Sleep With: Dentist Dr Ron Ehrlich

This week, we spoke with holistic dentist, Dr Ron Ehrlich on a topic that most of us may not have considered - the link between your oral health & your sleep. It's huge and it's important. Read on to find out how your breathing style, mouth size, and other habits are seriously impacting your quality of sleep. 


What does dentistry have to do with sleep?

Consistently getting a good night’s sleep is a function of quantity and quality. Regarding quantity, we know over 90% of us require between 7 to 9 hours of sleep per night. However, when it comes to quality, your oral health is a huge contributing factor as the way you breathe impacts how well you sleep. For best practice, you need to be breathing through your nose when you sleep.  

However, humans have evolved to have 32 teeth and over 90% of the population don’t have enough room in their mouth for all these teeth. From over 40 years of clinical observations, I’d say over 95% of my patients have impacted wisdom teeth or to some degree, a narrow crowded jaw, resulting in a narrow upper airway. This can have a huge impact on your sleep as it means there’s not enough room for your tongue, causing upper respiratory issues which can disrupt breathing whilst you sleep, and significantly impact the quality of your sleep.

Of course thankfully, humans are very resilient, so this isn’t to say 95% of the population aren’t breathing well, but it is important to consider when assessing your oral health.


Why is a holistic dentist different to a non-holistic dentist?

Dentists focus on what’s happening in your mouth. Holistic dentist do as well, but we also recognise there’s a whole person attached to the mouth with a digestive system, respiratory system, nervous system, the list goes on… Of course, this is not a new age philosophy….. It just happens to be how the body, and for that matter the planet works.

In 1983, Dr Ron developed a model of stress which explored how our overall health is affected by stress, which is a combination of five factors: emotional, environmental, postural, nutritional and dental. While dental health can be simple, when things get more involved dental treatment can be very high intervention, and it’s very costly, so being a holistic dentist, we start by reviewing a hierarchy of treatment to build resilience. To build resilience you need to focus on all these pillars, including sleep, as whilst dental stress can improve your health, there are also many other factors as play.

Whilst a dentist may see crooked teeth and may remove teeth to straighten them, a holistic dentist may note that this could create a smaller upper airway, resulting in negative longer term impacts.

Along with overcrowding, we also consider how some fillings could be toxic to the rest of the body. Chronic infection could also be reviewed differently - a patient may come in with a chronic infection which isn’t painful and not worry about it - however, we need to consider how this infection could be affecting the rest of the body, even it if isn’t painful.

In an initial appointment with our clinic, we allow for one hour - we ask lots of questions, take photographs, x-rays and whilst we do focus on the mouth, we also make referrals to other health professionals, like integrative medical practitioners, nutritionists, naturopaths, chiropractors, osteopaths and podiatrists.  


What's the impact of being a nasal breather vs mouth breather when sleeping?

The importance of nasal breathing is often overlooked. Noses warm humidify and filter the air before we take it into our lungs.It helps balance out acid/alkali boy chemistry and that can affect your physical and mental health. Narrow jaws mean less room for your tongues and a narrower upper airway. Add to that a food sensitivity or allergy, dust or mould in the house, and it may be difficult to breathe through your nose.

Establishing a cause is important. If you are a habitual mouth breather, there are other steps you can take to correct this. It’s often easier for children; dentists can show parents how to encourage proper position between children’s tongue, lips and cheeks through myofunctional therapy.

For adults, this can also be helpful. Another great strategy is using non-porous tape over the mouth whilst sleeping to help the body practice nasal breathing. It’s definitely a good idea to speak with a holistic dentist about this beforehand to ensure you’re practicing this correctly.


What are the consequences of clenching & grinding in your sleep?

Clenching and grinding can cause chronic pain, break restorations prematurely, crack teeth and really cause pain. Research suggests that in  70% of cases clenching & grinding is a result of not breathing correctly whilst sleeping. Waking with a headache, neck ache or jaw pain might be because you clench or grind, which contracts the muscles of the jaw, back of the neck and shoulders. Contracting those muscles all night can result in headaches, especially around the forehead & temples, even around the ears and eyes.

If you experience clenching or grinding, speak to your dentist. A custom made mouth guard could be a good option, however, there are many different styles and it’s very important for it to be properly fitted and balanced for each individual. Sometimes using mouth tape can make a difference as it can encourage nasal breathing which is a meditation-type of breath that has a relaxing effect on the muscles throughout the body.


In your opinion, what is the consequence of fragmented sleep caused by breathing disorders, like snoring and sleep apnoea?

The impact is huge. As Mathew Walker addressed in his book, Why We Sleep, sleep is our built-in, non-negotiable life support which affects our mental, physical and emotional health. If you snore or suffer from other sleep disordered breathing conditions, this can have a huge impact on your hormone balance, fertility, chronic inflammation, appetite, blood sugar, adrenaline, memory, mood, genetics, up-regulates inflammation, down-regulates the  immune system, even affects testicular size!

The key to a better night’s sleep is two part. Firstly, we need to prioritise sleep and recognise its importance. Secondly, it’s all about creating a routine - like we instilled for our children, adults also respond to and thrive on routine.


If you feel your oral health is impacting your sleep, what are some steps that can be taken?

If you have never thought about this, the next step is to start prioritising sleep and recognising its universal importance to every aspect of your life. Settling into a good routine is really important as well - no technology for at least an hour before bed, eating well and reducing bluelight ( computers, phones, tablets) all play a role.

From a dental perspective, start with a thorough dental examination. You don’t have to see a holistic dentist - I feel like dentistry is moving into a new era and many dentists are going in this direction and looking at oral health holistically- they just might not necessarily all themselves a holistic dentist.

Remember, the absence of pain does not mean everything is ok - 95% of oral health problems have no pain associated with them. Two of the most common infections in humans young and old occur in the mouth - gum disease and tooth decay. If you have bleeding gums, do not ignore this. Even though it may not be painful, it can result in many negative flow on effects, such as heart disease.


What final thoughts would you share with our readers?

Identify and minimise the stresses( emotional, environmental, postural, nutrition and dental ) in life that have the potential to compromise your health. Focus on sleep, breathe, nourish move and think to build the physical mental and emotional resilience to deal with our modern world. It is the foundation of your health journey. Your health is just too important to leave to anybody else. If you choose not to bother, thankfully there is a whole chronic disease management  industry willing to embrace you.


Find out more about Dr Ron Ehrlich

Over 35 years of clinical practice Dr Ron Ehrlich has developed a holistic approach to health and wellness, as well as a comprehensive model of how stress impacts on our lives. Empowering individuals and organisations is his passion.

Dr Ron is in clinical practice and continues to see patients at his group practice, the Sydney Holistic Dental Centre in Sydney CBD.

Dr Ron has also authored A Life Less Stressed: the 5 pillars of health and wellness, which explores confusing public health messages, the stresses in life and the pillars of health.

Read more about Dr Ron and his findings here.

Tags: Science