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Missing teeth and pediatric obstructive sleep apnea

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Background

Missing teeth in early childhood can result in abnormal facial morphology with narrow upper airway. The potential association between dental agenesis or early dental extractions and the presence of obstructive sleep apnea (OSA) was investigated.

Methods

We reviewed clinical data, results of polysomnographic sleep studies, and orthodontic imaging studies of children with dental agenesis (n = 32) or early extraction of permanent teeth (n = 11) seen during the past 5 years and compared their findings to those of age-, gender-, and body mass index-matched children with normal teeth development but tonsilloadenoid (T&A) hypertrophy and symptoms of OSA (n = 64).

Results

The 31 children with dental agenesis and 11 children with early dental extractions had at least 2 permanent teeth missing. All children with missing teeth (n = 43) had clinical complaints and signs evoking OSA. There was a significant difference in mean apnea-hypopnea indices (AHI) in the three dental agenesis, dental extraction, and T&A studied groups (p < 0.001), with mean abnormal AHI lowest in the pediatric dental agenesis group. In the children with missing teeth (n = 43), aging was associated with the presence of a higher AHI (R 2 = 0.71, p < 0.0001).

Conclusion

Alveolar bone growth is dependent on the presence of the teeth that it supports. The dental agenesis in the studied children was not part of a syndrome and was an isolated finding. Our children with permanent teeth missing due to congenital agenesis or permanent teeth extraction had a smaller oral cavity, known to predispose to the collapse of the upper airway during sleep, and presented with OSA recognized at a later age. Due to the low-grade initial symptomatology, sleep-disordered breathing may be left untreated for a prolonged period with progressive worsening of symptoms over time.

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Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Stanford University Sleep Medicine Division, Stanford Outpatient Medical Center, 450 Broadway Street, Pavilion B 2nd floor, MC 5730, Redwood City, CA, 94063-5730, USA

    Christian Guilleminault, Vivien C Abad, Hsiao-Yean Chiu & Brandon Peters

  2. Department of Orthodontics, University of California San Francisco Dental School, San Francisco, USA

    Stacey Quo

Authors
  1. Christian Guilleminault
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  2. Vivien C Abad
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  3. Hsiao-Yean Chiu
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  4. Brandon Peters
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  5. Stacey Quo
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Correspondence to Christian Guilleminault.

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Guilleminault, C., Abad, V.C., Chiu, HY. et al. Missing teeth and pediatric obstructive sleep apnea. Sleep Breath 20, 561–568 (2016). https://doi.org/10.1007/s11325-015-1238-3

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  • DOI: https://doi.org/10.1007/s11325-015-1238-3

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