When you think about taking care of your teeth, you probably think of brushing, flossing, eating right, and seeing your dentist for regular cleanings. But there are other drivers of oral health that you might not think of right away.

sleepingSleep, for instance.

Previous research, such as the 2007 Journal of Periodontology study we told you about before has suggested that lack of sleep is second only to smoking as a risk factor for gum disease. And more recent studies have lent more support for the relationship between sleep and periodontal health.

Consider the study published early last year in the Journal of Periodontal Research. For it, rats were divided into four groups: one fatigued, one infected with oral pathogens, one with both conditions, and a control group. They were observed and evaluated over the course of several weeks. In the end, the fatigued rats showed worse systemic health, more inflamed gum tissue, and more alveolar bone loss. (Gum disease degrades this thick ridge of bone that contains the tooth sockets.)

In conclusion, our results suggest that fatigue is a modifying factor for periodontal disease in rats.

What about in humans? We see the sleep-perio link there, too – especially in the research on sleep disorders and gum disease risk. For instance, a study published earlier this year in Clinical Oral Investigations found that obstructive sleep apnea (OSA) changed oral bacteria and correlated with gum disease severity. Studies that considered sleep disorders more broadly also show a relationship between poor quality sleep and poor periodontal health (this and this, for instance).

Why should sleep have anything to do with it?

For one, lack of sleep or constantly disrupted sleep raises cortisol levels, which in turn contributes to inflammation – one of the common denominators of gum disease and the ever-growing list of systemic conditions it’s been linked with. Cytokine levels also go up, also contributing to inflammation. Our immune systems become compromised.

At the same time, lack of sleep can lead us to less-than-healthy food and drink. For instance, you might caffeinate and sugar up with things like sodas, energy drinks, and over-the-top Starbucks concoctions. You may eat more for convenience or comfort, less for nutrition.

You may go slack on home care, as well – too tired to put too much effort into it.

All this, in turn, pollutes and stresses the biological terrain – the extracellular matrix that drives health and illness alike. The more stressed and compromised the terrain, the less able the body can self-regulate properly. Eventually, you get symptoms that we interpret as various illnesses – from cancer to gum disease and everything in between.

The best hygiene in the world is only partial help at best if the terrain is constantly, chronically compromised.

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