Jaw surgery

[sean99]

Hi Everyone

I live in the Boston/New Hampshire region and I am looking for good jaw surgeons...I need double jaw surgery to correct not just my apnea(23/hr) but also my bite which is causing chewing problems. I have tried every kind of treatment for sleep apnea over the years but have failed with everything except a jaw advancement mouthpiece, but that caused many other issues for me.

Thank you!

[The Choker]

This is a CPAP forum. Anyone who had a good jaw surgery that cured their sleep apnea left and never came back here. Why would they?

Talk to your dentist for some references. Then find more references locally. Then have a consultation with two or three of them. Ask them how many sleep apnea jaw surgeries they have done and get them to talk about their successes and failures.

How old are you?

[sean99]

I have and I have not been able to find any in my local area which do double jaw surgery. Hence I am asking around, including this site. And my situation is very complicated by the fact that I have sleep apnea, so I am searching for surgeons who deal in sleep apnea.

Just because someone has had the surgery does not mean they might not still be on a support site or have post before/after surgery. Gosh.

[Julie]

I think someone should tell you that of the many people who have the surgery to 'cure' their apnea, probably the majority of them find it not only comes back within the year, but having had the surgery can complicate using Cpap in future. I'd think about it very carefully and research it from patients' viewpoints rather than surgeons'.

[CPAPIST]

I think someone should tell you that of the many people who have the surgery to 'cure' their apnea, probably the majority of them find it not only comes back within the year, but having had the surgery can complicate using Cpap in future. I'd think about it very carefully and research it from patients' viewpoints rather than surgeons'.

Nonsense! He is talking about Maxillomandibular Advancement surgery which has a success rate over 90% permanent cure.

[CPAPIST]

Hi Everyone

I live in the Boston/New Hampshire region and I am looking for good jaw surgeons...I need double jaw surgery to correct not just my apnea(23/hr) but also my bite which is causing chewing problems. I have tried every kind of treatment for sleep apnea over the years but have failed with everything except a jaw advancement mouthpiece, but that caused many other issues for me.

Thank you!

I would call these guys and ask for referrals to doctors in the Boston area - http://www.sleepapneasurgery.com/maxill ... ement.html

You could also call the office of http://doctorstevenpark.com/

[sean99]

Hi everyone

Thanks you for the responses.

As CPAPIST said I am talking about double jaw surgery where both jaws are moved forward. I have been told by different doctors that it is highly successful at curing sleep apnea but insurance would be a battle. Right now I am just trying to find surgeons who specialize in double jaw surgery for sleep apnea, taking things one step at a time and one battle at a time.

I really have two reasons for the surgery at this point. One is the obvious sleep apnea issue, the other is my bite/chewing ability. I have tried everything under the sun to fix the sleep apnea over the years but have failed with everything. The only luck I had was when I was able to use a mandibular advancement mouth piece for about a year. Unfortunately that led to my teeth moving and a few becoming cracked from the pressure. That led to caps and my bite getting totally messed up.

My jaws have really needed the surgery since I was a child and my bite is extremely complicated because of that. So once my bite was messed up it has been rapidly downhill for me. At this point I can hardly chew anymore as my teeth are so out of position in multiple places and I have come to the conclusion that fixing the bite is far beyond the abilities of a normal dentist. Not to mention my jaw joints are being destroyed by the misalignment and the constant headaches I get from that. I have an under bite and my upper front teeth can actually smash into my lower front teeth now so I try and eat soft foods as much as possible.

I have been to several orthodontists who have said I will require surgery to correct my bite, so I am shutdown from simply doing braces to at least fix the bite, leaving me in an all or nothing situation really. I am trying to stay positive about this as much as I can, thinking that the surgery will not only allow me to fix my bite and get rid of the headaches but also cure the apnea. I am sure the sleep apnea is being caused by my jaws in the first place, with my upper jaw not growing out far enough and the lower jaw really needing to be advanced also. None of this is something I want to go through and the idea of the jaw surgery is nothing I ever wanted to face. Plus I get the added fun of trying to manage my way through all this with no sleep.

So I thank everyone for the suggestions. I will contact the centers that CPAPIST listed...I had not thought about going that route to try and find centers in my own area. Thank you Thank you!

[CPAPIST]

Sean, Did you ever say how old you are?

[sean99]

I am 47.

[lostsheep]

I've read about someone's positive experience with this surgeon in Keene, NH:
http://www.drhenrydds.com/

If you want to learn about jaw surgery, you are better off searching for jaw surgery forums and blogs.

