Elevated Sleep Apnea Risk, Bruxism As Independent Risk Factors for First-onset TMD

July 26, 2015 / BY PETER BLAIS, RPSGT

A study by Elizabeth Kornegay, RDH, BSDH, could help dentists better screen patients for potential obstructive sleep apnea (OSA) and assess the need for patients to get a sleep test by including questions about bruxism in conversations about snoring.

Kornegay’s study, “Elevated Risk for Obstructive Sleep Apnea Predicts Temporomandibular Disorder Independently of Sleep Bruxism and Awake Bruxism” earned her the AADSM Graduate Student Excellence Award.

“My research contributes to the growing body of literature regarding an association between obstructive sleep apnea and chronic orofacial pain, such as temporomandibular disorders (TMD),” Kornegay says. “It supports the hypothesis that the mechanisms underlying this association are complex and are not limited to sleep bruxism, which is often thought to contribute to TMD.

“A new finding of clinical interest was that individuals at high risk for OSA are four times more likely to report awake bruxism than individuals at low risk for OSA. However, awake bruxism could not explain the association between being at high risk for OSA and the increased likelihood of developing TMD.”
The prospective cohort, “Orofacial Pain, Prospective Evaluation and Risk Assessment” (OPPERA) study, investigated risk factors for TMD incidence in people with no lifetime history of TMD. Of a cohort of 2,660 adults, at baseline 5.8% of participants had elevated risk for OSA; 16.6% reported sleep bruxism at least 1-3 nights/month; and 14.7% reported awake bruxism at least some of the time. Over a median 2.8 years, 252 of the adults developed first-onset TMD. In univariate analysis, elevated risk for OSA, sleep bruxism, and awake bruxism were each significant individual predictors of TMD incidence. In multivariable analysis, the strength of association between OSA risk and TMD incidence was not attenuated with subsequent inclusion of sleep bruxism and awake bruxism. In the fully-adjusted model, incidence of first-onset TMD was 68% higher in participants at elevated risk for OSA compared to those at low risk for OSA.