Relationship between periodontal disease and obstructive sleep apnea in adults: A systematic review

Abstract

The purpose of this systematic review was to evaluate whether there are scientific evidence regarding
the association between periodontitis and obstructive sleep apnea (OSA) in adults. An electronic
search was performed on MEDLINE/PubMed for prospective and retrospective longitudinal studies,
cohort studies, and case–control studies conducted in human adults affected by both OSA and
periodontitis. Two reviewers extracted the data using a custom Excel spreadsheet. A methodological
assessment of the quality of the studies was performed using the Newcastle–Ottawa Scale. Fourteen
studies were included. All studies evaluated the association between periodontitis and OSA. None
of the studies evaluated the cause–effect relationship. Eleven studies found a significant positive
relationship between periodontitis and OSA, whereas three found no statistically significant
association. Several study limitations were observed, such as lack of standardization of study
groups, diagnosis of periodontitis and OSA, and differences in study design. Evidence of a plausible
association between periodontitis and OSA was found. The possible relationship could be explained
by systemic inflammation, oral breathing, and the comorbid relationship attributable to common
risk factors. Observational and randomized controlled studies are needed to clarify the mechanism
of interaction between the two conditions.
Key Words: Obstructive sleep apnea, periodontitis, review, sleep medicine

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Maliheh Nafisifard: Pubmed,Google Scholar