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Sleep apnea oral device and bruxism

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Benny75 +0 points · 8 months ago Original Poster

Hello,

I was diagnosed with OSA about 6-7 years ago and began using a CPAP. I didn't like it however, and started looking into oral devices. After meeting with a specialist, I learned my OSA was due to poor jaw/teeth alignment and that I'd be ideal for such a device. When I got the device, I found it worked wonderfully, but there is just one problem - it keeps breaking due to teeth grinding. Within the past year, it has broken 5 times and had to be replaced entirely once. My specialist has made additional efforts in the office to reinforce it, but nothing seems to work. Over the past year since I started using the appliance, I've gone without it for nearly half the time while it's been getting reworked and repaired.

I have no stress in my life that could be causing this, but my dentist first noticed the effects of teeth grinding when I was a teenager (I'm 46 now). And while my sleep specialist was informed of my bruxism from the start, he didn't believe it to be a cause for concern, but of course now realizes that it is. He and his assistants tell me they've never seen anything like this.

I've read that bruxism can be caused by sleep apnea. But this doesn't seem to be the case with me. I've sleep tested with very good results while using the device - low number of incidents, no snoring and everything looks good. So if the device is correcting my OSA, then the bruxism cannot be caused by the OSA or the device wouldn't be breaking from the stress of grinding....? I've also read (somewhat to the contrary of the first theory), that a misaligned jaw and teeth can actually induce grinding while also being the source of OSA problems. According to this view, teeth grinding is a result of your brain trying to find the proper resting place for the jaw - except it can't due to misalignment, and the result is grinding teeth. If this theory is correct and applicable to me, then it seems an oral device that creates more separation between upper and lower teeth might actually exacerbate a bruxism problem, inducing more force and stress on the device and causing breakage. Am I onto something, here?

I'm not sure where to go from this point and am looking for some professional feedback on my situation. Right now, I'm back on CPAP until this gets sorted out and I don't like it. Where to go from here?

Thanks

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jamesnumpana +0 points · 8 months ago

I had a similar situation and my trusted dentist took an impression and returned with a solid plastic device that was instantly useless. It was too thick, made noise when I ground my teeth and was totally unacceptable as a bruxism treatment. It made me brux more because it was upsetting to use and subconsciously I focussed on grinding it to death.

Then I went to him and got a set of soft plastic custom bleaching trays which is just a long way as of saying a custom soft mouth guard.

Got it 20 years ago and still use it every night. Because it’s soft there’s no anger or noise if I grind my teeth., it doesn’t feed back the vibration of a solid mouth guard so grinding is useless. I still grind during the day if I’m stressed but at night my brain just doesn’t bother to brux at all at night. I don’t know why dentists recommend a hard guard for bruxism but a soft one has been life changing for me. I tried making one from a sports mouth guard but they are too thick to be comfortable, gets a Professional one made that’s 1.0 mm thick and youll even forget you’re wearing it. Hope this helps.

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SleepDent +0 points · 8 months ago Sleep Commentator

I am a dentist working in dental sleep medicine. I have been practicing many years and have seen the bruxism breakage problems many times. The fix that I have found is a special appliance called the Luco Hybrid OSA appliance. It is made out of sturdy metal and actually SUPRESSES clench and bruxing. See: www.lucohybridosa.com. Arthur B. Luisi, Jr., D.M.D. The Naples Center for Dental Sleep Medicine.

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