Periodontal disease (PD) is associated with obstructive sleep apnea (OSA) by a postulated bidirectional causal-effect relationship of PD and OSA through systemic inflammation. PD may contribute to OSA through aspiration of periodontal bacterial pathogens into the lungs, causing a decrease in lung function that consequently contributes to OSA. Xerostomia also plays a role in increasing the surface tension of the upper airway lining liquid and resultantly contributes to OSA.