk with his walker
After a lifetime of “normal” sleep, he was finally discovering what real rest felt like.
What the Mouth Knew All Along
His oral signs told the story before medicine did:
Severe tooth wear
Missing and collapsed dentition
Facial fatigue and soft-tissue sag
Chronic mouth breathing and dry mucosa
To us, these are the vital signs of airway dysfunction.
And yet, how many of these do we see every day, unconnected to the heart beneath?
Clinical Management Summary
Following screening and diagnostic collaboration with a board-certified sleep physician, the patient was diagnosed with severe obstructive sleep apnea with hypoxemia.
Management has been comprehensive and interdisciplinary, emphasizing airway restoration and physiologic healing:
Bilevel PAP therapy was initiated under medical supervision to stabilize oxygen and cardiac function.
Oral airway appliance therapy in combination with PAP therapy to help reduce air pressure requirements and mask strap tension.
Adjunctive airway support included the use of nasal moisturizers, Xlear® nasal spray, and OTC Flonase prn to improve nasal patency and comfort.
Planned dental intervention: nonsurgical laser therapy will be used to help open and remodel the pharyngeal airway, supporting improved airflow.
Myofunctional therapy will complement treatment by retraining tongue posture and tone for optimal nasal breathing and oral stability.
Use of Spry Xylitol gum three times daily for one week and then once a day maintenance to reduce oral bacterial burden on the overall system.
This collaborative approach integrates medicine, dentistry, and airway rehabilitation, aiming not only to normalize sleep metrics but to restore energy, digestion, and whole-body balance.
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Click HERE for the full podcast showcasing this case and future dental sleep medicine technology.
Reframing the Conversation
Practice Implications: Sample Dialogue
How to Respond When a Patient Says, “My Sleep Is Fine.” Use the Feel–Felt–Found approach
“I completely understand. Many people have felt the same way, and I have felt that way myself.
But what they’ve found after looking at their sleep data is that it can be improved, often in ways they never realized. And when it is, their body has more energy to restore, repair, and heal.”
You might say:
“You don’t have to change anything today. A sleep checkup is simply information, like looking under the hood before a road trip.”
🔬 Evidence Corner: Sleep & Systemic Health
Condition | Connection to Poor Sleep (References listed below) |
---|---|
Cardiovascular disease | OSA increases heart attack risk 23x and causes 80% of nocturnal strokes (Hung et al., 2010; Yeghiazarians et al., AHA, 2021). |
Renal & GI dysfunction | Hypoxia reduces parasympathetic tone, contributing to urinary retention & constipation (Yoshimura et al., Neurourology & Urodynamics, 2014). |
Metabolic inflammation | Sleep fragmentation triggers insulin resistance & endothelial stress (Vgontzas et al., 2004). |
Dental & craniofacial | Bruxism, attrition, a scalloped tongue, and TMJ pain are correlated with SRBD (Oksenberg & Arons, 2002; Tomooka et al., 2017). |
“What the heart feels, the mouth often shows first.”
The Lab Connection: From Diagnosis to Device
In partnership with Apex Dental Sleep Lab (ADSL), we discussed this case on the More Than Teeth Podcast.
Our shared mission: making life-saving therapy accessible now, not months from now.
With digital workflows and LuxCreo 3D printing, dentists can:
Design and deliver a custom MAD in a single day
Use phonetic bite registration for physiologic accuracy
Begin treatment while motivation is highest
As Sonnie Bocala, CEO of ADSL, put it: “A good lab doesn’t just make devices. It builds outcomes.”
Chairside Takeaways
1. Screen everyone — especially patients with cardiac, metabolic, or urologic history.
Systemic issues often trace back to nocturnal hypoxia long before they appear in lab results or medical records. A quick screening can uncover what’s been missed for years.
2. Use simple, reliable tools.
Integrate STOP-BANG, Epworth, Mallampati, and visible oral indicators into hygiene and exam flow. The new Sleep Screening Packet provides all the necessary forms to get started tomorrow.
3. Reframe “normal sleep.”
Patients can’t compare their rest to something they’ve never experienced. Use empathic language — “Many people feel their sleep is fine until they discover how much better it can be.”
