Can sleep apnea cause me to grind my teeth?


This idea has been cropping up in some of the lectures I have attended.  I am not sure this is true but the idea behind this theory is that people with sleep apnea may unconsciously be positioning their mandible in a more anterior position in order to improve the opening of their airway.  Consequently their anterior teeth may become more worn. I am not sure of the validity of this theory and I am not aware of a peer review article that demonstrates this to be true.

I have even watched a video by a dentist treating sleep apnea that claimed that dentists making night guards in Centric Relation are making their patients sleep apnea worse. Now, I make a lot of hard night guards for my patients and they are all set up with a centric relation occlusal scheme (slightly posterior  bite) and I do not have a lot of my patients complaining of being woken up by poor breathing or excessive snoring. I do tend to use a flat plane hard night guard design that allows easy anterior movement. Patients wearing my night guards effectively have a long centric occlusion when wearing their night guards. A long centric allows them to slide easily back and forth between centric relation( the most retruded comfortable position of their mandible) and more protrusive bites (jaw thrust forward)

As far as I know the best way to determine whether a patient has sleep apnea is to run a sleep study with sensors that monitor sleep and breathing interruptions and to see whether a patient sleep apnea made worse with a night guard they would need two sleep studies performed; one wearing their night guard and one without one. That might demonstrate that a particular appliance was making them have more episodes of sleep disruption or not.

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