Poor breathing and reflux: The link

Since I began looking into people’s mouths some 20 years ago, a disturbing number of them often showed signs of severe acid damage on their teeth. The question we asked our patients back then was, “Do you drink lots of acidic beverages (like coke) or do you have reflux?”. If the answer about the drinks was negative then a referral to their local GP was recommended.

I always wondered what eventually happened to my patients after our initial discussion. The burning question I had for them six months later was “did you get any worse?”. As my understanding of medical disorders and their link to oral health grew, the number of my patients prescribed antacids or anti-reflux medication really bothered me. If this was their long-term solution then clearly nothing had been “fixed”. Whilst it is easy to be critical of the way reflux is managed in this country, our overworked medical practitioners are responsible for treating every ailment that walks in the door from the head down to the foot!

A search on authoritative websites such as the Mayo clinic or the Merck Manual explains that the main cause for reflux occuring is a weak stomach valve (called a sphincter) which allows acid to rise up into the esophagus. The most common risk factors for reflux are thought to be eating fat or spicy foods, obesity and even pregnancy. I managed to find some discussion on reflux worsening sleep apnea and breathing, but has anybody considered the opposite to be true? Can sleep apnea cause reflux?

The pictures on the left show an adult sufferering with severe night-time reflux. The top teeth are almost completely worn down to the gum and his back teeth are gone.  Severe reflux and sleep apnea are both frequently  observed together. For the unfortunate patient suffering with this condition, no antacids or treatment of “reflux disease” will ever fix the problem unless we treat the airway problems first.

A few years ago I saw an adolescent boy with significant tooth acid damage that had the usual warning signs of impaired breathing. These signs included enlarged tonsils, poor nasal airflow and darkness under his eyes. Darkness under the eyes occurs when impaired breathing reduces the blood oxygen levels at night. I informed the boy’s GP at the time to consider a sleep study for him as I felt that sleep apnea was driving his reflux disease.

The GP was less than obliging at the time and retorted that he had “never heard” of breathing issues causing reflux. Fortunately, due to my persistence a few months later the GP rang back to say that the boy indeed suffered with moderate sleep apnea!

I illustrate this story because it brings to mind the famous words of Arthur Schopenhauer who once said,

“All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.”

The Chek Totem Pole

This truth is also wonderfully illustrated by Paul Chek, a holistic health practitioner who spent the best part of ten years trying to understand the needs of the human body for health.

In 1994 he came up with the “Chek totem pole”. The illustration shows that the body priorities certain functions and the most important ones are at the top of the pole for normal health.

Interestingly, he observed that proper breathing was the body’s No. 1 priority for health followed closely by what foods we placed in our mouths. You may also observe further down the pole the green unhappy face. This is a person suffering with anxiety and depression. Many years of untreated airway problems will eventually lead to poor sleep, adrenal gland fatigue and mood swings! This should come as no surprise as many ancient health disciplines advocated the benefits of proper breathing for health including Tai Chi, Yoga and the various practices of meditation and relaxation.

In summary, I would recommend that you consult with your health care professional if you suspect you might be suffering with both reflux and your breathing is less than ideal. Reflux disease is a treatable condition when we know the cause!



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