Narcolepsy and dental health

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Having narcolepsy can obviously have knock-on effects on other aspects of your general health and well-being, and it is important that you and your medical practitioners pay attention to these.

One area that we have recently considered is the effect of narcolepsy and narcolepsy treatments on oral health and dental care.

Medications used to treat narcolepsy may have side effects that are detrimental to oral health, though there is conflicting evidence in the scientific literature. For instance, a small study (see here) showed reduced salivary flow rates and increased fungal microbes in people with narcolepsy, which may be due to the effect of medication. Another, slightly smaller, study (see here) a few years later showed no increase in salivary flow rate in narcolepsy, but did indicate that medication might also be increasing output of two salivary proteins. That could actually be good for teeth, as it helps remineralisation of tooth enamel.

Anecdotal reports that we have received include suggestions that medication may cause increased tooth grinding and/or jaw clenching at night, which can obviously result in damage to teeth. Dry mouth is also widely reported. Simple behavioural aspects of narcolepsy may also have an influence, such as night-time eating and failure to properly brush teeth as a result of falling asleep.

Other issues that may be important are potential interactions between narcolepsy medications and anaesthetics used in dentistry and the known influence of anti-depressants on blood clotting time.

All of this means that you must make your dentist aware of your narcolepsy and the medicaments that you take. We would also suggest that your dentist should contact your consultant for advice.

You should also make sure that your dentist is aware of the symptoms of narcolepsy that may present during dental treatment, such as

  • Excessive daytime sleepiness and sudden sleep attacks that may occur during a short period of inactivity, for instance while you are in the dentist's chair, perhaps during a short break in treatment while an anaesthetic takes effect.

  • Cataplexy that may be triggered by anxiety or apprehensiveness (which commonly accompanies dental treatment!)