Could inadequate sleep be a risk factor for periodontal disease? Over a third of US adults are chronically deprived of a full night’s sleep and new evidence suggests that it may be affecting oral health. Sleep is critical to physical and mental well-being, and evidence suggests that a combination of screen use, dietary habits and the prevalence of shift work may be interfering with access to a full night of restful sleep.
During sleep, the entire body experiences significant physiological changes that help re-organize and re-set for the next day. Core body temperature drops, metabolism drops by five to ten percent, and metabolic waste products are eliminated from the brain. Furthermore, sleep is critical in modulating the immune system. During sleep, the body works to reduce reactive oxygen species, downregulate inflammation and lower levels of the stress hormone cortisol.
In particular, signals (such as interleukin-6 and tumor necrosis factor alpha) regulated by the hypothalamus-pituitary-adrenal axis have been found to promote inflammation body-wide, playing a role in the development of periodontitis along with poor oral hygiene. In a preliminary study of 60 healthy subjects between 25 and 50 years of age, researchers found that when all other variables were controlled for, incidence of periodontitis and gingivitis rose as hours of restful sleep declined.
These findings may help explain in part the rising epidemic of periodontal disease, which is tied to a slew of unhealthy behaviors that are only becoming more widespread as time goes on. One of the best methods to address this broad-spectrum caries risk is to educate high-caries-risk patients on an "anti-inflammatory lifestyle," that prioritizes adequate sleep along with diets rich in vegetables and low in refined carbohydrates. These actions have been proven to lessen the effects of other inflammatory diseases such as arthritis, IBS, and heart disease, and may be effective in reducing periodontal disease along with good oral hygiene.
Understanding of the role habit- and environment-derived systemic inflammation plays in various health problems continues to grow, and we can expect more unique approaches to treating diseases like periodontitis through comprehensive, whole-patient approaches.
CDC Press Releases. (2017). CDC. Retrieved 24 May 2017, from https://www.cdc.gov/media/releases/2016/p0215-enough-sleep.html
Grover, V., Malhotra, R., & Kaur, H. (2017). Exploring association between sleep deprivation and chronic periodontitis: A pilot study. Retrieved 24 May 2017, from PubMed Central
Study Estimates Nearly Half of American Adults Have Periodontal Disease. (2017). Ada.org. Retrieved 24 May 2017, from http://www.ada.org/en/science-research/science-in-the-news/study-estimates-nearly-half-of-american-adults-have-periodontal-disease
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