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


CONCLUSIONS
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.
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. mclotildecarra@gmail.com.
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Carra
Centre d'Investigations Préventives et Cliniques (IPC), Paris, France.
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Thomas
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.
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Schmitt
Centre d'Investigations Préventives et Cliniques (IPC), Paris, France.|Manhès Hospital, Fleury-Mérogis, France.
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Pannier
Centre d'Investigations Préventives et Cliniques (IPC), Paris, France.|Department of Cardiology, Georges Pompidou European Hospital, AP-HP, Paris, France.
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Danchin
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.|EA 2496, Paris 5-Descartes University, U.F.R. of Odontology, Paris, France.
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Bouchard
D016022:Case-Control Studies; D015331:Cohort Studies; D045422:Continuous Positive Airway Pressure; D003728:Dental Calculus; D003774:Dental Plaque Index; D005260:Female; D005602:France; D005891:Gingivitis / Q000209:etiology; D006801:Humans; D008297:Male; D008409:Mastication; D008875:Middle Aged; D009909:Oral Health; D020181:Sleep Apnea, Obstructive / Q000628:therapy*
Continuous positive airway pressure; Gingival inflammation; Obstructive sleep apnea; Oral health