Food Tips for Your Patients on Thanksgiving

TMD is a painful condition that can worsen when eating the wrong foods. With the holidays just around the corner that often means there will be lots of different food for your patients to choose from! This is also the time of year where many people will eat more food than they normally eat during the year—and it is often food that they don’t typically eat other times. To help your patients protect their jaws and prevent pain, here is a list of diet changes that might help improve their TMD symptoms this Thanksgiving:

Skip the Crunchy and Chewy

When at the dinner table, there might be a lot of crunchy and chewy foods to choose from this holiday season, but it is important to urge your patients not to do it. Many crunchy foods, such as hard, crusty breads and crackers, can put a lot of strain on a person’s jaw. Additionally, chewy can also worsen TMD pain in patients. This is because chewy foods tend to be sweet, enjoyable treats that might be hard to avoid. While it may be difficult to pass on gum, caramel and gummy candy, it might be a sacrifice patients need to take for improved TMJ health this season.

Take Smaller Bites

Patients might also be tempted to eating everything in sight without chewing it all the way through, but remind them to be patient. Large foods that require opening the mouth wide such as corn-on-the-cob and whole apples can overextend the jaw and ultimately cause pain for a TMD sufferer. Even large sandwiches and burgers can overextend the jaw. Instead, patients should try using a fork and knife to cut food into smaller pieces that are easier to eat.

Choose Vegetables

Lastly, when it comes to Thanksgiving dinner make sure to encourage your patients to say “Yes” to vegetables. However, make sure they choose wisely what veggies to eat. For instance, patients should avoid carrots because they are harder and can hurt their jaw. On the other hand, if the carrots are cooked, then they are soft enough to not hurt their jaw.

When something in the body is causing pain when it moves, it is best to minimize the movement of that body part. However, when it comes to jaw pain it is not that easy to do since we have to eat, and speak. However, patients can limit the amount of movement their jaw makes as to not use the muscles that are causing pain by choosing foods that do not require a lot of chewing, while also avoiding habits that make the muscles work.

The Connection Between Gout and Sleep Apnea

As you know, sleep apnea can be linked to a variety of health conditions including heart disease. With recent research, we have found another connection: gout. A new study has found that sleep apnea can be linked to gout and flare-ups according to The Washington Post. Due to gout’s intense pain and swelling of joint, typically the big toe, it can often result in the deposit of uric acid crystals in joints and tissues. From this, our patients could be at a higher risk of developing gout when suffering from sleep apnea. Below I have outlined the study to help us gain a better understanding of the connection between sleep apnea and gout, and how we can continue to help protect our patients’ overall health.

The Sleep Apnea/Gout Study

It’s really exciting when new studies come out with new findings, isn’t it? This new study on sleep apnea and gout found that since sleep apnea causes periods of oxygen deprivation, it can trigger overproduction of uric acid in the bloodstream. Why is this bad? Well, when this happens, gout can develop, which is often very painful. And, according to the Centers for Disease Control and Prevention, almost six percent of men and two percent of women in the United States experienced gout from 2007-2008.

Sleep apnea is more common than gout, but it can increase the risk of high blood pressure, heart attack, stroke and heart failure. Obesity plays an important role in both sleep apnea and gout. However, sleep apnea increased the risk for gout even when weight was accounted for. Within this study, 10,000 people had a new diagnosis of sleep apnea and were compared to more than 40,000 people of similar sex, age, birth year and body composition but without sleep apnea.

Over a one-year period, there were 270 cases of gout—that was 76 in the sleep apnea group and 194 in the larger group. Gout was twice as common in people with sleep apnea as those who did not. Obesity increased the risk of sleep apnea, but some thin people still suffered from sleep apnea, and even these people the risk of gout was increased by 80 percent. The next step would be to test whether treating sleep apnea reduces the risk of gout.

What Can You Do?

Now that we are aware of this new connection, it opens up even more doors for your dental office. While we were aware of other connections, this connection with gout allows us to pay even closer attention to what our patients are saying. Complete continuing education so you can remain knowledgeable in sleep apnea and how you can better help your patients and the treatment options you offer.

