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Well if you want to come see us I am in Lafayette, LA. About a 2 hour drive. Or I can try to find you someone in New Orleans, North Shore, or Baton Rouge.
Dr Tony Office 3372343551
Wouldn't say normal but the appliances don't always work 100% the first week. Now 6 months is maybe a little toward the longer end of not working. The key to their effectiveness is to get the jaw far enough forward to keep the tongue out of the throat without pulling the jaw too fast too soon and now you have sore muscles, headaches, sore teeth, sore gums, appliance too tight because of muscle strain or too loose because you can't "get into it". We have an in house massage therapist that works on all of our patients at each visit. Using her to lengthen all the muscles connected to the jaw has made a hige difference in shortening the time it take to get the jaw far enough so the appliance is working. Most cases take 2-4 weeks and we are done. Some of my combination cases where the patient has both sleep apnea and really bad TMJ dysfunction can take up to 3-4 months because we have to get the muscles healthy along the way and slowly bring the jaw forward.
Changing diet, nose cones, xylitol (not sure why on this one) are all good things but often secondary to the appliance.
Where are you located? I may know someone close by that can help you.
Dr Tony
It sounds like your a lot better but if you could breath through your nose you would be doing fantastic. My first thought would be for an ENT consult.
Well your not alone I promise. 30% of my patients have dentures and wear sleep appliances. Some fit good. Some not much. And not fit awesome. I make my appliances to fit over the patient's denture if the denture has good retention. Usually its the bottom denture that wont stay on. The fact that the problem is your upper denture is good. The upper is easier to deal with.
The problem your having I am guessing is sore spots about where your canines or "eye teeth" would be. Is that correct? If it is that's because the sleep appliance is pressing on the denture in a way the denture was not made to be pressed on. The force is being directed toward your face and not up into the denture from the lower denture. So the pressure spots or straight in front. Maybe in the middle or just to the sides. Is this correct? This is where may denture patitient's usually get a sore spot. The solution is to grind away just a little bit of the denture in this area. That does mean the force will be applied somewhere else. If it is not applied to the middle about where you two front teeth would be that is best. When its where your canines would be the denture slides backwards into your mouth and rubs a sore spot. So if you don't mind a dentist grinding out a bit of your denture this should solve the problem and not make your denture loose during the day. It might though. The key is for the dentist to just rind away a little. Not much. I have had a couple of patients switch to a soft rubber liner in their denture to solve this problem. Ans a few have also elected to have implants placed and their same denture fitted to the implants to stabilize the denture while wearing the sleep appliance.
Does this sound like your problem? If not just let me know.
You may very well benefit from Combo therapy. Apnea appliance at night and TMJ appliance during the day. I use the Natural Fit Orthotic from Arum Lab in Canada. Fits great and looks like teeth. My patients love them. Probably half my sleep patients also wear an appliance during the day. Usually just for a few months and then the apnea is under control and they stop clenching/bruxing.
Yep, as Dr Luisi said every little thing help and gets you closer. I had turbinate reduction done two years ago. Best thing I ever did for my sleep after I made myself an appliance. Not saying its the best thing for you. But every little thing helps.
Your opinions are the frustrating part of treating sleep apnea. Everything is an argument or turf war when doctors discuss treatment. Have you talked to any chiropractors about diaphramatic breathing and the consequences of chest breathing? What about kinesiologist and sports trainers and and the cranio sacral relationship? Dentists wont study these things. Pulmonologist wont study TMJ. Cardiologist wont study body alignment. And no one talks to each other when everyone has valuable data to share. Just prefer to argue. While patients suffer. Sad.
Grinderfrank, I hear you. You were hoping for a solution to your sleep issues and instead woke up to sleep plus jaw and muscle issues. Sucks. Only way to put. These things do happen. Even with the best of care. Can I ask if between night 1-8 did you wake up feeling better. If you did then we know that the position your jaw is in with the TAP is a good one and now we just have to get the muscles to let go so you can be in that position comfortably. Good news is muscles are not hard to treat. Bad news is it may not be your dentist that fixes them. I have a massage therapist specially trained to work on muscles both out side and inside the mouth. I am really good at relaxing muscles. But the honest truth is I can't begin to compare to my massage therapist. She is just better than me. Its why I have her full time in my office. You need to find some one like her. Her name is Candid. Maybe she would know someone where you live. Our office number is 3372343551 if you want to call. And it does not have to be a massage therapist. Could also be chiropractor, physical therapist, acupuncturist, or anyone that can help. Think about an athlete that needs to run a certain speed. The speed is his goal. He then gets coaches and trainers to help him achieve it. If you slept better with the appliance in its current position then that the speed you need to run. Now go find a coach/trainer to get you there!
Treating sleep apnea is a team sport. It just is. Its not "one stop shopping".
If you had you knee or elbow operated on you would still need physical therapy no matter how great the surgeon performed. Same situation here. Your on the right road. Hang in there.
Be patient. did you have in the U0 and L0?
Not sure what Dr Luisi reply was so if I am repeating it I am sorry about that.
The Tap III will allow you to move side to side and some open and close but not much. How big a deal is talking with it? There are other appliances on the market that you will like much better than an EMA. If you do not want you be locked together take a look at the Micro2 made by Prosomnus. Very nice appliance that also has a slim version that is very comfortable. If you want to be able to yawn and talk without restriction this would probably be your best choice.
