Dentistry’s role in sleep health is expanding — not just clinically, but biologically — as emerging research links sleep duration to oral microbiome diversity and evidence grows around sleep’s impact on periodontal health. Experts also are calling on dentists to take a larger role in sleep disorder care.
At the American Dental Association’s Sleep and Airway-Focused Dentistry Summit on Dec. 3 in Chicago, more than 40 dental and medical professionals from across the United States discussed strengthening the dental profession’s involvement in sleep and airway health. Participants included dentists experienced in sleep care, neurologists, sleep medicine physicians and technology developers.
Interrupted breathing during sleep affects an estimated 30 million people in the United States, yet only about six million have been diagnosed with sleep apnea, leaving a substantial underdiagnosed population, according to the ADA.
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Throughout panel discussions and breakout sessions, speakers emphasized that dentists are uniquely positioned to identify airway issues, screen for sleep-related breathing disorders and deliver oral appliance therapy — a well-established treatment option for many patients with obstructive sleep apnea. Improving collaboration between dental and medical providers also emerged as a recurring theme.
“Better sleep health has and will always be a priority for all clinicians, specifically dentists, because one of the key treatments of sleep disorders can be the use of oral appliances,” said ADA member dentist Payam Attai, D.M.D., co-organizer of the summit.
Panelists also highlighted insurance credentialing challenges, coverage inconsistencies and financial disincentives that can limit the use of combination therapies — barriers that disproportionately affect underserved populations, including lower-income patients, women and diverse groups.
“As a sleep neurologist … it is exciting to see that the needle is moving with more attention being directed towards dental sleep medicine,” said summit attendee Jerald Simmons, M.D.
Sleep, menopause and underdiagnosis
Sleep and menopause were also highlighted as a critical intersection during a September event in Toronto covered by Oral Health Group.
Dr. John Viviano, a dentist at Sleep Disorders Dentistry RLC and a speaker at the event, pointed to persistent research bias in sleep medicine, noting that screening tools for sleep apnea are often designed around “typical” male symptoms — a gap that can leave women underdiagnosed.
Viviano said education around menopause must begin within dental practices, emphasizing that dentists and their teams are well positioned to engage patients in informed, empathetic conversations about sleep, hormonal changes and oral health.
Related: More women break menopause taboos — and why dentistry must pay attention
Role of the microbiome and sleep
In May, research published in Sleep involving 1,332 U.S. adolescents and young adults aged 16 to 26 years found that oral microbiome diversity was positively associated with longer self-reported sleep duration. Participants reporting “long” sleep — a small group representing about three per cent of the sample — showed significantly higher diversity across several alpha-diversity measures compared with those reporting healthy sleep duration. The study’s authors cautioned that further research is needed to understand the mechanisms behind these associations.
The findings add to a growing but still early body of evidence suggesting microbial patterns in the mouth may reflect broader systemic processes related to sleep, though causality has not been established.
Sleep and periodontal health
Additional research published in Sleep and Vigilance in July found that sleep quality and sleep deprivation may be linked to periodontal disease severity. Researchers reported that salivary melatonin levels varied with gingivitis and periodontitis severity, and that sleep deprivation was associated with an increased risk of more severe periodontal disease.
Melatonin — a hormone central to sleep regulation — also has antioxidant properties that may influence inflammatory processes relevant to periodontal health.
Together, these findings point to a potential biological pathway connecting sleep disruption, inflammation and periodontal disease, though researchers stress that larger and longitudinal studies are needed to clarify causation and clinical implications.