Sleep, Airway and Smiles: The Dentist's Role in Obstructive Sleep Apnea

AbstractBackground: Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder characterized by repeated episodes of upper airway obstruction during sleep, leading to intermittent hypoxia and sleep fragmentation. Early diagnosis of OSA is essential because untreated OSA is associated with cardiovascular diseases, hypertension, metabolic disorders, and neurocognitive impairment. Dentists can play an important role in early screening of OSA by recognizing oral and craniofacial features associated with airway obstruction.Aim: To assess the risk of obstructive sleep apnea using the STOP-BANG questionnaire, Mallampati score, and cephalometric evaluation in patients with airway obstruction and history of snoring.Materials and Methods: A comparative cross-sectional study was conducted among 100 subjects reporting to the Department of Oral Medicine and Radiology, SGT University. Participants with a history of snoring were screened using the STOP-BANG questionnaire and Mallampati classification. Subjects were categorized into high-risk and low-risk OSA groups. Lateral cephalometric radiographs were obtained and analyzed for upper pharyngeal space (UFS), inferior pharyngeal space (IFS), mandibular plane to hyoid distance (MP-H), maxillomandibular difference (ANB), maxillary effective length (CoA), mandibular effective length (CoGn), and anteroposterior jaw positions. Statistical analysis was performed using SPSS version 22.0, and p < 0.05 was considered statistically significant.Results: The mean age of the participants was 49.58 ± 18.03 years. High-risk OSA subjects demonstrated significantly higher STOP-BANG scores and Mallampati classifications compared to the low-risk group (p < 0.001). UFS and IFS were significantly reduced in the high-risk group, while MP-H distance was significantly increased (p < 0.001). Mandibular effective length (CoGn) was significantly reduced in the high-risk group (p = 0.008). No statistically significant differences were observed for age, BMI, neck circumference, ANB, CoA, A-N, and Pg-N.Conclusion: Airway narrowing, increased hyoid distance, and reduced mandibular length were significantly associated with high-risk OSA patients. STOP-BANG questionnaire, Mallampati score, and lateral cephalometric analysis can serve as useful and cost-effective screening tools for early identification of patients at risk for obstructive sleep apnea.