Oral health and sleep are joined at the hip, both for good and for bad. If you’re sleeping well and sleeping correctly, your chances of having a healthy mouth are much higher than if you are regularly getting a poor night’s rest. Before we jump into talking about what good or poor sleep looks like, let’s first take a look at what happens in everyone’s mouth when we drift off into dreamland.
One of the best defenses our mouth has to fight off cavities and gum disease is our saliva. Almost all of the food and drinks that we consume are acidic on some level. This acidity makes our teeth much more susceptible to decay. Our saliva, however, is composed of neutralizers that raise the pH of our mouth to a safe level where our teeth are less likely to experience decay. Everyone’s saliva flow slows down significantly as they sleep, which means that any negative oral health processes that are happening in our mouths while we are awake become exacerbated while we are sleeping. So, keep that in mind as we talk about the ways good and bad sleep affect overall mouth health.
The sleeping habit that has the worst impact on the overall health of our gums and teeth is mouth breathing. As previously mentioned, even in an ideal scenario, everyone’s saliva flow slows to an almost stop while they sleep, resulting in dry mouth. If you add mouth breathing to the mix, the already dry oral environment quickly turns into a desert. This is dangerous for the health of anyone’s teeth but is especially so for individuals with gum and bone recession. As our gums recede, our root structure (which doesn’t have an enamel covering) becomes exposed. Because they are not covered by enamel, our roots break down and decay at a much higher pH than our enamel does. In other words, our mouth doesn’t have to be nearly as acidic for the root structure to decay when compared to the part of our teeth covered by enamel.
With very few exceptions, when I have a patient with rampant decay on the root surfaces of several teeth, they (or their partner) report that they are a mouth breather and/or snorer. An easy fix for patients who mouth breathe, but don’t have sleep apnea, is mouth taping. We will do another article soon on everything you need to know about mouth taping, but for the time being, we’ll just point out that taping your mouth shut while you sleep is a good way to force yourself to breathe through your nose, keeping your mouth as lubricated as possible.
Another sleep habit that negatively affects oral health is clenching and grinding. The difficult part about this one is that, if you don’t have a roommate or partner, you may not even know that you are doing it. As a dentist, when I’m doing a routine exam, several indicators signal a patient may be a clencher and/or grinder. The most obvious sign of grinding is wear patterns on the biting surfaces of the teeth. In extreme cases, cusps (tall peaks on the teeth) become flattened due to heavy grinding. Other less obvious signs of grinding are gum recession and concave abfractions (loss of tooth substance) on the roots of the teeth near the gumline.
The analogy I often give for this is that our teeth are like nails that are halfway into a wooden board. As long as you hammer the nail down the center of its axis, the nail stays strong but if you start hammering the nail from the side, it doesn’t take long for the nail to bend and weaken right at the spot it enters the board. Similarly, our teeth are very well designed to receive pressure down the center of their axis. But, if you continuously grind your teeth from side to side, the teeth start to weaken and chip at the spot where they enter the bone. The best first course of action, if you’re a clencher or grinder, is to get a custom-fit night guard from your dentist. By design, a well-made night guard holds you open roughly 3mm. This amount of opening has been proven to deprogram (or shut off) the muscle of mastication (chewing). Because of this, patients often report fewer headaches as well as less tooth sensitivity.
Another area of concern related to sleep and oral health is sleep apnea. The concerns with this condition are very similar to mouth breathing. Whether you wear a CPAP machine or a special night guard that advances your lower jaw, I would always recommend mouth taping in conjunction with these therapies, in order to prevent dry mouth and all of the poor oral outcomes that accompany it.
The bottom line is, your oral and overall health are positively impacted by doing everything in your power to get a good night’s sleep. When our body is well-rested, we tend to exhibit less stress, anxiety, and lower incidences of depression overall. Whereas negative shifts in our sleep routine result in a variety of negative outcomes throughout the body. Low-quality sleep can lead to other issues like daytime clenching and/or grinding, as well as intensifying already present concerns like depression and anxiety. To learn more on how mental health struggles can to lead to poor oral health routines visit this blog. So, even if your dentist doesn’t bring up any specific sleep-related dental issues, do yourself a favor and try your best to get a good night’s rest.