Exploring the Link Between Sleep Quality and Oral Health


Consider this: the root cause of your oral health issues could be poor quality sleep or a sleep disorder. There is a strong link between sleeping disorders and dental problems, like cavities, gum disease, and oral microbiome imbalances.

In functional dentistry, we look beyond the mouth for the root cause of disease. For many patients, a sleep study is part of dental care. It can go the other way, too; dental disorders can impact sleep, so we want to understand connections throughout the body.

Today’s article will explore these sleep-oral health connections. Keep reading to discover:

  • How sleep affects oral health
  • Mouth changes during sleep
  • Types of sleep disorders that impact oral health
  • Sleep apnea and dental problems
  • The importance of improving sleep quality

How Does Sleep Affect Your Oral Health?

Several studies correlate poor sleep quality with poor oral health using epidemiological or self-reported data. Signs of poor sleep quality include difficulty falling asleep or staying asleep and not feeling rested in the morning. Short sleep duration (under 7 hours) also contributes.

On the other hand, high-quality sleep boosts immunity and decreases inflammation throughout the body, including your mouth.

What Happens to Your Mouth When You Sleep?

Saliva is essential for protecting the mouth from acid and pathogens, but saliva production slows down during sleep. Less saliva means bacteria can build up, which is exacerbated by sleep disorders.

Sleep Conditions that Negatively Impact Oral Health

There’s a long sleep disorders list, and I’ll cover a few of the most common ones here.

Sleep Apnea

What is sleep apnea? Obstructive sleep apnea , sleep apnea for short, occurs when there are brief decreases or stops in breathing airflow during sleep. Sleep apnea symptoms often include snoring. The sleep disorder correlates with obesity and raises the risk of cardiovascular disease and other chronic diseases.

Sleep apnea treatment is a CPAP (continuous positive airway pressure) machine that improves sleep quality and dental health.

Dry Mouth

Sleep apnea leads to dry mouth and even less saliva production overnight, contributing to tooth decay (cavities) and infections.

Tooth Decay

Tooth decay treatments save the teeth but don’t address the reasons for cavities in the first place. Oral hygiene plays a role, but poor sleep is an often overlooked contributor.

Gum Disease

Sleep disorders, including sleep apnea, correlate with gum disease ( gingivitis ) and periodontal disease. Poor sleep and airflow increased oral bacterial infections and mouth inflammation. Conventional dentists often don’t offer much in the way of gum disease treatments other than oral hygiene, like brushing and flossing. All gum disease patients need a sleep apnea evaluation.

Tooth Loss

Sleep apnea leads to inflammation of the mouth and poor oral health, which may lead to tooth loss. On the other hand, tooth loss may be an independent risk factor for developing sleep apnea.

Mouth Breathing

Breathing through your mouth instead of your nose is another factor in sleep disorders. Mouth breathing causes dry mouth, decreased saliva production, and unfavorable changes in the oral microbiome. It can be a reason behind disrupted sleep.

If you are a mouth breather and want to train yourself to breathe through your nose, read my article on mouth taping.

Bruxism (Teeth Grinding)

Bruxism, teeth grinding, refers to clenching or grinding teeth in your sleep. Teeth grinding in sleep often has to do with stress or breathing problems and can become habitual. Over time, it destroys tooth enamel, causes gum recession, and increases tooth sensitivity.

Mouth guards for teeth grinding are the standard of care in dentistry. While they help protect the teeth from damage, they don’t address the root cause, why the patient is grinding in the first place.

TMJ Disorders

Temporomandibular joint disorder, or TMJ, is another disorder that may affect sleep. More TMJ disorders affect those with poor sleep.

TMJ symptoms include jaw pain, headaches, and decreased range of motion in the jaw. Changes in posture, lifestyle habits, and physical medicine are TMJ treatment options.

How Can Improved Sleep Quality Promote Oral Health?

Now that you see the connections between sleep conditions and oral health, you may wonder how to improve sleep quality. From a functional medicine perspective, we want to put sleep strategies in place to help you address the underlying factors impairing sleep. A sleep plan may look different for each individual and include diet changes, sleep hygiene habits, supplements, and conventional tools like medication, CPAP machines, and more.

The benefits of sleep are far reaching. Improved sleep means better oral health and total body wellness.

Increased Blood Flow

Optimizing breathing during the night improves oxygen flow throughout the body, enhances the delivery of nutrients, and removes waste. Your body is better able to repair and heal since this primarily happens during sleep.

Reduced Inflammation

Sleep deprivation and poor sleep increase inflammatory signals in the body, which is very apparent in the mouth. Inflammation drives oral disease and all chronic diseases.

Restored Immune System

Your immune system requires rest for optimal function. If you’ve ever had poor sleep for a period and then gotten sick, you know this firsthand. Sleep helps the immune system manage unwanted bacteria in the mouth to promote a balanced oral microbiome.

If you are struggling with poor oral health, cavities, and gum disease, consider sleep issues as a possible root cause. If your dentist isn’t evaluating your sleep, it’s time for a new approach. I’m here to support you; schedule an appointment today!

Working to improve sleep quality works wonders for oral health now and into the future.


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Dr. Gerry Curatola is a renowned biologic restorative dentist with more than 40 years of clinical practice experience.

He studied neuroscience at Colgate University and attended dental school at the New York University (NYU) College of Dentistry where he now serves as Adjunct Clinical Associate Professor in the Department of Cariology and Comprehensive Care.