When most people think about sleep apnea treatment, they think of CPAP machines or dental appliances. But for a subset of patients — those whose OSA stems from skeletal jaw deficiencies — an oral and maxillofacial surgeon plays a pivotal diagnostic and treatment role.
What Is Skeletal Sleep Apnea?
Skeletal sleep apnea refers to obstructive sleep apnea caused primarily by the structural position and size of the jaws. A small or recessed lower jaw (retrognathia), a narrow upper jaw (maxillary hypoplasia), or a combination of both can significantly reduce airway space during sleep.
How Oral Surgeons Evaluate OSA
An oral and maxillofacial surgeon approaches sleep apnea from a structural perspective. The evaluation typically includes a clinical examination of jaw position, bite, and facial profile, dental and jaw X-rays or 3D cone beam CT imaging, airway analysis to measure the cross-sectional dimensions of the airway, and review of polysomnography (sleep study) results.
This multidimensional assessment allows the surgeon to determine whether skeletal deficiencies are contributing to airway obstruction and whether surgical treatment would be appropriate.
Maxillomandibular Advancement (MMA) Surgery
MMA surgery is the most effective surgical treatment for OSA, with success rates reported between 86–97% in published studies. The procedure moves both the upper and lower jaws forward simultaneously, expanding the entire airway from behind the soft palate to the base of the tongue.
Collaboration with Sleep Medicine
Oral surgeons treating sleep apnea work in collaboration with sleep medicine physicians. This interdisciplinary approach ensures that the diagnosis is thorough, treatment is appropriate, and outcomes are tracked with follow-up sleep studies.
If you or a patient has been diagnosed with OSA and conventional treatments have been ineffective, a consultation with an oral and maxillofacial surgeon may open new treatment pathways.