Why More Women than Men are Chronic Pain Victims

Almost two-thirds of both acute and chronic pain victims treated at my facility are women. This is a common statistic noted by other modern diagnostic centers located in other states.

Many reasons are given for this phenomena, and any one or more of these maybe true. Women are biologically structured differently than men; in addition, oncologists often refer to the variation in women’s emotional profiles. However, beyond the scientific studies, I am of the opinion that our modern culture places more demands upon our womenfolk, resulting in more inherent stress. It is this increased stress factor that acts as an “enabler” increasing the amount of pain in women’s chronic pain profile.

In today’s society, women are not only the primary focus responsible for the success of the family unit, but in many cases also provide a second income for that family. Thus, besides dealing with issues at the work place, women are also responsible for the endless list of mundane family chores from laundry to meals to Little League to PTA meetings to, most importantly, supplying the emotional stability pivotal for the whole family unit.

All of the above is expected to be provided by women seamlessly and without complaint. On the other hand, generally women are not usually given the emotional outlets which men often take for granted(i.e., watching sports events, with a cold beer in hand, golfing, nights out with the “boys”, poker night, dirt-biking forays, etc.).

Consequently, women are often functioning closer to the edge of their emotional limits. When chronic daily pain enters this equation, they are usually more devastated and certainly more frustrated as they see their many responsibilities challenged and ultimately adversely affected by this all-pervasive entity. Dysfunction is more pronounced and aggravated as the chronic pain persists unresolved and without reason. Worse yet, the women suffering from chronic pain must bear witness to the debilitating toll this has on not only her whole existence but on that of all of her family.

This is just a thumbnail sketch of the underlying female psyche as it responds to chronic pain. Add to this equation the responsibilities of single parenting and other such everyday problems and other medical burdens unique to some women and the ensuing consequences are exponentially increased.

Sleep Health

Approximately 40 million Americans suffer from chronic sleep disorder. And 20 to 30 million experience occasional sleep disturbances.

As dentist’s we routinely exam the oral and oropharyngeal cavity. Airway obstruction, respiratory dysfunction and associated airway collapse during sleep can lead to increased airway resistance along with associated snoring and sleep apnea. Therefore dentist’s are well positioned to aid in the management of these conditions. With the use of intra-oral appliances that reposition the mandible, dentistry can play a major role in reducing or eliminating snoring as well as reduce or control the adverse consequences of sleep related breathing disorders.

There are a number problems that relate to sleep disorders. They include but are not limited to heart disease , high blood pressure obesity and diabetes. Dentally they include Bruxism, malocclusion, and dental crowding orafacial pain, headaches and coated tongue from increased gastric esophaegeal reflux.

Profile of person with SRBD (Sleep Related Breathing Disorder)
Age: prevelance progressively increases with age.
Obesity: likelihood increases with increasing weight.
Gender: 5 to 10 times more common in males.
  • large tonsils or adenoids
  • disproportionate upper airway anatomy
  • sedative- hypnotic drugs in late P.M.

Dentally we can identify certain physical characteristics, a high palate which can be genetic but can also result from thumb sucking, narrow upper arch, moderate to severe overbite. Size of tongue as it relates to arch. amount of soft tissue in oral cavity. Size of uvula. Treatments available for sleep related breathing disorders include a CPAP (continous position airway pressure) the CPAP device involves wearing a mask like device while you sleep. Which provides pressurized air to prevent the airway from collapsing. Many patients find this device uncomfortable and difficult to use. Another commonly used treatment for mild to moderate sleep apnea are oral appliances. They are used to reposition the mandible so that the airway is improved and the potential for airway collapse during sleep is significally reduced. Surgery is another option for some patients. It will increase the size of your airway. By removing excess tissue at the back of the throat or inside the nose.

One other surgical intervention is called the “Pillar Procedure”where the surgeon places three tiny woven inserts in the soft palate to provide structural support this helps reduce the vibration that causes snoring and the ability of the soft palate to obstruct the airway. If you believe you have sleep problems you should see your physician and or dentist, So you can be properly diagnosed. Some self help include are not limited to maintaining regular sleep hours. Pay attention to your weight, obese individuals are at higher risk, elevating the position of your head while sleeping by 45 degrees can make breathing easier. Avoid alcohol, tobacco and sleeping pills for at least four hours before bedtime. Alcohol and tranquilizers cause the soft tissues of the back of the throat to sag. Smoking causes throat tissues to swell. Sleep on your side, laying on your back lets your tongue and nearby soft tissues slip back into the airway.

