Is there an association between periodontitis and obstructive sleep apnea?
This summary is based on the article published in the Journal of Periodontal Research: The association between periodontitis and obstructive sleep apnea: a preliminary study (August 2013)
Context
Periodontitis is becoming a highly prevalent disease worldwide. Obstructive sleep apnea is a common disorder that is characterized by repeated disruptions in breathing during sleep, and mouth breathing is a common characteristic among patients with obstructive sleep apnea.
Purpose
The study aimed to assess the hypothesis that obstructive sleep apnea is associated with the onset and progression of periodontal disease.
Key Messages
- The study identified that there is a significant association between obstructive sleep apnea and periodontitis.
- It has been recently identified that periodontitis has a number of systemic effects, such as diabetes, coronary heart disease, rheumatoid arthritis, osteoporosis, and malignancy. It is, therefore, important to know the risk factors in order to prevent periodontitis and possible systemic diseases.
- We suggest that obstructive sleep apnea may be a risk factor for periodontal disease and that the treatment of obstructive sleep apnea may prevent progression of periodontal disease.
- Further research is needed to establish the causal relationship between the two conditions.
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I think we need to be careful about how the findings from this kind of research are presented. From the terminology used, this post suggests that periodontal disease causes other conditions like diabetes, heart disease, etc. Although there has been shown to be an association between these diseases and periodontal disease, we still don’t know what causes the association. Also, just because there is an association there is little to no evidence that treating periodontal disease will have any impact of the other diseases’ progression or vice versa.
hear hear, ‘causal’ links so different from ‘association’ …..however much we want to raise awareness of the of importance of minimising the effects of periodontal disease we have to take care to remain cautious about overplaying the significance of such findings
The association in my view is weak because if we cure or treat sleep apnea do we also solve the periodontal disease or vice versa. I think not.
The abstract for this article states an odds ratio of 1.86 for periodontitis associated with OSA. It did not quantify the severity of the OSA and correlate to periodontal disease status. This is a pretty weak correlation. It also found no correlation for patients under 55 years old. There is no indication in the abstract if the authors factored for age or smoking status. I agree with the previous posts. Beware of any conclusions you might draw from this study.
I have been treating patients with sleep apnoea for 24years .The biggest problem I have noted is that few patients have actually received periodontal probing even at an early age of 18 yrs.What I do note is that they are totally unaware of the causes,progress or prevention of periodontal disease regardless of their sleep disorder.Before a dentist provides any treatment the periodontal condition must be recorded and explained to the patient.In cases of sleep apnoea – one is usually dealing with a medically compromised patient.They may have cardiovascular problems,diabetes,reduced manual dexterity reducing their ability to perform proper oral hygiene as a result of being grossly overweight.They are also prone to bruxing therefore placing excessive lateral forces on the periodontal apparatus leading to more rapid bone loss. I do not feel that sleep apnoea is a cause of periodontal disease.I would strongly recommend that before commencing treatment with a dental sleep appliance that the patient signs a document that states their periodontal condition which may become worse on wearing the appliance.Remember that we are dealing with a multi -factorial medical problem and must work closely with our medical colleagues.