The effect of nocturnal wear of dentures on the sleep quality: a systematic review and meta-analysis

Abstract

Purpose: The effect of nocturnal wear of denture on sleep quality and integrity is still not well understood. Therefore, this systematic review was conducted to provide evidence on this topic.

Methods: Electronic searches were conducted from 1964 up to September 2015, using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. Only publications in English or French, in which sleep quality of edentate adult individuals wearing dentures at night was compared to those not wearing were included in the review. Random effects models were used to pool the effect sizes.

Results: A total of 10 studies were included in the systematic review and 5 in the meta-analysis. No statistically significant difference between sleeping with denture and without denture was found for the Apnea-Hypopnea Index (AHI; Standard Mean Difference = -0.60, 95 % CI -1.67-0.47; Z = -1.10; p = 0.27). However, there was considerable heterogeneity in the studies included in the meta-analysis (Tau² = 1.34; Q-value = 59.32, df = 4 (P < 0.0001); I² = 93.3 %). When results from randomized controlled trials (RCTs) were pooled in subgroup analyses of AHI, there was a tendency towards favoring sleeping without dentures (P = 0.059) and no evidence of heterogeneity between studies (Tau² = 0.000; Q-value = 0.06, df = 1 (P = 0.80); I² = 0.000 %).

Conclusion: The current evidence suggests that there is no difference in the sleep quality and integrity of individuals wearing or not wearing their denture during sleep. However, the results of randomized controlled trials favoring sleeping without dentures and the likely presence of bias in the previous studies indicate the need for further randomized controlled trials for the development of clinical guideline.

Keywords: Denture; Obstructive sleep apnea; Sleep; Sleep disorders; Tooth loss.