4. Start small, act quickly.
A brief chairside conversation, followed by an HST or referral, can improve physiology within days — oxygenation, digestion, and energy all respond rapidly once sleep is restored.
5. Re-test, re-measure, and celebrate.
Show patients their progress. Improved O₂ levels, reduced bruxism, and brighter mornings reinforce trust and long-term engagement in airway care.
Free Tools for Your Practice: In-Office Screening Forms
A consistent, structured process helps identify airway risk efficiently and ethically during routine visits.
Utilize the following screening packet to integrate screening into every patient’s experience.
Combined Patient Sleep & Breathing Health Check Form (waiting-room version) and Patient Education Handout for take-home review. Click here.
Clinical SOP for Sleep Screening Workflow (hygiene and doctor exam flow). Click here.
These are ready to print or integrate into your hygiene workflow today.

Share Your Story
Every week, More Than Teeth highlights real experiences from clinicians who are changing lives through airway and sleep-focused care.
If you’ve had a memorable moment screening or managing a patient with a sleep-related breathing disorder, and you witnessed an impact on their sleep, energy, heart health, or oral stability, we’d love to hear about it.
Your story could help inspire other providers to take that first step in screening.
Submit your clinical story or reflection to [email protected] and give permission for it to be shared with subscribers
(Brief submissions are welcome — even a few sentences about what surprised or moved you most.)
Closing Reflection
As dentists, we live at the intersection of airway, structure, and healing.
Every worn tooth, every tired face, every “I’m fine” is an invitation, not to convince, but to awaken.
When we pause to ask about sleep, we do more than identify risk.
We remind our patients that their body is designed to heal — and that sometimes, the first step toward vitality begins with a single night of true rest.
Thank you for continuing to bring compassion and curiosity to your operatories, one breath at a time.
📚 References
➡️ Listen: Latest More Than Teeth Podcast
➡️ Connect: [email protected]
➡️ Share the Message: Recommend this newsletter to your colleagues.
Coach Cathy’s Take
“What you practice daily shapes how you sleep nightly.
Your airway isn’t just anatomy — it’s chemistry, rhythm, and recovery.
Small daily choices either inflame or restore those systems.
Start simple:
Eat something fresh before anything processed.
Take a short walk after dinner — it steadies blood sugar, calms the mind, and helps the body slip naturally into sleep.
Give your body the same grace you give your patients — consistency over perfection.
These habits don’t just support health; they create the internal conditions for deep, healing rest.
Better sleep starts long before bedtime — it begins with how you live between visits.”
— Coach Cathy
📚 Further Reading: The Science Behind the Story
For readers who want to explore the research connecting sleep, airway, and systemic health, this open-access review unites nearly every concept discussed in today’s issue:
Ravishankar, S., & Pai, S. (2024).
“A Narrative Review of Sleep Apnea and Oral Health.” Cureus, 16(5): e62582.
🔗 Read on PubMed Central →
This review explores:
How untreated OSA drives cardiovascular and metabolic disease
The oral biomarkers of airway dysfunction — worn teeth, scalloped tongue, periodontal inflammation
The immune and vascular cascades triggered by chronic intermittent hypoxia
Why dentists are in a unique position to identify and refer patients for sleep testing
For a more cardiac-focused review:
🩺 Obstructive Sleep Apnea in Cardiovascular Disease: A Review of the Literature and Proposed Multidisciplinary Clinical Management Strategy.
Read on AHA Journals →
Something Sweet
🍭Stuff so sweet you might get a cavity..
CE Opportunities / Events
Event | Dates | Location | Link |
---|---|---|---|
AADSM Mastery Program | Ongoing dates (check website) | Online | Click HERE |
Transform Your Practice with Dental Sleep Medicine | October 17-18, 2025 | Tempe, AZ | Click HERE |
Dentist’s Role in Snoring & Sleep Apnea | November 7-8, 2025 | Chicago, IL | Click HERE |
— Dr. Michael & Cathy Bennett
More Than Teeth | A Mission for Generational Health
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