Functional Dentistry
Oral Health & Inflammation
What Functional Dentists Actually Look For (And Why)
Aaron Hartman MD
February 11, 2026
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For years, I asked patients how many hours they slept.
It’s a reasonable question. Sleep matters. If someone is getting seven or eight hours a night, we tend to move on. What I failed to ask was:
“How are you breathing while you sleep?”
That distinction felt small until visit after visit, stacked up: Enough sleep … no recovery. Again and again.
Around the same time, I began hearing similar observations from functional dentists who were paying attention to a layer of physiology most of medicine ignores:
“A lot of these kids are sleeping. They’re sleeping through the night. But they’re not breathing well. And when that’s happening, their nervous system never really shuts off. So they’re asleep, but their body is still in a stress response.”
Dr. Staci Whitman described a pattern she kept seeing in children who, on paper, appeared to be sleeping just fine. They’re not insomniac. They’re not scrolling all night. But something about their sleep never allows the body to fully stand down.
The same thing I was seeing in adults.
When Physiology Gets Labeled as Behavior
What makes this pattern especially easy to miss is how often it gets framed as something else.
As Whitman explained, kids with these sleep patterns often show up with anxiety, attention issues, or difficulty regulating emotions, and “they’re labeled as behavioral before anyone looks at how they’re breathing at night.”
That framing feels familiar because it extends well beyond pediatrics.
When symptoms don’t line up cleanly to one system, effort and personality are often easier explanations than physiology. The problem is that explanations like that don’t actually explain very much.
The Moment the Assumption Breaks
At a certain point in her work, Whitman said, the distinction between sleep and recovery became impossible to ignore:
“That’s when it clicked for me that sleep isn’t rest if the airway is compromised. You can be unconscious and still in a stress response.”
That idea reframed a lot for me.
It clarified why patients can “do everything right” and still feel depleted. Why sleep can look adequate on the surface while the nervous system never truly downshifts.
Being asleep is not the same thing as recovering.
Once You See the Pattern…
After that realization, the same themes began showing up in different places: Jaw tension. Nighttime clenching. Waking unrested. A constant sense of being “on.” Fatigue that lingers even as labs improve.
Whitman noticed the same continuity:
“What’s really striking is how many adults with chronic fatigue or inflammation have the same patterns we see in kids. Mouth breathing. Clenching. Unrestful sleep. It doesn’t just go away.”
The symptoms may change with age, but the underlying pattern often remains.
This isn’t about a single diagnosis like clenching or early waking. It’s about a body that never fully exits stress mode.
Why It’s So Easy to Miss
Part of the reason these patterns persist is structural.
As Dr. Mary Ellen Chalmers has pointed out, dentistry is trained to look at structure and function in the mouth and jaw, while medicine focuses on labs and organs.
The airway lives in between.
This is what a medical blind spot looks like in practice. No single discipline fully owns the space where breathing, structure, and recovery overlap. As a result, subclinical breathing issues don’t always trigger alarms. They don’t always look like classic sleep apnea. And they don’t always cause dramatic drops in oxygen. Instead, they quietly shape stress physiology over time.
This is where airway and inflammation intersect…
Why Inflammation & Fatigue Persist
If the body never fully downshifts overnight, repair processes stay incomplete. Stress hormones remain elevated. Inflammatory signaling lingers.
Chalmers described the consequence succinctly:
“If the body never fully downshifts at night, inflammation doesn’t resolve. If recovery never turns on, there’s a ceiling.”
That ceiling explains a lot.
Why inflammation can persist even when diet improves.
Why fatigue dominates even when labs normalize.
Why progress stalls without an obvious reason.
It’s not that the interventions were wrong. It’s that recovery never fully engaged.
What This Explains (And What It Doesn’t)
I need to be careful. This perspective doesn’t explain every case of fatigue or inflammation.
It doesn’t mean airway issues are always the root cause. It doesn’t tell you what intervention is needed. It doesn’t replace proper evaluation.
What it DOES explain is why healing can stall when breathing, structure, and sleep quality are assumed rather than examined.
And why simply sleeping longer is not the same as recovering better.
Seeing the Pattern Before Treating It
Functional dentists are trained to notice patterns that don’t show up on standard lab panels. Not because they replace medical care, but because they look at a different layer of physiology.
Structure. Breathing. Load. Recovery.
Those layers matter when symptoms don’t resolve the way they should. Before treatment comes understanding. Before fixing comes mapping.
That sequencing matters.
Where to Start
If you sleep but don’t feel restored, the next step is not to guess at solutions. It’s to clarify which systems may be preventing recovery from fully turning on.
The Stress & Fatigue Quiz is designed to help identify where load may be accumulating and which patterns deserve closer attention.
Clarity comes first. Action follows later.
Series Context
This article builds on Functional Dentistry 101: The Mouth–Body Connection and prepares the ground for broader conversations about multi-system illness, diagnostic blind spots, and why better maps matter more than aggressive treatment.