Oral Findings in Patients with Obstructive Sleep Apnea Syndrome

Howard E. Strassler, DMD

Petrou-Amerikanou C, Belazi MA, Daskalopoulou E, et al. Quintessence Int.2005 Apr; 36(4):293-298.

Abstract

OBJECTIVE: To evaluate the role of dental parameters that may contribute in increasing apneic activity in patients with obstructive sleep apnea syndrome (OSAS). METHOD AND MATERIALS: A total of 152 subjects (121 males and 31 females) were examined from October 1999 until September 2001, for sleep disorder symptoms. All patients underwent polysomnography. Any abnormal or unusual features that could inhibit the upper airway of the oral cavity were evaluated by an oral pathologist. RESULTS: Statistical analysis of the independent structural variables and the respiratory disturbance index proved to be significant only in the cases of retropositioned or narrow hard palate with a vertically positioned soft palate, the type of breathing (oral breathing), and the enlarged uvula. CONCLUSION: The oral soft tissues seem to be more closely associated with OSAS. Therefore, the diagnosis of the structural features of the oral cavity by the clinician is useful to predict apneic activity.

COMMENTARY

Obstructive sleep apnea syndrome (OSAS) is a common sleep disorder associated with snoring and excessive daytime sleepiness. This article presents the fact that OSAS in the general population is found in 16% of men and 5% of women. In the elderly population, these numbers increase significantlyto 67% of men and 54% of women. OSAS symptoms occur during inspiration when sleeping. The airway often becomes obstructed after collapse at the soft palate by the base of the tongue. During apneic episodes, a person awakens after 10 seconds, inhales, and resumes sleeping. Although the disorder is multifactored, this article demonstrates the importance of dental clinicians in the diagnosis of OSAS based on the anatomic features in the oral cavity.

This article was excellent in thatit presents an overview of OSAS byproviding clinician with a heightened awareness of the prevalence of the disease, its characteristic signs, and the fact that dentists have an important role in the ability to help patients with thisdisorder. With such a large number in the population suffering from OSAS, the dentist can provide patients with increased awareness about OSAS and referral to sleep disorder clinics for treatment. In many cases, the dentist can be part of the team in treating OSAS. If you are not already documenting anatomic features that might contribute to OSAS, one might consider documenting oral examinations with the sizes and shape of the palate, tongue and uvula, and also, retropositioned small maxillas and mandibles as well as other oral abnormalites which could contribute to narrowing of the airway during sleep.

About the Author

Howard E. Strassler, DMD Professor and Director of Operative Dentistry Department of Endodontics, Prosthodontics and Operative Dentistry University of Maryland Dental School, Baltimore,Maryland