Symptoms of sleep problems are but not limited to:
  • Snoring (intermitted with pauses)
  • Excessive Daytime sleepiness.
  • Awakenings, gasping or choking.
  • Fragmented, Non- refreshing, light sleep.
  • Poor memory, Clouded Intellect
  • Irritability, Personality change
  • Decreased sex drive, Impotence
  • Morning Headaches
  • Dry Mouth
  • Swollen legs
If left untreated sleep / snoring problems can have the following effect:
  • Age more rapidly
  • Be more susceptible to colds, flu’s and other infections.
  • Display or increase risk of accidents due to sleepiness and poor coordination.
  • Experience more emotional problems including anxiety and depression.
  • Feel irritable and experience mood swings.
  • Have reduced ability to deal with stress.
  • Increase your risk of obesity, heart disease, diabetes and strokes.
  • Show poor judgement, poor concentration and or inability to make decisions.
Surgery is an option for some patients with obstructive sleep apnea. They include nasal reconstruction, Uvulopalatopharynoplasty/ Uvulopalatalflap, genioglossus advancement, Hyoid advancement, Maxillomandibular advancement, Maxillomandibular expansion and Temperature controlled radio frequency tongue base reduction. The most widely performed procedure is Uvulopalatopharyngoplasty (UPPP). Potential surgical risks include pain, dysphasia, bleeding and altered palatal function. These risk have caused concern for both patients and doctors. So more often than not patients, who are CPAP intolerant and or do not use oral appliances go untreated. Studies demonstrate that the airway is significantly smaller in patients with obstruction occurs at multiple levels of the airway. Therefore the surgical management or obstructive sleep apnea must address the multiple sites of obstruction.

Airway Obstruction

A child’s airway may be partially obstructed, as evidenced by mouthbreathing, snoring, tooth grinding, bedwetting, allergies or frequent ear or other ent infections.

Breathing is primary. when obstruction is present, the body adapts muscle positions to create as much airway space as possible. if muscle positions are not normal, then bones grow abnormally.

Airway obstruction also leads to poor esthetics- lessened attractiveness, poor self-image lessened self confidence, postural changes & dysfunction.

look at what a child’s airway obstruction can cause:
  • open mouth posture
  • mouthbreathing and abnormal forward head posture
  • decreased oxygen to the developing brain:
  • diminished ability to think and learn
  • diminished school performance
  • heart enlargement
  • impaired immune response (due to less nasal filtering & warming)
  • more allergies
  • frequent ent and lung infections with post-nasal drip
  • reduced ability to hear- hearing deficiencies
  • the need for ear tubes
  • frequent stuffiness and runny nose
  • frequent prescriptions for antihistamines,
  • decongestants, other respiratory medications
  • chronic fungal sinusitis.
  • tonsil inflammation, enlargement and infection
  • adenoid inflammation, enlargement and infection
  • low, forward tongue position
  • inadequate development of the elevator muscles of the
  • tongue and soft palate
  • speech deficiencies throughout life
  • narrow maxilla and crossbite
  • abnormal tooth positions
  • smaller than normal development of the nasal passages
  • snoring and episodes of sleep apnea
  • halitosis
  • tooth grinding
  • adverse neuromuscular balance
  • bedwetting (due to poor sleep, then very deep, sleep)
  • vertical growth of the head and face
  • long face with decreased attractiveness
  • skeletal and dental openbite
  • functional problems, including neuromuscular disorders.
  • class ii dental growth- protrusive incisors at high
  • risk for traumatic injuries
  • forward growth (underbite growth)
  • too-narrow upper jaw (maxilla) and crossbite
  • asymmetric face
Thumbsucking, pacifiers, sippy cups and baby bottles cause many of these same health problems because, during sucking, the tongue is held in the low forward position, with resulting:
  • narrow upper jaw (maxilla) and crossbite
  • blockage of the eustachian tubes
  • tooth grinding
  • chronic middle ear infections
  • tonsil inflammation, enlargement and infections
  • adenoid inflammation, enlargement and infections
and risk of any or all of the above health problems, extending througout life.

We will evaluate the child’s
  • tongue position
  • posture
  • habits
  • mouthbreathing
  • toothgrinding
  • snoring
  • allergies
  • bedwetting
What can you do?
If recommended, or if you are concerned, get an ent consult with a specialist (otolaryngologist).

Eliminate habits - we can help!
Treat a narrow maxilla with expansion appliances.
Treat skeletal problems with craniofacial orthopedic treatment.