Large Tonsils and Tongue Indicate Apnea Risk

10 Mar 2016
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Dentists can’t diagnose obstructive sleep apnea (OSA). But they can look for oversized tonsils and tongue indentations, which are teeth imprints that indicate that the tongue is too large for the mouth. Patients with these symptoms face an elevated risk for OSA and should be referred to a sleep specialist, according to Thikriat Al-Jewair, clinical assistant professor at the University of Buffalo School of Dental Medicine.

“Dentists see into their patients’ mouths more than physicians do, and the signs are easy to identify,” said Al-Jewair. “We need to teach students about this condition before they get out in the field and educate dentists about the major role they play in identifying and treating patients with sleep-related disorders.”

Al-Jewair and her colleagues analyzed 200 patients at the dental clinics at the University of Dammam’s College of Dentistry in Saudi Arabia. They tested the subjects using the Berlin Questionnaire, a validated assessment used to screen people for OSA. Subjects were screened for risk factors such as weight, neck circumference, and blood pressure, as well as tongue, tonsil, and uvula size.

According to the results, 23% of participants were at high risk for OSA. Of those at risk, 80% were male. Also, obese patients were 10 times more likely to report OSA symptoms than non-obese patients. Along with obesity, the most common factors among those identified at high risk of OSA were large tonsils, tongue indentations, and a high Epworth Sleepiness Scale score, which is used to measure daytime sleepiness.

Sleep apnea affects more than 18 million American adults, though many cases are undiagnosed, according to the National Sleep Foundation. In fact, Al-Jewair’s study found OSA symptoms in 21.7% of its female subjects and 78.3% of its male subjects. Severe cases of OSA are linked to cardiovascular disease, diabetes, depression, memory loss, and other ailments.

Next, the researchers will expand the sample size to include various age groups and monitor participant sleep overnight to confirm the prevalence and severity of OSA. The study, “Prevalence and Risks of Habitual Snoring and Obstructive Sleep Apnea in Adult Dental Patients,” was published by the Saudi Medical Journal.

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