Study on the association between sleep disorders versus oral health related variables

Association of periodontitis, tooth loss, and self-rated oral health with circadian syndrome in US adults: a cross-sectional population study

BACKGROUND

This study was to investigate associations of periodontitis, tooth loss and self-rated oral health with circadian syndrome.

METHODS

Data regarding periodontitis, dentition, oral health questionnaire and circadian syndrome of 30-85 years old participants from US National Health and Nutrition Examination Survey 2005-2020 were analyzed. Periodontitis questions for periodontitis and dentition status were validated. Weighted multivariable logistic regression analyses were used.

RESULTS

Weighted prevalence of circadian syndrome and stage II-IV periodontitis was 33.29% and 88.87%, respectively. When compared with stage I periodontitis, stage II periodontitis was significantly associated with greater circadian syndrome prevalence after adjustment (odds ratio (OR) and 95% confidence interval (CI): Stage II: 1.35 (1.03, 1.76), P = 0.032; Stage III: 1.30 (0.97, 1.73), P = 0.069; Stage IV: 1.17 (0.82, 1.65), P = 0300). Stage II periodontitis was significantly associated with greater prevalence of lower high-density lipoprotein cholesterol (HDL) and elevated triglycerides and stage III and stage IV periodontitis were significantly associated with greater hypertension prevalence. A 1 tooth increase in the number of missing teeth was associated with a 1% increase in circadian syndrome and its components of obesity, elevated fasting plasma glucose (FPG) and short sleep. Poor or fair self-rated oral health showed a specificity of > 70% for periodontitis and lack of functional dentition. Meanwhile, poor or fair self-rated oral health had relatively higher levels of sensitivity for stage II-IV periodontitis (35%), stage III-IV periodontitis (46%), stage IV periodontitis (60%) and lacking functional dentition (56%). When compared to excellent self-rated oral health, good, fair and poor self-rated oral health were significantly associated with higher circadian syndrome prevalence (OR and 95% CI: Very good: 1.13 (0.97, 1.32), P = 0.120; Good: 1.34 (1.14, 1.57), P < 0.001; Fair: 1.41 (1.16, 1.71), P = 0.001; Poor: 1.63 (1.32, 2.03), P < 0.001). Additionally, participants with worse self-rated oral health had significantly higher prevalence of elevated FPG, hypertension, low HDL, elevated triglycerides, short sleep and depression.

CONCLUSIONS

Periodontitis, tooth loss and worse self-rated oral health were associated with circadian syndrome in US adults. Self-rated oral health may be a simple question to indicate oral and systemic health.

Oral health and sleep disorders: A systematic review and meta-analysis

Oral health and sleep quality are critical components of overall health, but their relationship remains poorly understood. The present meta-analysis therefore investigates the association between oral health and sleep quality, synthesizing evidence from diverse populations. To this aim, a comprehensive search strategy identified 311 articles, from which 8 studies encompassing 18 comparisons met the inclusion criteria. These studies, conducted between 2015 and 2023, included 36,559 participants across various countries. Oral health was assessed using indices such as the Decayed, Missing, and Filled Teeth Index and gingival indices. At the same time, sleep quality was measured using tools such as the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale. The results of the meta-analysis revealed a significant association between poorer oral health and poorer sleep quality, with a standardized mean difference of 2.166 [95% confidence interval (95% CI), 0.677-3.655; P=0.004]. Sensitivity analyses confirmed the robustness of the findings, and publication bias assessments indicated no significant bias. Precision interval analysis showed a mean effect size of 2.17 with a 95% CI of -4.83 to 9.16, suggesting variability in the strength of the association across populations. In conclusion, the results of the present meta-analysis provide strong evidence for a significant link between oral health and sleep quality, highlighting the importance of considering oral health in the management of sleep disorders. Future research should focus on longitudinal studies and standardized measurement tools to further elucidate this relationship and inform public health strategies aimed at improving both oral health and sleep quality.

Sleep and periodontal health

Sleep is fundamental for health and well-being. An adequate amount and quality of sleep is a cardinal component of a healthy lifestyle at the basis of the prevention of many non-communicable chronic diseases. Recent evidence suggests that sleep disorders, particularly obstructive sleep apnea, represent an emerging risk factor for periodontal health. This review article provides a critical appraisal of the existing literature concerning the association between sleep duration, sleep quality, sleep disorders in general, and obstructive sleep apnea with periodontal diseases, including gingivitis and periodontitis. The putative mechanisms underlying these associations are described as well as the potential clinical implications for diagnosis and treatment.

Investigating oral health among US adults with sleep disorder: a cross-sectional study

BACKGROUND

This study aims to investigate the relationship between sleep disorders and oral health outcomes among a representative sample of the United States population.

