title: Which oropharyngeal factors are significant risk factors for obstructive sleep apnea? An age-matched study and dentist perspectives.
abstract: OBJECTIVE
  Obstructive sleep apnea (OSA) is a common sleep breathing disorder. Untreated OSA may lead to a number of cardiovascular complications. Dentists may play an important role in OSA detection by conducting careful oral examinations. This study focused on the correlation of oral anatomical features in Thai patients who presented with OSA.
  
  
  METHODS
  We conducted a prospective comparative study at a sleep/hypertension clinic and a dental clinic at Khon Kaen University in Thailand. Patients with OSA were enrolled in the study, along with age-matched patients with non-OSA (controls). Baseline characteristics, clinical data, and oropharyngeal data of all patients were compared between the two groups. Oropharyngeal measurements included tongue size, torus mandibularis, Mallampati classification, palatal space, and lateral pharyngeal wall area. Multivariate logistic regression analysis was used to identify the factors associated with OSA.
  
  
  RESULTS
  During the study period, there were 156 patients who met the study criteria; 78 were patients with OSA and the other 78 were healthy control subjects. In the OSA group, there were 43 males with a mean age of 53 (standard deviation 12.29) years and a mean BMI of 30.86 kg/mm(2). There were 37 males in the control group with a mean age of 50 (standard deviation 12.04) years and a mean BMI of 24.03 kg/mm(2). According to multivariate logistic analysis, three factors were perfectly associated with OSA, including torus mandibularis class 6, narrow lateral pharyngeal wall, and Mallampati class 4. There were two other significant factors associated with having OSA, namely, BMI and Mallampati classification. The adjusted odds ratios (95% confidence interval) of these two factors were 1.445 (1.017, 2.052) and 5.040 (1.655, 15.358), respectively.
  
  
  CONCLUSIONS
  Dentists may play an important role in the detection of OSA in patients with high BMI through careful oropharyngeal examination in routine dental treatment. A large torus mandibularis, Mallampati class 4, and a narrow lateral pharyngeal wall are important anatomical risk factors for OSA.
authors.affiliation: Department of Oral Biology, Faculty of Dentistry; Neuroscience Research and Development Group (NRDG).
authors.forename: Supanigar
authors.initials: S
authors.lastname: Ruangsri
authors.affiliation: Department of Oral Biology, Faculty of Dentistry; Neuroscience Research and Development Group (NRDG).
authors.forename: Teekayu Plangkoon
authors.initials: TP
authors.lastname: Jorns
authors.affiliation: Department of Community Dentistry, Faculty of Dentistry.
authors.forename: Subin
authors.initials: S
authors.lastname: Puasiri
authors.affiliation: Faculty of Dentistry.
authors.forename: Thitisan
authors.initials: T
authors.lastname: Luecha
authors.affiliation: Faculty of Dentistry.
authors.forename: Chariya
authors.initials: C
authors.lastname: Chaithap
authors.affiliation: Department of Medicine, Faculty of Medicine; Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Kittisak
authors.initials: K
authors.lastname: Sawanyawisuth
keywords: Mallampati classification; hypertension; lateral pharyngeal wall; neck circumference; obstructive sleep apnea; palatal vault; tongue size; torus mandibularis