Forum · Teeth hurt??

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[-] RationalYellowMantis0858 +1 point · 8 months ago

Hi y'all, newbie here. I've had my CPAP for 10 days now and I love it. My problem is my front teeth hurt. At first I wasn't wearing a chin strap and I thought my jaw was becoming slack and my front teeth were sitting together instead of normally. I tried the chin strap and it helped somewhat but I had the still problem. I tried tightening it but that left me feeling strangled. Any ideas? (I have the nasal pillows if that makes a difference.) Thanks!

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[-] wiredgeorge +0 points · 8 months ago Sleep Enthusiast

I use a mouth guard that you fit by placing in hot water then biting down on to keep my jaw from going slack. Took me almost a year to figure out where the leaks came from. Doesn't matter which type mask you use if your jaw slackens and your mouth is open unless you have a full mask and then your lower mask edge ends up in your mouth as mine was. Good luck. Beyond the strap you are using, the mouth guard is one way to fix the problem and some people have resorted to tape over their mouth. The latter fix doesn't appeal to me and would likely prove painful upon removal with my beard, hehe.

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[-] DWalsh +0 points · 8 months ago

wiredgeorge, where did you purchase your mouthguard?

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[-] wiredgeorge +0 points · 8 months ago Sleep Enthusiast

https://www.amazon.com/gp/product/B003X0T050/ref=oh_aui_detailpage_o04_s00?ie=UTF8&psc=1

You heat water in your microwave, drop the mouth guard in for a period (there are directions), then put the thing in your mouth while the mouthguard is still soft. Don't over do the leaving in water part thinking you can form the mouth guard better. It will turn into a glob of goo very quickly if you leave it in the hot water too long. You may want to buy a couple if you can't follow directions (personal experience talking here!). The mouth guard has worked well for me.

If my jaw drops, as I noted, the mask lower edge ends up in my mouth and my L/Min are very high. If my jaw stays in place, the leak rate is usually zero. It was zero for 11 of the last 14 days. One of those days I didn't use the machine all night as I was getting ready for a medical procedure and couldn't wear the mask. The two nights I had leaks was because I used my Simplus full face and had minor leaking. I get nearly no leaks with the Amara View and mouth guard.

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[-] DrTonySoileau +0 points · 8 months ago

I am normally not a fan of boil and bite dental appliances of any kind. If you have no muscle or joint issues these appliances can work well. But if you do have any tendencies to have muscle or teeth pain and you do not have the appliance soft enough and bite into it with even force on both sides it will hold your jaw slightly crooked. This can make teeth and muscle pain much worse. Or create pain that was not there to start with.

But I also respect that these boil and bite appliances are very inexpensive and easy to purchase. And if you listen to wiredgeorge he molded the appliance just right. Even the idea of buying more than one in case the first one does not come out right is a great idea.

We make a few boil and bite appliances each year for patients. Its all they can afford so I have them bring the boil and bite in and we fit it for them at no charge. Its not hard to do and my assistant is a master of making them.

If you are honest with yourself and have no teeth or muscle sensitivity nothing wrong with trying a boil and bite. If you do have some sensitivity as your dentist if he can help you fit it to your mouth. May not charge you anything if your a great patient or very little. If you have a lot of sensitivity or migraine headaches consider asking your dentist to help right from the start. If you dont have a dentist find one that treats sleep apnea or even a sports dentist. A sports dentist that makes custom mouth guards for sports teams will have no problems fitting you with a boil and bite. I am the dentist for our local hockey team so my assistant has made hundreds of mouth guards over the past 5 years. She is amazing at making them is no time. Better than me. Just dont tell her I said that!:)

Dr Tony

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[-] RationalYellowMantis0858 +0 points · 8 months ago

Thanks everyone for the comments and advice. I'm going to switch to a full mask and see if that works for me. That way I can mouth breathe to my heart's content. After all, that is what landed me in this pickle in the first place. But I think a full mask may help some of the other issues I've been having such as the "pig nose" and nasal irritation caused by the nasal pillows. Thoughts?

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[-] DanM +0 points · 8 months ago Sleep Enthusiast

I think trying a full face mask is a great idea. Make sure your home care company does a proper fitting and lets you try on various masks, if needed. They should also let you lay down and wear the mask with a machine running to make sure it does not have too much leak or cause too much discomfort. Best wishes, and let us know how things work out!

