Obstructive sleep apnea- a possible domain of orthodontics

Sleep related breathing disorders specially obstructive sleep apnea is a multifactorial complex condition associated with high co-morbidity and mortality rates. Obstructive sleep apnea is associated with decreased oxygen saturation due to mechanical obstruction at different level of upper airway associated with anatomical deviation like maxillary or mandibular retrognathism, large tongue, elongated soft palate inferior hyoid position and severe malocclusion. It affects both children and adults equally and causes neuropsychological impairment, metabolic and cardiovascular co-morbidity, sexual dysfunction, compromised economic potentiality and quality of life. Epworth sleepiness scale data, polysomnogram along with cephalometric radiographs, 2D-3D scans for anatomical variations and clinical evaluation are reliable measures to detect Obstructive Sleep Apneas. Multi disciplinary approaches from non invasive to advanced surgical procedures provided by specialty like ENT, Chest medicine, Sleep specialist, Maxillofacial surgeon and Orthodontist can serve better treatment to OSA patient. Orthodontic specialty has the opportunity to detect anatomical deviation early and can provided growth modifications with different non-invasive better compliant oral appliances for mild to moderate OSA patients. Classical treatment ranges from behavioral modification and MAD’s like oral appliances for mild to moderate OSA situation. Continuous positive airway pressure (CPAP) is the most effective measure for moderate to severe conditions .In severe situation different surgical approaches are followed with variable responses. This article reviews the current basic scientific knowledge about Obstructive Sleep Apnea including definition, prevalence, riskfactor, pathophysiology, diagnosis, complication and conventional & advanced treatment modalities with special emphasis on orthodontic mode of treatment.