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Saudi Journal of Oral and Dental Research (SJODR)
Volume-11 | Issue-05 | 195-200
Review Article
When Gums Follow the Clock-the Role of Oral Circadian Rhythm
Swathi S Malagatti, Rashmi S Pattanshetty, Prakash N, Garadala Pragna Sri
Published : May 26, 2026
DOI : https://doi.org/10.36348/sjodr.2026.v11i05.010
Abstract
Chrono-dentistry is a new area of study in dentistry that examines the relationship between circadian cycles and periodontal health. Circadian clocks are natural timekeeping mechanisms that synchronise daily cycles with physiological functions. Both the central nervous system and periodontal tissues, such as the gingiva, periodontal ligament, alveolar bone, and fibroblasts, express molecular clocks, which include genes like BMAL1(Brain and Muscle Aryl Hydrocarbon Receptor Nuclear Translocator (ARNT) like protein), PERs (Period genes), Crys (Cryptochrome genes), and DEC1/2 (Differentiated Embryo Chondrocyte 1 and 2). With rhythmic gene expression influencing bone resorption, vascularization, and inflammation, these peripheral clocks regulate crucial processes such as tissue remodelling, wound healing, immunological responses, and cellular proliferation. A person's susceptibility to periodontitis is increased when their circadian cycles are disrupted by shift work, sleep deprivation, or genetic changes. This results in increased tissue degradation, heightened inflammatory mediators (Tumor necrosis factor-α, Interleukin-1β), and decreased salivary antioxidant capacity. CLOCK gene (Circadian Locomotor output Cycles Kaput) downregulation, particularly of BMAL1, enhances pro-inflammatory pathways controlled by NF-κB (Nuclear Factor κB), thereby accelerating bone loss and influencing bone resorption, vascularization, and inflammation. The potential of chronobiology-guided periodontal therapy is highlighted by our growing understanding of the molecular pathways relating circadian rhythm and periodontal disease. Long-term oral health may be supported and treatment outcomes may be enhanced by coordinating therapeutic and preventive measures with the circadian cycle.
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