Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 24

Let's Talk About That

Dr. Patrick Turley Interviews
Dr. Benjamin Pliska

Dr. Patrick K. Turley
Editor, Let's Talk About That
Manhattan Beach, CA

Biography
Dr. Benjamin Pliska is an assistant professor in
the Division of Orthodontics at the University of
British Columbia Faculty of Dentistry, an orthodontic consultant at BC Children's Hospital, and a
certified specialist in orthodontics practicing in
Vancouver. He is an affiliate member of the
Northwest Component of the Edward H. Angle
Society and an orthodontic fellow of the Royal
College of Dentists of Canada, where he also
serves as an examiner. Dr. Pliska obtained his DDS
from the University of Western Ontario; he is a
graduate of the University of Minnesota School
of Dentistry, where he obtained his orthodontic
training and MS degree. The author of two book
chapters and 20 articles, Dr. Pliska also frequently
lectures on the intersection of orthodontics and
sleep medicine.
Patrick Turley (PT): How did you become interested in sleep medicine?

Dr. Benjamin Pliska
Vancouver, BC

Dr. Benjamin Pliska (BP): When I first arrived at
the University of British Columbia and a tenurestream appointment in the Faculty of Dentistry,
I benefited greatly from the mentorship of Graduate Orthodontics Program Director and former
dean, Dr. Ed Yen. Early on, I was given a key piece
of advice for a successful career in academics:
focus my area of research into as a narrow a subject as possible. At roughly the same time, I was
introduced to Dr. Alan Lowe and the obstructive
sleep apnea (OSA)-related research he was leading with mandibular advancing oral appliances
at UBC. Until that point, my research experience
had centered on following clinical questions that
I found interesting (friction in self-ligating brackets, white spot lesions, etc.) but that were unrelated to each other. However, at UBC I became
fascinated with sleep medicine, and more specifically with obstructive sleep disorders. As I learned
more about this field, I was surprised that a problem like OSA, which often involves issues with
growth and development of the craniofacial
anatomy, and which is often successfully treated
with orthognathic surgery or oral appliances, was

not better incorporated into orthodontics. In
sleep medicine I found a research area that really
grabbed my attention, one with many unexplored areas of research that I felt would
benefit from being approached from an orthodontic perspective.
PT: I've often heard the term sleep-disordered
breathing being used interchangeably with
obstructive sleep apnea. Can you clarify the difference between these terms?
BP: I must admit I'm probably guilty of using
them interchangeably myself; however, there is a
clear distinction between them. Sleep-disordered
breathing (SDB) is really an umbrella term
encompassing a wide spectrum of chronic respiratory issues involving the upper airway, ranging
from primary snoring at its mildest end to
obstructive sleep apnea at its most severe. OSA
specifically is the condition of repeated complete
or partial collapse of the upper airway, leading to
fragmented sleep and abnormal gas exchange.
OSA typically is diagnosed by some form of
objective sleep test, while the broader term of
SDB is often applied from clinical findings and
patient history.
PT: Are you surprised to see the current level of
interest in SDB within the orthodontic and larger
dental profession?
BP: I think orthodontists have always been interested in, if not concerned with, the airway and
how it may affect the growth and development
of the face and dentition. What has changed,
however, is our improved understanding of the
prevalence and pathophysiology of SDB as well
as the serious health consequences associated
with the disease. No longer is it simply an issue
that results in a stubborn anterior open bite;
orthodontists have come to realize that a significant fraction of their patients may suffer from
a serious disease that they can identify and possibly help to manage. I believe we are keen to
improve the health and well-being of our

PCSO Bulletin  Spring 2018

Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Spring 2018