Robert Wilkoff DDS Blog

Dentistry Pennsylvania

Update on Sleep Apnea

March 18, 2014 @ 03:48 PM — by rwdds

I recently attended a dental continuing education seminar on SLEEP APNEA that was really interesting and I wanted share it with everyone. The speaker was Dr. Robert Diecidue, DMD, MD, MBA, MSPH., who is a professor and the acting Chief of Oral and Maxillofacial Surgery at Jefferson Hospital, here in Philadelphia. Bob is a brilliant and talented doctor who teaches oral surgery residents and treats patients as well.


Obstructive Sleep Apnea is a very common sleep disorder that is identified when a person stops breathing while sleeping, for more than 12 seconds. During these “events,” a blockage somewhere in the airway prevents the normal inhale/exhale rhythm that people need to breath properly. A person suffering from sleep apnea can be seen struggling, chest heaving for these extended periods, until their body wakes them up, the mouth opens and a ‘gasp’ of air is taken in. These apnea events are disturbing to watch but more importantly, devastating to the health and well being of those who suffer. Apnea patients are often obese, snore loudly, are usually very sleepy in the daytime and complain of headaches and dry mouth.


Apnea problems tend to occur more frequently in overweight males, but do show up in all types of people in the population. A common difficulty for doctors is in finding where the obstruction is located. In some people, OSA is caused by blockages in the nasal area and for others the barrier is in the soft palate and uvula structures, which can slip back to block the throat during breathing. Lastly, some patients have a lower blockage, where the tongue falls back and stops the free movement of air. Overly large tonsils and adenoids can be involved, as well.


Dentists are involved in treating these problems because special mouth appliances can be made to pull the jaw forward during sleep, improving the airway opening. Another treatment that was more popular a few years ago, involves using a laser to remove some of the soft palate and uvula tissue. These procedures were quite difficult and painful to have done and offered little real help to many who have had it done.  


Positive Airway Pressure devices, (known as CPAP masks) are breathing masks worn at night time to gently force air in to keep the lungs full. These work well for some people, but are not tolerated easily by many others.


Finally, for those patients who cannot seem to find a treatment that works (mostly, those with the lower type of blockages), a special surgical technique has ben developed that can be very effective. Highly trained oral surgeons, like Dr. Diecidue, can take a small, rectangular section of the chin bone and gently pull it forward. This procedure permanently moves the tongue and muscles around the front of the throat to a more  forward position and opens the airway forever. The results are quite often good, allowing the sleep apnea patient to breath better and live a happier more normal life. For more information, check this link for Dr. Diecidue.