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The Connection Between Oral Health and Sleep

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Medically reviewed by
Dacelin St Martin, MD
Triple board-certified in Sleep Medicine,
Internal Medicine, and Pediatrics.

 
 
Sleep Duration and Oral Health | Sleep Conditions that can Affect Oral Health |
How Poor Dental Health Affects Your Sleep | How to Manage Sleep and Oral Health |
A Closed Mouth is Better for Sleep

 

Overview

How well you look after your oral health reflects your ability to maintain your overall well-being – your commitment to pristine oral hygiene is testimony to your overall general health.[1] 

Several studies have established the link between bad oral health and other morbidities, including those attributed to the cardiovascular and endocrine systems.[2] But what do we know about the connection between sleep and oral health?

 

Sleep Duration and Oral Health

It’s been demonstrated that long and short sleep durations are significantly associated with poor oral health status, particularly in those aged 60 and above.[2] This finding is thought to occur due to a cluster of potential factors. 

Sleep duration is correlated with the function of the immune system, whereby abnormal sleep durations, defined as those exceeding 9 hours or below 6 hours of sleep per night, can impair immune function and increase your likelihood of developing bacterial periodontal disease.[2,3]

Additionally, ensuring you get an adequate night’s sleep is essential in maintaining your mental and physical functions. Not getting enough or too much sleep can increase stress levels, suppressing the immune system and promoting bacteria flourishing in the oral cavity. It can also induce bruxism – the involuntary grinding of your teeth at night.[2,4]

Arguably the most prevalent consequence of poor sleep duration is how it can directly affect your lifestyle. It’s no secret that poor sleep promotes an unhealthy lifestyle. However, the unhealthy lifestyle sprung upon by poor sleep can, in turn, impair oral health, among other physiological and psychological functions.[2,5]

 

Sleep Conditions that can Affect Oral Health

Compelling evidence suggests the role of sleep conditions in inducing changes in the immune, endocrine, and metabolic systems in a way that negatively influences oral health.[6]

 

1) Sleep Apnea

Obstructive sleep apnea is a condition that causes the tissues in your airway to collapse, temporarily stopping you from breathing at various points throughout the night.[7] 

Individuals who suffer from sleep apnea may breathe from their mouth, linked to bad breath, changes in facial structure, and the risk of infection.[8,9] Your risk for sleep apnea also increases if you frequently grind your teeth at night, which too can put you at a higher risk for temporomandibular joint disorder (TMJ).[10]

 

2) Insomnia

Chronic insomnia can deteriorate your oral health. As mentioned above, a consistent lack of sleep can interfere with how your immune system functions. When combined with the other consequences of insomnia, namely the promotion of binge-eating of unhealthy foods, your risk for tooth decay and infection increases substantially.[11]

 

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How Poor Dental Health Affects Your Sleep

The relationship between poor oral health and sleep is a two-way street. Just as poor sleep can bring about various oral health problems, those who do not maintain their oral health can increase their risk of developing bad sleep habits in the ways outlined below.

 

1) Tooth Pain

Toothache, gum disease, and other conditions that can promote mandibular (jaw) pain can make it difficult to fall and stay asleep, which in turn can cause sleep fragmentation and increased daytime sleepiness.[12] 

 

2) Promotes the Development of Sleep Apnea

Oral health conditions, including dry mouth, abscesses, and gum disease, can inflame the throat and block parts of the airway, making breathing more difficult. 

This effect can encourage mouth-breathing behavior, inadvertently increasing your sleep apnea risk.[13]

 

How to Manage Sleep and Oral Health

The human mouth contains over 500 different bacterial species belonging to various families. Though not all these bacteria are bad, some can spread and cause infection around the oral cavity.[14]

Various oral care experts have long known the negative impacts of mouth breathing as it can cause snoring, impact your facial structure, and be a sign of obstructive sleep apnea.[9] 

Sleeping with your mouth wide open can also result in a dry mouth, which, aside from fueling your desire to chug a gallon of water, can increase your risk of developing infections. 

As such, you are looking after your mouth becomes a necessity equivalent to the two other foundational pillars of health: nutrition and fitness. 

Improving your sleep and implementing a better oral hygiene routine can pave the path to longevity and a better quality of life. 

Below are a few examples of oral and sleep health-promoting activities you can do to help you maintain a good sleep routine and a healthier oral cavity:

 

  1. Maintain Good Oral Hygiene: Brush frequently, scrape your tongue, and floss your teeth following a meal to eliminate any conspicuously lodged foods that may rot and provoke unsolicited oral problems.
  2. Avoid Caffeine Late in the Day: Caffeine and alcohol are both stimulates, which can disrupt the quality and duration of your sleep.
  3. Routine Dentist Visits: Regularly visiting your dentist can help you keep on top of your oral health and help identify various conditions before they become troublesome. 

