Relationship between Obstructive Sleep Apnea and Self-assessed Oral Health Status: An Internet Survey

Abstract

The purpose of this study based on a cross-sectional internet survey was to investigate the relationship between risk of obstructive sleep apnea (OSA) and self-assessed oral health status. The participants, who comprised individuals registered with an online research company, were required to complete a self-reported questionnaire. Those answering in the affirmative to both of the following two questions were placed in the OSA-risk group, while those answering in the negative were assigned to the control group: 'Have other people noticed pauses in your breathing while you are sleeping?' and 'Do you feel excessively sleepy during the daytime?'. A total of 493 were included in the OSA-risk group and 2,560 in the control group. Among the total 3,053 respondents, the highest prevalence for OSA risk in men was in the 50-59-year age range, although this tended to level off after age 60 years. No such trend was observed in women, however. Multiple logistic regression analysis was performed to identify the relationship between risk of OSA and self-assessed oral health status. Significant correlations were observed with the following parameters: difficulty in opening mouth (odds ratio [OR]: 2.66; 95% confidence interval [CI]: 1.647-4.311), dry mouth (OR: 2.11; CI: 1.544-2.876), bad breath (OR: 1.69; CI: 1.309-2.186), gingival bleeding (OR: 1.48; CI: 1.134-1.932), and gingival swelling (OR: 1.44; CI: 1.046-1.981). These results suggest a relationship between risk of OSA and self-assessed oral health status, indicating that treating OSA might improve oral health status. Further study is needed to demonstrate a causal relationship between OSA and self-assessed oral health status, however.

A Systematic Review on Sleep Related Disorders and Periodontal Disease

“…Nuha Ejaz et al 18 extended the findings of Gunaratnam et al 7 which diagnosed and classified periodontitis by same clinical parameter and suggested that the odds of moderate or severe periodontitis was elevated by a 4.1-fold margin among patients screening high risk relative to low risk for OSA after adjustment for potential confounders. Both studies suggested that the prevalence of periodontitis is greater in patients with OSA.…”

“…Their study showed a positive association between periodontitis and HR-OSA which was more generalized and more severe than in LR-OSA patients. Suzuki S et al 18 (2016, Tokyo) did a cross sectional study by using Epsworth sleepiness scale (ESS) questionnaire and results revealed association between risk of OSA and poor oral health status. Theirs was an internet based survey involving 3053 respondents; the OSA group included 493 patients and control group consisted of 2560 patients.…”

“…(Table.3) Moreover, Keller et al 9 (2013, Taiwan) through their case-control study design determined that there is an association between OSA and chronic periodontitis using Polysomnography as the diagnostic test. Ahmad et al 18 (2013, USA) through a case control study used a "STOP" OSA screening questionnaire to assess the OSA and it was found that a significant association between moderate or severe periodontitis and the risk of OSA in patients. Gunaratnam et al 7 (2009, Australia) used the Apnea-hypopnea (AHI Index) in their case-control study design and their results revealed that there is significant association between periodontal disease and OSA.…”

Obstrüktif uyku apne sendromu olan hastalarda CPAP tedavisinin klinik periodontal duruma etkisi: Altı yıllık takip

“…28,29 Nitekim OUAS tedavisinin ağız sağlığını iyileştirebileceği belirtilmiştir. 30 OUAS hastaları CPAP cihazı ile tedavi edildiğinde periodontal durumlarının nasıl etkilendiğini araştırdığımız bu çalışma, 6 yıllık CPAP tedavisi sonunda hastalarda klinik periodontal bulgularda başlangıç verilerine göre istatistiksel olarak anlamlı bir fark oluşmadığını ortaya koymaktadır.…”

The Global Need for Easy and Valid Assessment Tools for Orofacial Pain

“…This resolution reinforces the recognition by the WHO (2022a) that “oral health is a key indicator of overall health, well-being and quality of life.” The seriousness of the new resolution resides in the high prevalence of untreated oral conditions, most notably dental caries (tooth decay), severe periodontal (gum) disease, and extensive tooth loss, affecting around 3.5 billion individuals worldwide (Peres et al 2019). Poor oral health is not only associated with reduced quality of life, disruption to family life, lost school days, and decreased work productivity (Peres et al 2019) but has also been suggested to be associated with general health conditions such as cardiovascular disease, diabetes, cancer, pneumonia, premature birth, obesity, obstructive sleep apnea, and dementia (Suzuki et al 2016; Seitz et al 2019; Nadim et al 2020). The ensuing economic burden for our society is enormous: the direct and indirect costs associated with oral health problems have been estimated at US $545 billion per annum worldwide, which is comparable to the economic burden of the 2 most expensive illnesses: cardiovascular diseases and diabetes (Righolt et al 2018).…”