METHODS

The study sample comprised 6,161 participants who participated in the NHANES 2017-2018, representing a population of 255,939,599. Oral health outcomes were assessed using the Oral Health Questionnaire (OHQ), covering dental pain, periodontal disease, bone loss, emotional perceptions of oral health, and impact on daily life. Sleep disorders were evaluated using questions related to sleep trouble and daytime sleepiness.

RESULTS

Analysis of the NHANES 2017-2018 dataset, revealed notable associations between sleep disorders and oral health outcomes. Individuals with sleep disorders were more likely to report dental pain (19.79% vs. 11.8%), periodontal issues (19.5% vs. 12.25%), and feeling bad or embarrassed about their oral health (21% vs. 12%), compared to those without sleep disorders. Difficulty due to oral health issues was also more prevalent among participants with sleep disorders (32.6% vs. 12.9%). Adjusted models demonstrated that individuals with sleep disorders had a significantly higher likelihood of experiencing oral aches [adjusted odds ratio (aOR) = 1.58 (1.22-2.22)], reporting negative emotions about oral health [aOR = 1.59 (1.06-2.37)], and encountering challenges in school or job performance [aOR = 2.27 (1.47-3.51)], compared to individuals without sleep disorders (refer to Table 3). Other significant covariates affecting oral health outcomes included smoking, income, and education level.

CONCLUSIONS

This study reveals a compelling association between sleep disorders and adverse oral health outcomes in the U.S.

POPULATION

Relationship between Behavior and Periodontal Health Self-Perception in Diabetic and Non-Diabetic Patients from Transylvania, Romania-A Self-Report Study, including The Desire to Use a Mobile App for Oral Care Improvements

The study aimed to assess self-reported symptoms of periodontal disease (gingival bleeding, tooth mobility and halitosis) among diabetic and non-diabetic patients from Transylvania, Romania. Using statistical analysis methods, correlation between the aforementioned symptoms and diet, oral hygiene habits, stress, physical activity, and BMI (body mass index) were researched. Another secondary objective was to assess the impact of self-reported oral health, aesthetics, and halitosis on their life. Patients' willingness to use a mobile app for generating awareness of oro-dental complications, improving their knowledge of oro-dental health, and reminding them to visit the dentist based on an awareness-raising function, was also assessed. Methods: The study was based on an original self-administered questionnaire, applied to 182 subjects, in an unselected, randomized manner. A total of 110 questionnaires were applied in two dental offices and 72 questionnaires were applied in a public clinic for diabetic patients from Cluj-Napoca, Romania. Results: Warning signs and symptoms relevant to periodontal disease were identified by respondents, having statistically significant associations with the declared oral health-care habits, including interdental aids, vicious habits (nail biting, bruxism), etc. Some of these periodontal signs could be correlated with a certain lifestyle, such as the perceived stress, smoking status, practicing maintenance sports, and alcohol consumption. A total of 66% of the non-diabetics and 68% of the diabetics of the surveyed subjects consider a software application for generating awareness of oro-dental complications useful, and are willing to pay around EUR 6 for it. Conclusions: Having a medical condition such as diabetes makes patients pay more attention to dental health compared with non-diabetic patients. Patients expressed their desire to use a software application to help them to be aware of their condition and for improving their self-report capabilities, including their oral-health-related status.

A world panorama of bruxism in children and adolescents with emphasis on associated sleep features: A bibliometric analysis

BACKGROUND AND OBJECTIVES

To present a world panorama of the published papers on bruxism in children and adolescents, emphasising the characteristics of studies related to the sleep features of these patients.

METHODS

Literature searches were conducted in six databases without language or date restrictions. Data on the titles, types of study, main subjects, countries of origin, keywords, years of publication, authors and their network collaborations, journals and sleep studies were extracted and analysed using VantagePoint™ software.

RESULTS

A total of 725 studies met the eligibility criteria. Most included only children (75.31%), with observational design (66.34%), and risk or aetiology (53.93%) as the main subject. Brazil (18.06%) and Brazilian authors (54.84%) had the largest number of studies, with a low amount of network collaboration. The Journal of Oral Rehabilitation published most of the studies (6.2%); publications in this field have grown considerably from 2000 to 2020. Of the studies, 123 (16.96%) included sleep studies; night sweating, restless sleep, sleep talking, mouth breathing, snoring, obstructive sleep apnoea syndrome, sleep-disordered breathing, nightmares, poor sleep quality and duration, and daytime naps were significantly associated with bruxism in most.

CONCLUSION

Studies on bruxism in children and adolescents have increased in the past 20 years, with most being observational, and risk or aetiology as the main subject. Brazil and the Journal of Oral Rehabilitation have published most in the field. Sleep studies have shown some features associated with bruxism, such as night sweating, restless sleep, somniloquy, snoring, breathing problems, nightmares, daytime naps, and poor sleep quality and duration.