An Update on the Association Between Periodontitis and Obstructive Sleep Apnea.

A recent article from a US University further supports the association of gum disease and obstructive Sleep Apnea The study and article – An Update on the Association Between Periodontitis and Obstructive Sleep Apnea is from 2020.

An Update on the Association Between Periodontitis and Obstructive Sleep Apnea

Purpose of Association Between Periodontitis and Obstructive Sleep Apnea Review

In the U.S.: 47.2% of adults aged 30 years and older have some form of periodontal disease

The aim of this systematic review and meta-analysis was to update evidence answering four questions:

(1) Is there an association between periodontitis and obstructive sleep apnea (OSA)?

(2) Is there evidence of causality?

(3) Is there a dose-response relationship between the two conditions?

(4) Is there evidence on efficacy of periodontitis interventions on the occurrence and/or severity of OSA or vice versa?

Recent Findings in the Association Between Periodontitis and Obstructive Sleep Apnea Review

Thirteen studies were included in the qualitative analysis, and nine of them were included in the quantitative analysis. Seven studies were case-control and six were cross-sectional.

All studies assessed the association between periodontitis and OSA, five studies evaluated the dose-response relation, and one examined the efficacy of periodontal interventions on OSA occurrence.

There is a significant positive association between periodontitis and OSA. Evidence on a dose-response gradient was conflicting however and present and available evidence was insufficient and/or non-existent for efficacy of interventions and causality, respectively.

According to the Canadian Dental Association, gum disease develops in 70% of Canadians at different points in their lives.

Summary of the Association Between Periodontitis and Obstructive Sleep Apnea Review

There is mounting evidence that supports an association between periodontitis and OSA. However, future studies are warranted to determine does-response relation, causality, and reversibility.

My “take home”.

Clearly there is a need for a more thorough investigation of these two diseases and their association. In my opinion it is likely that blood borne inflammatory markers will reflect their association.

Some years ago, periodontal disease was linked with heart attacks and cardio-vascular disease. Again, inflammatory markers were implicated as a commonality. The redox reaction (oxidative stress) is closely connected with the inflammatory process (or cascade) – see also, cytokine storm.

Periodontal tissues require adequate levels of antioxidants to prevent tissue damage caused by reactive oxygen species.

It is clear that the three simple approaches to these diseases must be fulfilled for health maintenance.

Screening for OSA is appropriate for everyone. Where indicated testing is fairly simple and straight-forward. Treatment options have increased patient comfort for management of the disease if present. OSA remains a potentially serious yet poorly diagnosed and treated disease.

Periodontal disease is still a common finding in the general population even with the widespread use of dental hygienists.

Insurance and dental practice culture and mentality often determine that gingival and even periodontal disease is treated on a regular basis at the cleaning and check-up appointment without a completely disease-free state being achieved or recorded before the patient is discharged for regular health review.

The supplemental use of antioxidants has been shown to be of value in the treatment of periodontal disease and health maintenance and yet the regular use remains unknown by most dental team members.

Stephen Bray DDS

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