List 3 risk factors for OSA
- BMI > 34
- Hypertension
- Retrognathic mandible
Explain the pathophysiology of osa and describe how it relates to oral manifestations
- OSA results from repetitive collapse of the upper airway during sleep due to loss of pharyngeal muscle tone
- collapse leads to intermittned hypoxia and hypercapnia
- Arousal responses cause sleep fragmentation and sympathetic nervous system activation
- Oral manifestatoins
- Increased respiratory effort and jaw bracing during airway obstruction may contribute to masticatory muscle hyperactivity and sleep bruxism.
- Chronic mouth breathing secondary to upper-airway obstruction can cause xerostomia and increased caries risk.
- Myalgia — potential for muscle pain related to bruxism and muscle hyperactivity.
Describe the role of the dentist in screening and diagnosing OSA
- Identify risk factors through comprehensive history-taking and oral examinatoin
- use validated screening tools like STOP-BANG questionnaire and Epworth sleepiness scale
- Referring to a sleep physician for defintive diagnosis via polysomnography or home sleep testing
outline 2 oral appliances commonly used in OSA management and explain their MOA
- Tongue retaining devices
- hold the tongue in an anterior position via a negative pressure bulb preventing posterior displacement of hte tongue and pharyngeal obstruction
- Mandibular advancemenet appliances
- protrude the mandible anteriorly to enlarge the uppar aire, increase pharyngeal muscle tone, and reduce upper-aireway collapsibility
List 3 non - pharmacological lifestyle modifications that may reduce the severity of OSA
- weight reduction
- reduction or elimination of alcohol and sedatives before sleep
- Positional therapy - avoidance of supine (back sleeping )
What challenges may arise in long-term management of OSA with oral appliance therapy
- Patient non-compliance iwht nightly appliance use
- appliance induced occlusal changes over time
- posterior or anterior open bite
- Need for ongoing montiroing and review of tx
- osa may progress over itme requiring repeated adjustments and follow-up sleep studies