From Surgery to Systems: How Airway Health Became My Focus

I didn’t begin my career intending to specialize in airway health. Like many oral and maxillofacial surgeons, my early years were focused on correcting bites, restoring facial balance, and addressing structural jaw problems through orthognathic surgery.

However, something unexpected kept showing up in my patients...

An Observation I Couldn’t Ignore

As I performed jaw surgery, particularly cases that involved advancing the upper and lower jaws, I began hearing the same feedback, again and again. Patients would return not only with improved function and alignment, but with stories that had nothing to do with their bite.

They were sleeping through the night for the first time in years, snoring had stopped, CPAP machines were no longer needed, daytime fatigue, brain fog, and headaches had lifted.

At first, these improvements felt like secondary benefits. As the pattern repeated, it became clear they were not coincidences, they were structural outcomes.

The Airway Connection

Advancing the jaws doesn’t just reposition teeth or improve facial harmony. It physically enlarges and stabilizes the airway. For patients with obstructive sleep apnea, this structural change can be life-altering. What struck me most was how many patients had never been told their jaw position could be contributing to their sleep or breathing issues. They were treating symptoms without addressing anatomy. That realization changed the trajectory of my career.

Building a Practice Around Airway Health

Once I understood the role jaw structure plays in breathing, sleep, and systemic health, I knew I couldn’t treat it as a side effect anymore. It had to become the focus.

That’s when I made the decision to build my own practice, centered on airway-first, structurally driven care. A place where patients could receive comprehensive evaluations, advanced digital planning, and treatment strategies designed not just to correct bites, but to restore function at the most fundamental level.

A Mission to Make Airway Health Mainstream

Today, my work is about education as much as surgery. Whether I’m treating patients, speaking with colleagues, or sharing conversations on The Alfi Podcast, the goal remains the same: to bring airway relevance into mainstream healthcare.

When we understand how structure influences breathing, sleep, and long-term health, we can move beyond symptom management and toward lasting solutions.

This journey began with an observation in the operating room. It continues with a commitment to helping patients, and the medical community, see the airway for what it truly is: foundational.

- Dr. David Alfi