Weight Watchers. Whole30. Keto. Paleo.
Zumba. SoulCycle. Barre. Peloton.
Our society becomes obsessed with the newest fad diets and the most recent exercise crazes every few years. These trends capture our collective mindset because we all understand that our nutrition and fitness are two of the foundational pillars of our health. And while there is absolutely nothing wrong with prioritizing these aspects of health, there is a third pillar that is often ignored: the essential, yet mysterious, act of sleep.
The data shows that between 50 and 70 million US adults have a sleep disorder. Many of those who experience chronic poor sleep are suffering from either insomnia or sleep apnea. These conditions negatively impact your daytime function, reduce your quality of life, and can result in numerous long-term health conditions. And, just in case we needed even more reasons to take our sleep health seriously, reduced, or poor-quality sleep even has negative effects on one’s oral health.
Insomnia affects anywhere from 10% to 30% of the population. Chronic sleep loss is linked to an increase in the incidence of periodontitis—a staggering 36% increase. Additionally, the reduced sleep duration that is the hallmark of insomnia means that there is less saliva production, which is essential to healthy teeth and gums. And finally, many people get out of bed and get a snack when they have trouble falling and staying asleep. Night Eating Syndrome, or NES, not only contributes to depression and weight gain, but can also lead to the breakdown of tooth enamel, since most insomniacs do not take the time for teeth-brushing after their midnight snack.
Another common sleep disorder is sleep apnea. Obstructive sleep apnea, or OSA, occurs when your airway either partially or fully closes while you are asleep. Each time this happens, your oxygen levels drop, you wake up without remembering it, or both in many cases. This can also lead to an array of poor health outcomes, many strongly linked to oral health. Many people with obstructive sleep apnea tend to breathe through their mouths, since this is the path of least resistance for airflow. Chronic mouth-breathing is linked to everything from bad breath to changes in facial structure. There is also a 50% chance that someone with bruxism (teeth-grinding) has OSA—in fact, it’s been shown that those with mild or moderate OSA have more severe bruxism than those with severe OSA. Last, those with high risk of sleep apnea are also three times more susceptible to suffering from TMJ disorder.
The American Academy of Dental Sleep Medicine recommends that all dental patients should be screened for sleep apnea. Those who screen positive should be tested and, if diagnosed, treated with either oral appliance therapy or CPAP. Ideally, patients should look for dentists and sleep physicians who demonstrate a bidirectional relationship between each other. Considering the high likelihood of periodontitis, bruxism, and TMJ in sleep patients, there is a strong clinical justification for new sleep patients to be sent to a dentist if they show symptoms of periodontal disease or pain.
There is plenty of evidence confirming that oral health and sleep quality are intrinsically linked to one another. Given the prevalence of sleep disorders among the general population, patients need to educate themselves on the impact that sleep disorders could have on their oral health and their overall quality of life. Education on this link between oral care and sleep disorders is the first step in early detection and comorbid treatment.