Influence of Obstructive Sleep Apnea on the Risk of Dental Caries: Insights from a 13-Year Population-Based Retrospective Study

Obstructive sleep apnea (OSA) is a cyclic condition characterized by a complete or partial obstruction of the upper airway during sleep, often leading to a dry mouth. The main characteristic of dry mouth is that saliva secretion decreases, and saliva can inhibit the growth of microorganisms in the oral cavity. Therefore, in patients with OSA, the self-cleaning ability of the oral cavity is usually decreased, resulting in dental problems such as caries or periodontitis. According to previous studies, OSA is highly related to oral diseases such as periodontitis; however, studies on the association between OSA and dental caries are limited. This study aimed to evaluate the association between OSA and dental caries in a large-scale population-based cohort in Taiwan. A total of 6,060 enrolled patients, including 1,515 patients with OSA and 4,545 age- and sex-matched controls from the Longitudinal Health Insurance Dataset of 2000 to 2013, were selected from a sub data set of the National Health Insurance Research Database. The Fine and Gray competing risk model analysis was used to explore the hazard ratio and 95% confidence interval for the association of OSA with the risk of developing dental caries during the 13-y follow-up period. Overall, patients with OSA had no significant discrepant cumulative risk of developing dental caries in subsequent y (P from log-rank test = 0.669). However, after the data were analyzed after stratification based on factors such as gender, age, diabetes mellitus, hypertension, hyperlipidemia, obesity, and coronary heart disease, OSA patients aged 45 to 64 y (adjusted hazard ratio [aHR] = 1.201, P = 0.004) and ≥65 y (aHR = 1.206, P = 0.041) had a significantly higher risk of dental caries than patients without OSA did. Our findings demonstrated that once OSA patients are ≥45 y old, they have significantly developed dental caries compared with patients without OSA.

Obstructive sleep apnea has been proven to have a great negative impact on patients, and the relationship between sleep apnea and dental caries is still inconclusive. Our study shows that patients with sleep apnea and those older than 45 y have a significant risk of dental caries.