Like many of my colleagues, I am always on the lookout for new ideas and concepts in dentistry. Not only is this an integral part of the ever-evolving dental profession, but it is also important to remain abreast of patient expectations and desires.
In recent months, I have noticed an increase in conversations about sleep dentistry, or dental sleep medicine. The link between sleep quality and dental health is not a new concept. Indeed, it was initially considered back in the 1880s,[i] though it has been more widely recognised for at least the past few decades. Even today, it remains a relatively unknown field of dentistry, with education and management techniques still emerging into the profession.
Sleep and dentistry
There is a growing body of evidence to show how sleep affects dental health. For example, sleep duration has been shown to impact the risk of dental caries, with less than 7 hours sleep per night increasing the risk.[ii]
Poor sleep quality and fatigue have also been shown to reduce immunity function and increase risk of inflammatory markers – in turn potentially raising the risk of periodontal disease.[iii] Interestingly, patients with more severe periodontitis symptoms also had lower sleep quality scores, suggesting that later stages of periodontal disease could impact sleep duration as well.
It is also worth noting that sleep disorders are widely acknowledged to reduce oral health status too. One study[iv] found self-perceived oral health, masticatory function and gingival bleeding to all be worse among patients with sleep disorders. There is even evidence to suggest that sleep duration has a greater impact on oral health among people under the age of 60 and men. Interestingly, it wasn’t a linear relationship – it’s not always the more sleep the better!
Sleep and endodontics
Of interest to my fellow endodontists will be the link between sleep and pain control within endodontic therapy. A study[v] published in 2021 found a direct correlation between effective sleep hygiene and sleep quality, and lower pain perception during endodontic therapy. The research postulated that undisturbed sleep improved the health of the part of the brain responsible for pain regulation, as well as supporting the body’s metabolism and homeostasis. It also reduces emotional and mental health concerns, exacerbating the patient’s experience of discomfort when undergoing dental treatment.
The dental team’s role
The role of sleep hygiene and its impact on oral health is increasingly becoming a topic of importance in the profession. Whether you focus your practice on endodontics, implantology or general dentistry, it is necessary to consider sleep quality and quantity for every patient. Asking patients some simple questions is a great start – do they snore themselves awake? Do they wake up with a dry mouth? Has a sleep partner complained that they make loud noises or sudden movements during sleep? All of these can provide a useful insight into their oral and systemic health. After all, let’s not forget that sleep disorders are associated with a number of systemic health concerns as well as dental – including diabetes, hypertension, obesity, depression, heart attack and stroke.[vi]
Patient education is also crucial. If we can inform our patients about the links between sleep and dental or general health, they can introduce simple steps to improve their situation.
At the end of the day, modern dentistry encompasses a wide range of systemic health and general lifestyle factors. Sleep quality and quantity is just one area that we have to consider as dental professionals.
Author: Michael Sultan
EndoCare, led by Dr Michael Sultan, is one of the UK’s most trusted Specialist Endodontist practices. Through the use of the latest technologies and techniques, the highly-trained team can offer exceptional standards of care – always putting the patient first. What’s more, EndoCare is a dependable referral centre, to which dentists from across the country send their patients for the best in specialist endodontic treatment.
[i] Bailey DR, Attanasio R. The history of sleep medicine. Dent Clin North Am. 2012 Apr;56(2):313-7. doi: 10.1016/j.cden.2012.02.004. Epub 2012 Mar 20. PMID: 22480804.
[ii] Alawady, A., Alharbi, A., Alharbi, H. et al. Association between sleep duration and dental caries in a nationally representative U.S. population. BMC Oral Health 23, 497 (2023). https://doi.org/10.1186/s12903-023-03147-z
[iii] Taştan Eroğlu, Zeynep, Özkan Şen, Dilek, Uçan Yarkac, Fatma, & Altiparmak, Fatma. (2023). The association Between Sleep Quality, Fatigue and Periodontal Status: a pilot study. Odovtos International Journal of Dental Sciences, 25(3), 99-117. https://dx.doi.org/10.15517/ijds.2023.54866
[iv] Pereira D, Progiante P, Pattussi M, Grossi P, Grossi M. Study on the association between sleep disorders versus oral health related variables. Med Oral Patol Oral Cir Bucal. 2021 Mar 1;26(2):e164-e171. doi: 10.4317/medoral.24096. PMID: 32851986; PMCID: PMC7980294.
[v] Sana, Usman & Virda, Maryam & Haroon, Faizan & Shakoor, Tehmina & Abdul Qayyum, Hiffa & Shoaib, Maahin & Tariq, Amina. (2021). Role of Sleep and Pain Control in Endodontic Therapy. Pakistan Journal of Medical and Health Sciences. 15. 1891-1893. 10.53350/pjmhs211581891.
[vi] Institute of Medicine (US) Committee on Sleep Medicine and Research; Colten HR, Altevogt BM, editors. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington (DC): National Academies Press (US); 2006. 3, Extent and Health Consequences of Chronic Sleep Loss and Sleep Disorders. Available from: https://www.ncbi.nlm.nih.gov/books/NBK19961/
