Have I recommended tongue exercises to all my patients, yes. Do they do them....... about as much as they follow my hygienist instructions to floss!:)
If you need to do tongue exercises then the tongue has lost its muscle "tone". This is one of the areas I am exploring with cranial never stimulation. Another way to look at it is why did the tongue lose tone in the first place????
Turbinate reduction made a HUGE difference for me. Mine were just about all the way shut. I could barely get air through my nose. Just didn't realize it until it was opened up. 10 minute procedure that made a huge difference.
A little on the high side. Not quite to te level of yours. Need to go get my study to see what the actual number was.
For cranial nerves find one of these doctors. http://quantumneurology.com/
Good luck with your sleep doc.
Do you have any ideas what might be causing the problem? As a general answer I would say poor nerve health. Muscles are controled by nerves. If the nerves are not active (means turned off, not dead) then the muscle looses tone and activity. I have a few patients with Myasthenia Gravis that are getting amazing result from seeing a chiropractor to specializes in nerve health. Consider going to this website and finding a chiropractor trained in http://quantumneurology.com/. Might make a world of difference for you. I have found that the medical community in my area does not have very good answers for Myasthenia. But Dr Cormier who is trained in quantum neurology gets really good results by "turning the nerves back on".
Do you think it would be a good idea to have a second opinion from a Sleep Medicine specialist? My doctor is wonderful but seems to be at a loss for what is happening. Yes. I always agree with second opinions when a patient hits a road block.
Would a mandibular device cause the same facial fatigue that the boil and bite mouth guard and the Good Morning Snore Solution cause? Maybe. But the question is what the true cause. Is the fatigue truly being caused by the appliance or do you have a problem with the trigeninal nerve (facial nerve) and the movement of your jaw forward is shutting down the nerve because its not healthy? I would still suggest getting a dental appliance if you dont want to wear a CPAP. Getting air into your lungs is always a first thought.
Hope I helped a little. Good questions. Just hard to give great answers to them. Let me know your thoughts.
Jaw problems with mouth pieces is common. But its not the mouth piece causing the problem. Lets look at a similar situation. You throw out your knee playing football. Tear ligaments, Chip cartilage. Its a mess. So you go to an orthopedic surgeon. He says yeah I can go in an repair everything and your going to need physical therapy for a few months so the supporting muscles, ligaments and tendons let the knee JOINT heal and return to its full range of movement and motion. Make sense and you expected there would be some physical therapy or the knee JOINT would be stiff and sore and take a longer time to heal after the surgery. The same issues occur when treating sleep apnea with a dental appliance. Sleep apnea causes an increase in cortisol, rapid chest breathing, poor sleep, etc. This is the cause of a lot of TMJ dyfunction (jaw problems) which is a JOINT similar to your knee. And if its not the true cause sleep apnea certainly make it worse. Half my practice is sleep apnea and TMJ dydfunction therapy. I have yet to see a sleep apnea patient in 20 years of practice that did not have a lot of teeth wear. This means their muscles have been squeezing their jaw JOINT together way too hard for way too long! The muscles are not supporting the jaw JOINT anymore and are part of the problem. Now you decide to go to your dentist and get an appliance for sleep apnea. The appliance simply brings the jaw forward to about where you bite through a sandwich. Maybe a little more or little less. The muscles should have no problem with the jaw being brought to this position. But the muscles are not healthy any more. And you may not realize it because you don't get head aches and you didn't make the connection between broken teeth and sleep apnea. So the appliance brings your jaw forward and sure enough the JOINT says OUCH!!!! Your muscles need therapy. Just now you know it. Its not the appliances fault. As I said my office is different because I treat both dental patients and sleep apena patients equally. So I have a massage therapist that works for me full time trained to use trigger point therapy, acupressure, and yoga stretches to get the muscles back loose and moving. I have a chiropractor that specializes in nerve heath that comes to my office every Tuesday to get all the muscles working together again. So we start with a lot of jaw problems but quickly solve them. Most dental practices will not have "muscle therapy" options other than tensing. So you may have to find therapy for your muscles on your own. But ask your dentist about it first. For some of my patients with really sore jaws we slow down how fast I bring their jaw forward to give the massage therapist and chiropractor time to get the muscles and tendons back in shape. Usually just a couple of weeks for the really bad cases.
So for the long response. Hope I explained it oK.
Does this mean that my apnea is under control, or just that I am not snoring? A good indicator but not a definite answer. The only way to know if you no longer have apnea is with a sleep study.
still waking up exhausted and am tired all day. So what's going on? The mouth piece's only function is to get the base of your tongue out of your throat so you can get air into your lungs. That's it. It can indirectly help you to sleep better. But not directly. You may be having some cortisol issues disrupting your sleep in addition to sleep apnea. Have you ever been diagnosed or at least examined for adrenal fatigue syndrome? Do you take anxiety meds?
Still waiting for some of my buddies that are incredible sleep dentists to get back to me to see who is closest to you.
Still finding you a dentist close to you. Everyone is at the American Academy of Sleep Dentistry conference this week so no one returned my emails yet.
Not necessarily. If the filling is small and duplicates the original shape when the impressions for the Narval was taken then your fine. The bigger the filling the greater the chance that the shape of the tooth is changed. For crowns the chance is even bigger. I make all my own crowns. I do this so if my patient needs the same shape I can make sure its duplicated as close as possible. But still sometimes I cant make it exact. There is a technique to heat the Narval and "stretch it over the new tooth and let the material cool on the tooth so it matches the new shape. I have tried this a bunch of times and it just never fits as good as it originally did.
If it fits your budget I strongly suggest you see a dentist for a properly fitting appliance. First this is about getting air into your body. Not something to play around with. And if you could end up with some TMJ issues.
The Narval is the thinnest on the market so its great for a small mouth. The downside is it takes 4-6 weeks to get it back from the lab, the cost can be a little higher, and if you get any dental work down you pretty much have to buy a new one. But for a small mouth and especially if you have TMJ issues its a great appliance once you start wearing it. What city are you in? Maybe I will know someone close to you.
The Panthera is very similar to the Narval and look almost exactly alike. I have not used a Panthera appliance but have delivered 30-40 Narval appliances. Both the Narval and Panthera are made with CAD CAM technology. Both are practically indestructible and very thin/light compared to other appliances on the market. The newer technology does add to their cost making the lab bill significantly higher for the dentists using them. This is probably why they dont have the popularity of other appliances.
Yes the Micro2 can be relined if you have additional dental work. Also because it works with a series of appliances it is less expensive if you just need a new lower or upper.