 

A Closed Mouth is Better for Sleep

In this ever-growing ‘hustling’ society, losing track of the preventative mindset once instilled into us during our early years can be easy. Alas, this shouldn’t be the case. We forget that there are other factors of our health we should be prioritizing that go beyond walking 10,000 steps a day and eating a balanced diet.

Sleep is arguably the most important of the health pillars. Without it, our metabolism suffers, our mental health is driven to the ground, and physically, we become broken. 

However, sleeplessness affects around 70 million Americans.[15] As such, we must adhere to the mountains of evidence confirming the link between oral health and sleep and ensure that we do our part in protecting our oral health to get the sleep we long for. 

 

References:

  1. Rwagasore, E., Schaller, B., Kramer-Gauchat, M. F., Getaz, L., Wolff, H., Gaspoz, J., & Rieder, J. (2011). [Oral health as the mirror of health: the primary care medicine’s poor relative?]. Revue Médicale Suisse, 7(310), 1871–1875.
  2. Han, S., Jee, D., Kang, Y., Park, Y., & Cho, J. (2021e). Possible association between oral health and sleep duration. Medicine, 100(48), e28035. https://doi.org/10.1097/md.0000000000028035
  3. Patel, S. R., Malhotra, A., Gao, X., Hu, F. B., Neuman, M. I., & Fawzi, W. W. (2012). A Prospective Study of Sleep Duration and Pneumonia Risk in Women. Sleep, 35(1), 97–101. https://doi.org/10.5665/sleep.1594
  4. Saczuk, K., Łapińska, B., Wilmont, P., Pawlak, L., & Łukomska-Szymańska, M. (2019). Relationship between Sleep Bruxism, Perceived Stress, and Coping Strategies. International Journal of Environmental Research and Public Health, 16(17), 3193. https://doi.org/10.3390/ijerph16173193
  5. Patel, S. R., Malhotra, A., Gottlieb, D. J., White, D., & Hu, F. B. (2006). Correlates of Long Sleep Duration. Sleep, 29(7), 881–889. https://doi.org/10.1093/sleep/29.7.881
  6. Mannarino, M. R., Di Filippo, F., & Pirro, M. (2012). Obstructive sleep apnea syndrome. European Journal of Internal Medicine, 23(7), 586–593. https://doi.org/10.1016/j.ejim.2012.05.013
  7. Carra, M. C., Schmitt, A., Thomas, F., Danchin, N., Pannier, B., & Bouchard, P. (2017). Sleep disorders and oral health: a cross-sectional study. Clinical Oral Investigations, 21(4), 975–983. https://doi.org/10.1007/s00784-016-1851-y
  8. Oksenberg, A., Froom, P., & Melamed, S. (2006). Dry mouth upon awakening in obstructive sleep apnea. Journal of Sleep Research, 15(3), 317–320. https://doi.org/10.1111/j.1365-2869.2006.00527.x
  9. Basheer, B., Hegde, K. S., Bhat, S. S., Umar, D., & Baroudi, K. (2014). Influence of mouth breathing on the dentofacial growth of children: a cephalometric study. Journal of international oral health : JIOH, 6(6), 50–55.
  10. Sanders, A. E., Essick, G. K., Fillingim, R. B., Knott, C., Ohrbach, R., Greenspan, J. D., Diatchenko, L., Maixner, W., Dubner, R., Bair, E., Miller, V., & Slade, G. D. (2013). Sleep Apnea Symptoms and Risk of Temporomandibular Disorder. Journal of Dental Research, 92(7_suppl), S70–S77. https://doi.org/10.1177/0022034513488140
  11. Stillman-Lowe, C. (1997). Insomnia and oral health. British Dental Journal. https://doi.org/10.1038/sj.bdj.4809439
  12. Muniz, F. W. M. G., Pola, N. M., Silva, C. F. E., Da Silva, F. R., & Casarin, M. (2021). Are periodontal diseases associated with sleep duration or sleep quality? A systematic review. Archives of Oral Biology, 129, 105184. https://doi.org/10.1016/j.archoralbio.2021.105184
  13. Berggren, K., Broström, A., Firestone, A. R., Wright, B. M., Lindsten, R., & Lindmark, U. (2021). Oral health problems linked to obstructive sleep apnea are not always recognized within dental care—As described by dental professionals. Clinical and Experimental Dental Research, 8(1), 84–95. https://doi.org/10.1002/cre2.517
  14. Reynolds-Campbell, G., Nicholson, A., & Thoms-Rodriguez, C. (2017). Oral Bacterial Infections. Dental Clinics of North America, 61(2), 305–318. https://doi.org/10.1016/j.cden.2016.12.003
  15. Sleep Science and Sleep Disorders | NHLBI, NIH. (2021, June 23). NHLBI, NIH. https://www.nhlbi.nih.gov/science/sleep-science-and-sleep-disorders

 

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