Temporomandibular disorders and sleep medicine: implications for dental practice

To provide a comprehensive overview of the diagnosis and management of temporomandibular disorders (TMDs) in patients with comorbid sleep-related conditions, specifically obstructive sleep apnoea (OSA) and sleep bruxism, while exploring their clinical interrelationships within an integrated dental care model.

A narrative review of the existing literature was conducted to synthesise current evidence regarding the physiological and pathological links between sleep disordered breathing, neuromuscular jaw dysfunction, and nocturnal parafunctional habits.

This review demonstrates that TMD and sleep disorders are intrinsically linked, with sleep bruxism often acting as a potential protective mechanism for airway patency in OSA patients, while fragmented sleep exacerbates chronic TMD pain. Findings suggest that a "siloed" treatment approach often leads to sub-optimal outcomes. Conversely, an integrated diagnostic framework - utilising screening questionnaires alongside clinical TMD examinations - facilitates more accurate identification of these interrelated conditions.

Effective management requires a shift from isolated dental interventions to a coordinated, interdisciplinary approach. By combining conservative measures, such as sleep hygiene and physiotherapy, with targeted therapies like mandibular advancement devices, dentists can significantly enhance oral rehabilitation success. Collaboration between dental professionals and medical sleep specialists is essential to ensure patient safety, optimise treatment sequencing, and improve the overall quality of life for patients presenting with this complex triad of disorders.