Sleep apnea and gout can be reduced in many people by losing weight if they are overweight, eating healthy, and indulging in alcohol and red meats in moderation. Please feel free to contact me for more information on sleep apnea, how treatment can help and the best continuing education options. Let’s not ignore these new findings and continue to help our patients receive the best care available.

The Added Dangers for Women with Sleep Apnea

Sleep apnea can be a dangerous disease if it is not properly treated. As stated by The New York Times, a recent study indicated that sleep apnea may be even more dangerous for women than for men. With this new study, it is important to pay close attention to sleep apnea if you currently suffer from it and are a woman. However, it is still important as a man to receive treatment as well. Let’s take a look at why women may have added dangers when suffering from sleep apnea.

Heart Disease

Epidemiological studies have linked sleep apnea to heart disease in men, but the differences in risk between men and women were often overlooked. In this study quoted by The New York Times, researchers measured sleep quality electronically in 737 men and 879 women with the average age of 63 who were free of cardiovascular disease at the start of the study. This study also tested each person for troponin T, which is a protein that can be released into the bloodstream if the heart is damaged. When this is present in otherwise healthy people, it often indicates an increased risk for heart disease.

Each participant was tracked for 14 years and incidents of coronary artery disease, heart failure and death from cardiovascular disease or other causes were recorded throughout the process. Once completed, this study was published in Circulation.

What We Learned

Through this study, we learn that obstructive sleep apnea was independently associated with increased troponin T, heart failure and death in women, but not in men. Strange, right? Additionally, in women, but not in men, sleep apnea was associated with an enlarged heart, which is another risk factor for cardiovascular disease. As we already know, most people with sleep apnea already have an increased risk of heart disease, but in women the relationship is stronger—persisting even after accounting for the other risks. Even if women with sleep apnea do not get heart failure, it is associated with changes in the heart that lead to worse outcomes.

So, what do we do with these results? The same thing we have been doing all along—helping our patients find the care they need in order to protect them from harm. Please contact me if you have any questions about sleep apnea and the increased risk for women as well as other patients.

Sleep Apnea May Increase a Patient’s Risk of Depression

The more and more research we conduct, the more connections we find with sleep apnea. And, what does that mean? It means that our roles as dentists in dental sleep medicine are more important than ever before! A fundamental part of the human experience is when we feel sad every now and then. This can be even more apparent during difficult or trying times.

However, in contrast, persistent feelings of sadness, anxiety, hopelessness and disinterest in things that were once enjoyed are common symptoms of depression—this is not something that should go untreated or ignored. Depression is an illness that affects at least 20 million Americans—now that is a lot. It is just a little more than the 18 million suffering from sleep apnea.

Just as sleep apnea should never be ignored, neither should depression because it is a serious disorder that affects the way a person eats, sleeps, feels and thinks. While the cause of depression often remains unknown, it can be effectively controlled with treatment. Additionally, the relationship between sleep and depressive illness is complex—depression can cause sleep problems and sleep problems can cause or contribute to depressive disorders. As dentists offering dental sleep medicine services, we can continue to be our patients’ line of defense against sleep apnea and other conditions, such as depression.

What is the Connection?

Sleep-disordered breathing has been linked with depression, especially since insomnia is very common among depressed patients. Evidence suggests that people with insomnia have 10 times the risk of developing depression compared with those who sleep well. Depressed individuals may suffer from a range of insomnia, including:

  • Difficulty falling asleep
  • Difficulty staying asleep
  • Un-refreshing sleep
  • Daytime sleepiness

However, research suggests the risk of developing depression is highest among people with both sleep onset and sleep maintenance insomnia. Obstructive sleep apnea is linked with depression, as people with depression were found to be five times more likely to suffer from sleep-disordered breathing. The good news is that treating OSA may improve depression. And, in many cases, because symptoms of depression often overlap with symptoms of sleep apnea, there can be a risk for misdiagnosis.

People with symptoms of depression should be screened for sleep apnea by being asked about symptoms such as:

  • Snoring
  • Breathing pauses while sleeping
  • Disrupted sleep
  • Excessive daytime sleepiness

Please contact my office for more information on sleep apnea. Through further experience and research, I hope we can all continue to improve our patients’ health through proper diagnosis and treatment options.