Dentist Helps Patient Eliminate His GERD Symptoms With Simple Face Muscle Exercises
“Most people don’t realize how bad they felt until they start to feel better.”
-Dr. Jordan Brenner, DDS
My patient, a fit male in his 30’s, had two main concerns. The heavy tartar and plaque that kept building up on his teeth (despite his thorough brushing and flossing) and the redness and tenderness of his gums. While speaking to this patient, I noticed something. He was breathing through his mouth and also having difficulty breathing through his nose. This prompted some questions.
🤔 Have you ever experienced acid reflux?
🤔 What about a chronic cough in your mouth?
🤔 Do you often feel tired?
The patient responded yes to all three questions.
He stopped taking his GERD medication
The patient then shared with me that he had been diagnosed with Gastroesophageal reflux disease (GERD), a more severe form of acid reflux. And his physician prescribed him a medication (omeprazole) to treat it, but…
He stopped taking it. He didn’t like the way it made him feel. Some common side effects of omeprazole include headaches, abdominal pain. diarrhea, nausea, etc.
His body was producing too much acid
He was told that his body was producing too much stomach acid. And he needed to go on a medication that would lower the total amount of acid his stomach was producing. But, here’s the catch 22. Our bodies realize that there’s not enough acid to digest our food properly, so it just produces more. In other words, you’re not actually treating the disease. You are just telling your body to produce more acid to make up for the shortfall. This becomes a negative feedback loop which can also cause other stomach issues.
The negative pressure of the airway was the problem
They think that the GERD is caused by too much stomach acid when really it is caused by the negative pressure that comes with an airway issue (hence the mouth breathing). So the goal here is to get the patient to breathe properly. And to stop that negative pressure from pulling the acid from his stomach.
His mouth breathing was creating the wrong environment for his teeth and gums
His mouth breathing was also affecting the appearance of his teeth and gums. Even though his oral hygiene was good (his daily brushing and flossing was pretty consistent), he was still building up large amounts of plaque and tartar, and his gums were getting inflamed. Why was this happening?
Mouth breathing causes dry mouth, which means you have less saliva to help protect your oral cavity. And a dry mouth creates the perfect environment for bad bacteria to grow3.
We needed to fix his airway issue to address his problems. The acid reflux symptoms, his inflamed gums and the large recurring buildup of tartar and plaque.
The first step is having a sleep study done
So one of the things that I do when I expect an airway issue is I have a sleep study done to confirm the presence of bad breathing or airway deficiencies.
The results of his sleep study? He had an upper airway resistance — a mild form of sleep apnea.
He had an upper airway resistance that wouldn’t let him sleep
With an upper airway resistance, your body almost feels like it’s starting to choke itself. You then get a little bit of an adrenaline rush to wake you up to get your tongue out of your airway so you can breathe properly. These events happen many times throughout the night and they keep you from getting into a deep quality sleep4.
I recommended oral muscle exercises to open his airway
Sometimes we can open the airway with simple oral muscle exercises, so I recommended we try that first. We call these exercises myofunctional therapy.
He really liked the idea that there was an alternative option because by this point, he had given up. There was one particular part of this treatment that he really liked — no medication.
What is myofunctional therapy?
Myofunctional therapy is essentially physical therapy for the muscles of your face, lips, and tongue.
Believe it or not, many patients actually have to learn how to properly swallow, where to position their tongues, and how to hold their lips. If one of those things is off, it could potentially develop into a bad habit that may negatively affect the airway.
We laid out the exercise plan
So with this patient, I gave him a series of exercises to do and we started off easy. Just like any strength training or physical therapy program, we started off with a simple exercise. Once he mastered that exercise, we then moved on to the next exercise. And that feedback happened about once a month. And after 12 sessions, we got him to where he needed to be.
The actual exercises only took about 15 minutes a day. So not a huge commitment. Essentially, this is training for your body to do the thing it’s supposed to be doing in the most functional way.
Is your tongue tied down?
It’s important to note that whenever we’re dealing with the tongue, we also need to assess certain structural problems. For example, if your tongue is “tied down” it will be tough to get the results we’re looking for.
These are 4 ways to see if you have a possible tongue-tie:
Look in the mirror and stick their tongue straight out. Does your tongue separate in the middle and form a “heart” shape?
Do you see a deep groove down the middle of your tongue?
When you stick your tongue out, does it go down? Are you unable to lift it?
When you swallow, does it feel like your tongue is resting right behind the top of your back teeth? Does it feel like your tongue is moving in a gentle wave when swallowing?
In this patient’s case, he did not have tongue-tie issues. So we only used myofunctional therapy.
His results had an unexpected surprise
After completing the myofunctional therapy the patient has reported that he is no longer experiencing acid reflux symptoms. The tartar and plaque buildup on his teeth have been significantly reduced. And his inflamed gums are almost back to normal. But the biggest, and most unexpected, surprise for him was how rested he now feels.
Your current problem may be masking other problems
You see, a lot of times when we experience problems and health issues, we tend to focus on the worst one.
Our body can only take so many stimuli at a time. For example, let’s say you have really bad elbow pain and a little bruise on your left arm. You’re not going to notice the bruise. But the elbow pain is what’s going to drive you to get treatment and get something done for both issues.
In my patient’s case, his reflux and the way his teeth looked were so annoying that he wasn’t focusing on anything else. Those problems drove him to get treatment. And that allowed him to discover the real underlying problem — his airway.
In general, most people don’t realize how bad they felt until they start to feel better.
Quality sleep is a game changer
He is no longer taking medication for his acid reflux symptoms. He’s happy with the way his teeth look. He’s waking up rested. And in general, he’s just a happier person because he’s not fighting through fatigue all day and he’s not having problems when he eats food.
Overall, people that are tired are more prone to have problems with the things going on around them. If you’re stressed, you’re gonna feel the stress more. If you have anxiety, your anxiety is going to be worse. Having inadequate sleep, being tired, will amplify a lot of the negatives in your life.
Now, ideally, we hope to catch airway issues before we get to a GERD diagnosis. We don’t want to see damage to the esophagus and other tissue around the stomach. Chronic GERD / acid reflux will increase your risk for developing esophageal cancer. This chronic reflux can also erode your teeth and damage your current dental work (e.g. fillings, crowns, veneers, etc.)
Let’s make sure your airway is not the issue
Anyone who has been diagnosed with GERD or other stomach acid issues, should be checked for any possible airway issues. It’s not gonna be the underlying issue for everyone, but I always like to rule out the possible diagnoses that could have been overlooked. GERD is just one side effect of an airway issue. If we see other things going on, we’re going to correct those things for that patient as well. GERD might just be the one issue that’s most noticeable to you at the time.
What should I do?
Talk to your dentist. We dentists are used to looking at the structures of the mouth and we can tell what is and isn’t normal.
If you visit our office for an evaluation we will look at all the things that are going on. Are there other clinical signs? Are there other symptoms?
If we see things lining up towards a possible airway issue, then the next step to do is a sleep study and a 3-D evaluation to see. Is there enough space for your tongue? Is your airway large enough to accommodate everything? Can you breathe properly? Will you need myofunctional therapy? An oral appliance? Help to grow and expand your airway?
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