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Oral health in patients treated by positive airway pressure for obstructive sleep apnea: a population-based case–control study

  • Dentistry • Original Article
  • Published:
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Abstract

Purpose

Recent epidemiological evidence suggests that patients with obstructive sleep apnea (OSA) have an increased risk of periodontal disease. Little is known about the oral health of OSA patients treated by continuous or bi-level positive airway pressure (CPAP/BiPAP). The aim of this population-based case–control study was to compare oral health variables (amount of plaque, calculus, gingival inflammation, and masticatory function) between CPAP/BiPAP users and control subjects.

Methods

The study population was retrieved from a French cohort examined between 2012 and 2013 at the Centre d’Investigations Préventives et Cliniques of Paris. Cases were selected if they reported to be treated by CPAP/BiPAP; controls were age-, gender-, and BMI-matched based on a 1:2 ratio. Univariate and logistic regression analyses were performed for group comparisons.

Results

Over a total of 20,436 subjects, 287 CPAP/BiPAP users (mean age (SD) 57.6 years (11.5); 76.3 % males) who underwent medical and dental examinations were compared with 574 matched controls (no OSA, no CPAP/BiPAP). CPAP/BiPAP users reported significantly higher prevalence of diabetes (15.6 vs. 10.3 %; p = 0.012; odds ratio (OR) 1.68), history of hypertension (36.5 vs. 26.1 %; p = 0.003; OR 1.62), cardiovascular diseases (14.1 vs. 8.8 %; p = 0.029; OR 1.69), and sleep complaints (59 vs. 34.4 %; p = 0.0001; OR 2.75). CPAP/BiPAP users also showed higher levels of depression and stress compared to controls. However, no group difference was observed for the amount of dental plaque, calculus, gingival inflammation, and masticatory function.

Conclusion

Oral health of OSA patients treated by CPAP/BiPAP is comparable to that of matched controls in terms of amount of plaque, gingival inflammation, and masticatory function.

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Acknowledgments

The authors would like to thank the Caisse Nationale d’Assurance Maladie des Travailleurs Salariés (CNAM-TS, France) and the Caisse Primaire d’Assurance Maladie de Paris (CPAM-P, France) for helping to make this study possible.

Conflict of interest

All authors certify that they have no conflict of interest to disclose in relation to the subject matter or materials discussed in the present study. ND received funding and research support from Amgen, AstraZeneca, Bayer, Daiichi Sankyo, Sanofi, and Eli Lilly. He is consultant and speakers’ bureau for Sanofi, MSD, GSK, Pfizer, Novo-Nordisk, Sevier, Daiichi Sankyp, Eli Lilly, and Bayer. PB received funding and research support from Colgate and Johnson & Johnson. MCC, AS, FT, and BP have no affiliations with or involvement in any organization or entity with any financial interest.

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Authors and Affiliations

  1. Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7-Denis Diderot University, U.F.R. of Odontology, 5 rue Santerre, 75012, Paris, France

    M. C. Carra, A. Schmitt & Ph. Bouchard

  2. Centre d’Investigations Préventives et Cliniques (IPC), Paris, France

    F. Thomas, B. Pannier & N. Danchin

  3. Manhès Hospital, Fleury-Mérogis, France

    B. Pannier

  4. Department of Cardiology, Georges Pompidou European Hospital, AP-HP, Paris, France

    N. Danchin

  5. EA 2496, Paris 5-Descartes University, U.F.R. of Odontology, Paris, France

    Ph. Bouchard

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  1. M. C. Carra
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  2. F. Thomas
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Correspondence to M. C. Carra.

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Carra, M.C., Thomas, F., Schmitt, A. et al. Oral health in patients treated by positive airway pressure for obstructive sleep apnea: a population-based case–control study. Sleep Breath 20, 405–411 (2016). https://doi.org/10.1007/s11325-015-1239-2

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  • DOI: https://doi.org/10.1007/s11325-015-1239-2

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