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Newton Wellesley Oral and Facial Surgery

Adam Orden DDS, MS

Pediatric and Adult Oral and Facial Surgery

Diplomate, American Board of Oral and Maxillofacial Surgery
1330 Beacon Street, Brookline, MA 02446

OBSTRUCTIVE SLEEP APNEA - A Serious Medical Condition

DO YOU SHOW THE SIGNS OF OSA?

Do you feel tired or doze off during daytime, or unable to sleep through night. These are the signs of obstructive sleep apnea (OSA).
  • Unable to sleep through the night/ discontinuous sleep
  • Frequent urination at night
  • Daytime sleepiness or tiredness
  • Morning headache
  • Dry mouth or sore throat in the morning
  • Easily irritated, depressed, with violent mood swings or sudden personality changes
  • Trouble concentrating
  • Forgetfulness
  • Inhibited sexual desire
Do you have breaks or pauses while snoring, or suddenly waking up and breathing hardly then falling back into sleep? These are signs of lack of oxygen caused by airway obstruction

THE FOUR RISK FACTORS ASSOCIATED WITH OSA

  • Age over 65
  • Obesity
  • Smoking
  • Frequent intake of alcohol

OSA IS NOT A BENIGN CONDITION.

It has real and profound medical consequences including:
  • Heart attack
  • Memory Loss and Cognitive Dysfunction
  • Weight Gain
  • Stroke
  • Depression

During sleep your tongue and pharynx move towards the rear of your neck narrowing the space for air to move freely into your lungs

TREATMENT OF OSA HAS THREE PHASES

  1. Proper Diagnosis
  2. Non-Surgical Treatment
  3. Surgical Treatment
Diagnosis is accomplished through measurements taken at a Sleep Center. The amount of time spent in OSA and the oxygenation of the blood are measured. A score, the AHI index is calculated. Sleep apnea is classified as mild (AHI < 15 ), moderate (AHI=15-30) and severe (AHI > 30). Secondly, specialized CT scans of the airway can be done to quantify how much space is available for breathing. Our office has the latest high resolution CT imaging for diagnosis of airway size and imaging.

NON –SURGICAL TREATMENT

  • Change in sleep position
  • Avoidance of alcohol and sedatives
  • Weight Loss
  • CPAP continuous positive airway pressure
  • Mandibular advancement devices

Oral Jaw Advancement Appliance

These devices are custom made for each patient from dental models. Worn at night, the devices positions the lower jaw in a more forward position. They are comfortable to wear and provide a nice alternative to CPAP, which is anything but comfortable. Quite often they are covered by your medical insurance. The devices are made in two visits to our office.

Surgical Jaw Advancement

Surgical treatment is aimed at increasing the available room for breathing by advancing either the upper jaw, lower jaw or both jaws. By advancing (moving forward the jaw) the available room for breathing is increased. This therapy is highly effective in those patients that have backward positioning (retrusion) and a narrow airway. We can provide patients will all the available surgical options. Treatment usually involves only a 1 day surgical stay at the hospital. Many health care plans provide insurance benefits for this surgery.

Jaw advancement is the most effective procedure for relief of severe OSA

Retruded Jaw and OSA