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International Journal of Evidence-Based Practice for the Dental Hygienist
Int J Evidence-Based Practice Dent Hygienist 2 (2016), No. 4     5. Dec. 2016
Int J Evidence-Based Practice Dent Hygienist 2 (2016), No. 4  (05.12.2016)

Page 270-278

Recognition of the Anatomy of Airway Space as a Screening Tool for Obstructive Sleep Apnea
Efurd, Melissa G. / Tucker, Claire Sallee / Kennedy, Robert L.
Background: Obstructive sleep apnea (OSA) is a common disorder that involves frequent, partial, or complete obstruction of the upper airway and affects 15% to 24% of the population, with 70% to 80% of cases undiagnosed. Dental professionals are trained to evaluate the entire patient and have the potential to identify risk factors for this condition. The purpose of this study was to determine possible relationships between class on the Mallampati Airway Classification tool and the variables neck circumference, weight, snoring, sex/gender, and use of Continuous Positive Airway Pressure (CPAP) to investigate the plausibility of utilizing Mallampati Airway Classification as a screening tool for OSA.
Methods: This study was conducted by 32 dental hygiene students and 7 clinical faculty members calibrated for the correct determination of class on the Mallampati Airway Classification tool. After a patient's verbal consent, a voluntary paper survey requested the following patient information: self-reported weight, age, gender, neck circumference (measured by students and/or faculty), history of snoring, sleep patterns, daytime sleepiness, xerostomia, previous OSA diagnosis, and participation in a previous sleep study. Patients (n = 275) were classified as Mallampati class I, II, III, or IV. Surveys were coded and entered into SPSS for statistical analyses.
Results: The Kruskal-Wallis One-Way ANOVA revealed that weight and neck circumference increased as the Mallampati class increased from I to IV. Neck circumference was not significant at P = .06, but weight was significant at P = .00032. Chi-square analyses revealed significant relationships between Mallampati Airway class and past participation in a sleep study (P = .039), use of CPAP (P = .013), and whether the patient responded that he or she snored (P = .00025).
Conclusion: Mallampati Airway Classification may be a useful screening tool for OSA, but weight, neck circumference, and self-described snoring may be useful risk indicators as well.

Keywords: airway space, CPAP, Mallampati Airway Classification, sleep apnea, sleep disorders, snore guard