These two areas of care may seem unrelated at first glance — but emerging research and clinical experience tell a very different story. Jaw pain and sleep-disordered breathing are deeply interconnected conditions that frequently coexist, and treating one without evaluating the other can not only lead to incomplete care — it can make things worse. At Sloan Family Dentistry, we approach both with the same rigor, training, and commitment to getting to the root cause that defines everything we do.
For years, temporomandibular joint disorder (TMD) and sleep apnea were treated as entirely separate conditions. We now understand that this separation was an oversimplification. Many patients who grind their teeth — particularly those who grind in a forward motion — are not simply stressed or clenching out of habit. Their jaw is instinctively trying to move forward to open the airway during sleep. The grinding is a symptom of something deeper. The connection extends further. Gastroesophageal reflux disease (GERD) is strongly associated with sleep apnea — during an apneic event, diaphragm contraction creates pressure changes that can drive acid into the esophagus, triggering a grinding response. Patients presenting with bruxism, jaw pain, or chronic reflux may have an underlying airway issue that has never been identified or addressed.
This is why, at Sloan Family Dentistry, every patient presenting with TMD symptoms is screened for sleep-disordered breathing before any appliance therapy is introduced. Introducing an occlusal appliance in a patient with an undiagnosed airway condition can alter the jaw position in ways that affect the airway — potentially worsening breathing during sleep rather than improving it. Without proper screening, we simply cannot know whether appliance therapy is safe to proceed with, and that is a risk we are not willing to take.
Temporomandibular joint disorder encompasses a broad spectrum of conditions affecting the jaw joint, surrounding muscles, and associated structures — ranging from muscle tension and bite discrepancies to more complex joint pathology. Symptoms can include jaw pain, clicking or popping, headaches, facial pain, limited opening, and chronic neck or shoulder tension. Dr. Sloan received focused training in orofacial pain diagnosis and treatment during his advanced residency and has
treated TMD conditions successfully throughout his career. We are equipped to diagnose and manage the majority of TMD presentations — providing front-line care including occlusal appliances, bite evaluation, and conservative therapies. As with all areas of complex care, when a case progresses beyond what conservative treatment can address, we refer to trusted specialists to ensure the patient receives the highest level of care available.
Obstructive sleep apnea is one of the most prevalent and underdiagnosed health conditions of our time. Hundreds of millions of people worldwide are affected — the majority of them unaware. The consequences of untreated sleep apnea extend far beyond feeling tired. Research has consistently linked it to some of the most serious health conditions we face:
Cardiovascular disease — including hypertension, heart failure, atrial fibrillation, coronary artery disease, and stroke — represents the most extensively documented consequence of untreated OSA. The repeated cycles of oxygen deprivation during apneic events activate the sympathetic nervous system, elevate blood pressure, and place enormous strain on the heart over time. Sleep apnea is also strongly associated with Type 2 diabetes and metabolic syndrome, cognitive decline and dementia, depression and anxiety disorders, GERD and chronic reflux, increased cancer risk, and a significantly elevated risk of motor vehicle accidents due to impaired alertness. The research is unambiguous: sleep is not a luxury. It is one of the most fundamental pillars of long-term health.
The dental office is uniquely positioned to identify patients at risk for sleep-disordered breathing. There are numerous oral manifestations of sleep apnea — including specific wear patterns, scalloping of the tongue, narrow arch forms, and other clinical signs — that a trained clinician can recognize before a patient has ever been formally diagnosed. Dr. Sloan has pursued extensive continuing education in sleep dentistry, including training through his AEGD residency, Spear Education, the Spencer Study Club, and multiple dedicated sleep courses, giving him the knowledge and clinical framework to identify at-risk patients and provide appropriate guidance and treatment.
Sleep medicine physicians are the first line in diagnosing and managing sleep apnea, and CPAP therapy remains the gold standard treatment for moderate to severe cases. We fully support this model and work collaboratively with sleep medicine physicians as part of a patient’s care team.
However, CPAP is not the right solution for every patient. For those who are unable to tolerate CPAP or find its efficacy limited by compliance challenges, a custom mandibular advancement appliance — designed and delivered by a knowledgeable dental professional — is a well-researched, effective alternative. These devices work by gently repositioning the lower jaw during sleep to maintain airway patency, reducing or eliminating apneic events. They are not over-the-counter devices. They require proper clinical assessment, precise fabrication, careful titration, and follow-up monitoring to be both safe and effective. In the right hands, they can be genuinely life-changing.
At Sloan Family Dentistry, we take this responsibility seriously — screening thoughtfully, collaborating with medical colleagues, and providing appliance therapy with the same standard of care we bring to everything else we do.