Prevalence and Risk Factors of Obstructive Sleep Apnea in Edentate Patients at Faculty of Dentistry, KKU
Ruangsri S, DDS, MScDent, PhD1,2, Norraparn C, DDS3, Theprungsirikul W, DDS3, Tiskratok W, DDS3, Yodsuwan D, DDS, Grad.Dip.in Clin.Sc4, Puasiri S, DDS, MPH 5, Sawanyawisuth K, MD, MAS, PhD, MHPE6
Affiliation : 1 Department of Oral Biomedical Science, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand 2 Neuroscience Research and Development Group (NRDG), Khon Kaen University, Khon Kaen, Thailand 3 Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand 4 Department of Prosthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand 5 Department of Dental Public Health, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand 6 Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background : The prevalence of obstructive sleep apnea (OSA) has been reported to be 11.4% in Thai population and has been
increased in elderly patients especially those who suffer from cardiovascular disease. Thai elderly people loss 13.38 teeth/person
and approximately 7.2% of them are edentulous. Edentulism causes a loss of vertical dimension that may affect upper airway by
reducing retropharyngeal space and tone of the pharyngeal musculature and patients subsequently develop OSA. The consequences
of OSA lead to a pathological cascade that is responsible for cerebrovascular and cardiovascular diseases.
Objective : The present study aimed to investigate the prevalence and risk factors, which may be associated with OSA in edentate
patients.
Materials and Methods : 131 edentate patients previously delivered complete dentures during 2013 to 2015 at Faculty of Dentistry,
Khon Kaen University were recruited for telephone interview using modified Berlin questionnaire (Thai). Of those, 55 patients
were high OSA risk. Twenty subjects in high OSA risk group were randomly selected to have sleep test for further diagnosis of OSA
using portable polysomnography. All data including gender, age, neck circumference, BMI, systemic diseases, oropharyngeal space
classified by Mallampati’s score, lateral pharyngeal wall, ridge relation, torus palatinus and torus mandibularis, tongue size and
tongue position were collected by history taking together with physical and oral examination
Results : Descriptive statistics revealed that prevalence of high risk OSA was 41.98% in edentulism of our study population. The Chi-
square test (p-value = 0.032) and multiple logistic regression (backward and stepwise) showed that risk factor associated with
OSA was only Mallampati’s score level 4 (OR = 16.00). Gender, age, neck circumference, BMI, systemic diseases, lateral pharyngeal
wall, ridge relation, torus palatinus and torus mandibularis, tongue size and tongue position were, however, not correlated with
OSA in our sampled edentate patients.
Conclusion : Mallampati’score level 4 is an important risk factor of OSA in edentate patients. This oral manifestation can easily be
examined and identified during dental treatment. Therefore, dentist could be the first health profession to screen, give advice or refer
edentate patients who are at risk of OSA to physician.
Keywords : Edentate, Mallampati’ score, Obstructive sleep apnea (OSA)
