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Tooth loss and obstructive sleep apnea signs and symptoms in the US population

  • Epidemiology • Original Article
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Abstract

Purpose

The aim of this study is to investigate the relationship between tooth loss and signs and symptoms of obstructive sleep apnea (OSA) in a representative sample of the general US population.

Methods

Data were from 7305 men and women aged ≥25 years participating in the 2005–2008 National Health and Nutrition Examination Survey. Tooth loss, occlusal contacts, and denture use were determined by dental examination. Four cardinal OSA signs and symptoms were evaluated by questions based on American Academy of Sleep Medicine criteria. Adults with ≥2 signs/symptoms of OSA were classified at high-risk of OSA. Prevalence ratios (PR) and 95 % confidence limits (CL) from log binomial regression models estimated the strength of association between tooth loss and high-risk for OSA, adjusting for demographic characteristics, body mass index, dentures, and sleep duration.

Results

Prevalence of high-risk for OSA increased 2 % for each additional lost tooth (PR = 1.02, 95 % CL, 1.01, 1.03) among adults aged 25 to 65 years. When tooth loss was modeled as an ordinal variable with 0–4 lost teeth as the referent category, adjusted prevalence of high-risk for OSA was as follows: 25 % greater in those missing 5–8 teeth (PR = 1.25, 95 % CL, 1.07, 1.46); 36 % greater in those missing 9–31 teeth (PR = 1.36, 95 % CL, 1.06, 1.73); and 61 % greater in the edentulous (PR = 1.61, 95 % CL, 1.11, 2.33).

Conclusion

Tooth loss may be an independent risk factor for OSA.

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Acknowledgments

Akinkugbe A.A. was supported by the National Institute of Health NRSA T90 Training Grant NIH/ NIDCR (5T90DE021986).

Author information

Authors and Affiliations

  1. Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, 385 S. Columbia Street, Room 4502, Chapel Hill, NC, 27599-7455, USA

    Anne E. Sanders & Gary D. Slade

  2. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA

    Aderonke A. Akinkugbe

  3. Department of Prosthodontics and Center for Pain Research and Innovation, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7455, USA

    Greg K. Essick

Authors
  1. Anne E. Sanders
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  2. Aderonke A. Akinkugbe
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  3. Gary D. Slade
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  4. Greg K. Essick
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Corresponding author

Correspondence to Anne E. Sanders.

Ethics declarations

Data collection protocols were approved by the Centers for Disease Control and Prevention/National Center for Health Statistics Ethics Review Board and all participants gave informed consent.

Conflict of interest

The authors declare that they have no competing interests.

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Comments

This paper introduces an interesting question as to the relevance of tooth loss as a potential factor and possible predictor of sleep apnoea risk . Linking tooth loss and sleep apnoea symptoms may at first seem a challenge as numerous co-variables and confounders are present but the use of large population studies have the potential to refine and reduce effects of such co variable confounders by careful selection and elimination. The use of large population studies with similarly focused research questions is encouraged to highlight potential loci between sleep apnoea and modifying conditions/co morbidities that healthcare providers can identify and influence. The challenge we as clinicians have is considering the person as a whole and carefully examining all the clinical, social, symptomatic and physiological data together and trying to evaluate and prioritise interventions based on the scientific evidence that we possess. As further research is completed and tested, our understanding and ability to refine such evaluation and prescribe the most appropriate interventions and preventative regimes will improve.

Quentin Jones

Cardiff, UK

Important study that showed in a large cohort that tooth loss is associated with increased risk of OSA.

Geraldo Lorenzi-Filho

Sao-Paulo, Brazil

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Sanders, A.E., Akinkugbe, A.A., Slade, G.D. et al. Tooth loss and obstructive sleep apnea signs and symptoms in the US population. Sleep Breath 20, 1095–1102 (2016). https://doi.org/10.1007/s11325-015-1310-z

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  • DOI: https://doi.org/10.1007/s11325-015-1310-z

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