Obstructive Sleep Apnea's Effects on Oral Health: A Review of the Literature

Marcus Thronton^*
*Correspondence: Marcus Thronton, Department of Oral Biology, Sorbonne University, 75006 Paris, France, Email:

Introduction

Obstructive Sleep Apnea (OSA) is a prevalent sleep disorder characterized by recurrent interruptions in breathing during sleep, primarily due to obstruction of the upper airway. Affecting millions of individuals worldwide, OSA is often associated with numerous systemic health issues such as cardiovascular diseases, diabetes, and hypertension. However, the impact of OSA on oral health is a field that has garnered increasing attention over recent years. With more research emphasizing the interconnectedness of oral and systemic health, it has become evident that OSA can significantly impact oral health, contributing to a range of dental and periodontal issues. This article explores the effects of OSA on oral health, drawing on findings from existing literature to provide a comprehensive overview of the ways in which this sleep disorder influences oral health and the underlying mechanisms responsible for these effects [1].

Oral health is intricately linked to an individual’s general well-being, and emerging studies suggest that poor oral health could exacerbate OSA and vice versa. Several mechanisms and factors associated with OSA, such as reduced oxygen levels, frequent arousals, and inflammation, can adversely impact the oral cavity. The oxygen desaturation and frequent disruptions to sleep seen in individuals with OSA contribute to systemic inflammation, which plays a role in several oral health conditions, including periodontitis and xerostomia, or dry mouth. Research also suggests that individuals with OSA may have a higher prevalence of bruxism, Temporomandibular Joint (TMJ) disorders, and other oral health issues [2].

Description

OSA has also been associated with a higher prevalence of bruxism, or teeth grinding, which can lead to tooth wear, fractures, and Temporomandibular Joint (TMJ) disorders. Bruxism in OSA patients is often believed to be a consequence of the arousals caused by apneic episodes. These frequent arousals can trigger a grinding response, potentially as a mechanism to reopen the airway. The physical stress exerted on the teeth and jaws during bruxism can lead to a range of dental issues, from worn tooth surfaces to cracked teeth, all of which can exacerbate oral discomfort and lead to TMJ disorders. TMJ disorders are characterized by pain in the jaw joint and the muscles that control jaw movement, and these disorders are often aggravated by bruxism. Research suggests that OSA patients may be at higher risk for TMJ disorders due to the mechanical strain associated with bruxism and the inflammatory response induced by OSA [3].

Additionally, malocclusion, or improper alignment of the teeth, has been observed more frequently in individuals with OSA. Some studies propose that the structural and functional abnormalities in the craniofacial region associated with malocclusion may contribute to airway obstruction, further exacerbating OSA symptoms. Conversely, the chronic sleep disruptions and breathing difficulties in OSA patients can contribute to structural changes in the oral cavity and jaw, potentially leading to malocclusion. The relationship between OSA and malocclusion is complex, with each condition potentially influencing the other through various physiological mechanisms. Understanding this relationship is crucial, as malocclusion can affect chewing efficiency and oral hygiene, both of which play a role in maintaining oral health [4].

Another concern for individuals with OSA is the potential for Gastroesophageal Reflux Disease (GERD) to exacerbate oral health issues. GERD, a condition in which stomach acid flows back into the esophagus, has been found to be more prevalent in OSA patients, possibly due to the increased negative intrathoracic pressure during apneic episodes. Acid reflux can lead to enamel erosion, as the acid in the stomach is highly corrosive to the tooth surface. Enamel erosion not only weakens the structural integrity of the teeth but also increases their sensitivity and susceptibility to decay. In individuals with OSA, the combination of GERD and dry mouth can create a particularly harmful environment for dental health, contributing to rapid and often severe enamel wear. Moreover, studies indicate that OSA-related fatigue and excessive daytime sleepiness may contribute to poorer oral hygiene practices in affected individuals. Fatigue and lack of motivation due to sleep deprivation can result in decreased adherence to regular oral hygiene routines, such as brushing and flossing [5].

Conclusion

The association between OSA and oral health highlights the need for multidisciplinary collaboration between healthcare providers. Dentists and sleep specialists should work together to identify early signs of OSA and its oral manifestations. Regular dental check-ups can play a crucial role in identifying symptoms of OSA, as some oral health issues may serve as indicators of underlying sleep disorders. For instance, signs of bruxism, TMJ pain, or xerostomia may prompt a referral to a sleep specialist for further evaluation of possible OSA.

In conclusion, obstructive sleep apnea has a profound impact on oral health, affecting multiple aspects of the oral cavity and contributing to a variety of dental issues. The interplay between OSA and oral health is multifaceted, with factors such as systemic inflammation, mouth breathing, bruxism, and GERD playing key roles in the pathogenesis of OSA-related oral health issues. Given the bidirectional relationship between OSA and certain oral conditions, it is essential for healthcare providers to adopt a comprehensive approach to treatment that addresses both sleep and oral health concerns. Integrating dental care with OSA management can enhance the overall health and quality of life for affected individuals. Further research is needed to explore the underlying mechanisms and develop targeted interventions that address the oral health needs of OSA patients, ensuring a holistic approach to managing this common and often debilitating sleep disorder.

Acknowledgement

None.

Conflict of Interest

None.

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