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[-] wiredgeorge +0 points · 8 months ago Sleep Enthusiast

I want to pop in and say that the full face mask MAY allow you to mouth breath BUT if your jaw slips and the mask lower edge ends up in your mouth, you will not get the pressure from the machine that effective therapy requires. I wear a full face and use a mouth guard to keep my jaw from going slack so I don't have this problem. I am not sure what percentage of folks using therapy have jaw problems as has been mentioned by DR. TS but I don't and the mouth gaurd has been critical to my sucsess using the BIPAP therapy. Good luck.

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[-] RationalYellowMantis0858 +0 points · 8 months ago

Update on my situation: I got a full mask and it's amazing. No tooth pain and no pig nose! My husband makes fun of me for looking like a Top Gun pilot, but my mask isn't leaking and whistling when I roll toward him, so there's that. I feel like I'm really off to the races now.

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[-] DanM +0 points · 8 months ago Sleep Enthusiast

Congrats on finding a mask that works! That can be half of the battle with treatment!

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[-] RonKnights +0 points · 8 months ago

I'm 66 years old. I had all my remaining teeth extracted about a decade ago. I got dentures a year after all my teeth were extracted. I was diagnosed with Sleep Apnea 17 years ago. I've used nasal pillows and masks that cover the nose and mouth. I've finally admitted all those masks fail to maintain a seal. Now I'm trying to convince my doctor and CPAP nurse that I need a mask that covers the forehead, chin, etc. I'm surprised it's been so difficult.

I don't believe it's safe to wear my dentures when sleeping. At times I woke and realized I was popping the dentures loose when I was sleeping. The dentures banged on the inside of the BiPap mask. It was a really frightening experience. I also noticed that my BiPap mask still gets out of adjustment whenever I wear dentures. The noise of escaping air wakes me up & scares me. Sometimes all that noise becomes part of my dreams.

I'm hoping to finally get a handle on this situation. I hesitate to get a mouthguard. I fear it won't be any better than dentures.

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[-] DrTonySoileau +0 points · 8 months ago

Ron, I appreciate you didn't really ask for my advice. So not trying to change your mind on anything either.

If your going to try a mouth guard start with a soft one. Its the opposite of what I recommend when you have teeth. When you dont have teeth the mouth guard os totally resting on your gums. If the mouth guard is made of a hard material you may end up with some nasty sore spots over time. Be ready to try different mouth guards until you find the one that works the best. If you get a small sore spot on your gums please stop wearing the guard until it heals. Warm salt water a few times a day is still a good remedy. Them trim out the guard where the sore spot is with a dremal tool or hot knife. Whatever works. I have seen these small sore spots turn into angry ugly ulcers if you ignore them for a long time. If the guard just can't be made to fit very comfortably try a different on.

Sorry for the unsolicited advice. Just trying to help.

Dr Tony

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[-] wiredgeorge +0 points · 8 months ago Sleep Enthusiast

I use the MMA mouthguard and try and protect my gums by rinsing with hydrogen peroxide every night. I also rinse with normal mouth wash. Not sure if this is a great idea for others but it works for me in that my gums seem to be in gteat shape. I also have never tried a soft mouth guard but it wouldn't be a bad idea to try. I suspect Dr Tony has more experience in these issues than many of us patients do.

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[-] DrTonySoileau +0 points · 8 months ago

My experience is really just hearing from years of patients all kind of different ways they have tried to solve the same problem. And some of the ways make me a little nervous. Cajun ingenuity with duct tape and gorilla glue is not always a good thing! LOL. And some of the ways are pretty smart.

The soft foam football mouth guards are the least abrasive to the gums. They fit on both top and bottom jaws. Usually have a lip protector that you have to cut off. Channels are placed between the top and bottom to let air flow in and out. I would not have thought the channels would let enough air flow for the CPAP to work but I guess it dos. The soft foam is also the least supportive of the jaws which is why I don't like it for sports unless its the only option because of braces and it not really a hard contact sport. But for denture patients with CPAPs it works for a couple of my patients. Most however prefer a more stiff mouth guard like Wiredgeorge wears.

Dr Tony

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