Relationship Between Short Sleep, Exercise Frequency and Media Use with Oral Health in Korean Elementary School Children: A Cross-Sectional Study

<b>Background:</b> Dental caries, periodontal disease, and malocclusion are common childhood oral diseases strongly influenced by lifestyle factors, including sleep, exercise, and media use. In Korea, the prevalence of dental caries among elementary school children is approximately 20-25%, periodontal disease 1-2%, and malocclusion 12-18%. Sleep is a key determinant of child health; insufficient sleep is linked to weakened immunity, higher systemic inflammation, and greater susceptibility to cariogenic bacteria, suggesting a potential pathway to poor oral health. This study aimed to analyze the combined effects of sleep duration, exercise frequency, and media use on oral health indicators in Korean elementary school students. <b>Methods</b>: We analyzed Student Health Examination data from the Ministry of Education (2021-2023) for 93,220 children aged 6-12 years. Oral health indicators included dental caries prevalence (DCP), required rate of improved oral hygiene (RRIOH), periodontal disease prevalence (PDP), and malocclusion prevalence (MP). Sleep duration was categorized as short (<8 h) or adequate (≥8 h). Exercise (≥3 times/week) and media use (>2 h/day) were assessed as lifestyle factors. Associations were examined using the Rao-Scott χ² test and logistic regression. <b>Results</b>: Short sleep was significantly associated with a higher prevalence of all oral health indicators, with particularly strong associations for DCP and PDP. Low exercise frequency and excessive media use were also linked to increased DCP and RRIOH. These lifestyle factors were closely interrelated with sleep duration. <b>Conclusions</b>: Short sleep, infrequent exercise, and high media use form a lifestyle pattern associated with poor oral health in children. Improving sleep and lifestyle habits should be emphasized as a preventive strategy in pediatric dentistry.