[sean99]

I found this Dr at the Lahey clinic in Mass, have an appointment in a few weeks.

http://physicians.lahey.org/directory/p ... id=0003519

Lahey has a top notch reputation in this area. I am thinking a plastic surgeon who is also Otolaryngology-Head and Neck Surgery trained would be the best route as the plastic surgeons probably have extensive training with the facial nerves also.

[musculus]

Hi Everyone

I live in the Boston/New Hampshire region and I am looking for good jaw surgeons...I need double jaw surgery to correct not just my apnea(23/hr) but also my bite which is causing chewing problems. I have tried every kind of treatment for sleep apnea over the years but have failed with everything except a jaw advancement mouthpiece, but that caused many other issues for me.

Thank you!

I would call these guys and ask for referrals to doctors in the Boston area - http://www.sleepapneasurgery.com/maxill ... ement.html

You could also call the office of http://doctorstevenpark.com/

I will call Dr. Park's office to ask about the same thing. Only few oral surgeon do MMAs.

[musculus]

If it involves surgical bite fixing, you may need additional procedures such as palatal expansion, where your jaw bones will be cut in the middle and move sideways, making more space for your teeth.

So your jaws would be both moved forward and expanded sideways. Not sure if those two can be done together.

Hi everyone

Thanks you for the responses.

As CPAPIST said I am talking about double jaw surgery where both jaws are moved forward. I have been told by different doctors that it is highly successful at curing sleep apnea but insurance would be a battle. Right now I am just trying to find surgeons who specialize in double jaw surgery for sleep apnea, taking things one step at a time and one battle at a time.

I really have two reasons for the surgery at this point. One is the obvious sleep apnea issue, the other is my bite/chewing ability. I have tried everything under the sun to fix the sleep apnea over the years but have failed with everything. The only luck I had was when I was able to use a mandibular advancement mouth piece for about a year. Unfortunately that led to my teeth moving and a few becoming cracked from the pressure. That led to caps and my bite getting totally messed up.

My jaws have really needed the surgery since I was a child and my bite is extremely complicated because of that. So once my bite was messed up it has been rapidly downhill for me. At this point I can hardly chew anymore as my teeth are so out of position in multiple places and I have come to the conclusion that fixing the bite is far beyond the abilities of a normal dentist. Not to mention my jaw joints are being destroyed by the misalignment and the constant headaches I get from that. I have an under bite and my upper front teeth can actually smash into my lower front teeth now so I try and eat soft foods as much as possible.

I have been to several orthodontists who have said I will require surgery to correct my bite, so I am shutdown from simply doing braces to at least fix the bite, leaving me in an all or nothing situation really. I am trying to stay positive about this as much as I can, thinking that the surgery will not only allow me to fix my bite and get rid of the headaches but also cure the apnea. I am sure the sleep apnea is being caused by my jaws in the first place, with my upper jaw not growing out far enough and the lower jaw really needing to be advanced also. None of this is something I want to go through and the idea of the jaw surgery is nothing I ever wanted to face. Plus I get the added fun of trying to manage my way through all this with no sleep.

So I thank everyone for the suggestions. I will contact the centers that CPAPIST listed...I had not thought about going that route to try and find centers in my own area. Thank you Thank you!

[wut]

When considering jaw surgery to address sleep apnea, it's absolutely CRITICAL to ensure the jaw surgeon has trained and performed hundreds of MMA surgeries specifically treating sleep disordered breathing. Very few of these surgeons exist and many don't accept insurance. All jaw surgeons are not created equally - treating the airway requires a very different approach than simply moving the jaw. The same is true for ENTs.

The best known surgeons include:
sleepapneasurgery.com (Dr. Li) (full disclosure - my MD)
http://www.calsleep.com/ (Drs. Powell & Riley)

[balor123]

When considering jaw surgery to address sleep apnea, it's absolutely CRITICAL to ensure the jaw surgeon has trained and performed hundreds of MMA surgeries specifically treating sleep disordered breathing. Very few of these surgeons exist and many don't accept insurance. All jaw surgeons are not created equally - treating the airway requires a very different approach than simply moving the jaw. The same is true for ENTs.

An MMA is just double jaw surgery with a 10mm+ advancement measured at the chin with CCW rotation and maxilla advancement inferred from that. These are actually routine problems for oral surgeons and most can do these movements. It's important to find an oral surgeon who's good at jaw surgery. Dr Li's guide in Dr Park's podcast is "at least 2 MMAs/mo near an academic center". However, this is just a rule of thumb and in practice, most oral surgeons know what to do you just don't want to risk it on a big surgery like this. Another option is to ask your sleep doctor who they recommend.