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Dental Devices Helpful?
I have severe sleep apnea and my doctor said that a dental device would not work for me. My dentist disagrees. I have not been using my CPAP for the past few months and figure that using the dental device would be better than nothing. What do YOU think?
Bex
Views: 372
Replies to This Discussion
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Permalink Reply by Steven Y. Park, MD on
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Although dental devices don't work as well for people with severe sleep apnea, it doesn't mean that it won't work for YOU. Research studies report averages and statistical significance. If you look at these studies, there were some people with severe obstructive sleep apnea that did respond to oral appliances. What this means is that you have a lower chance of responding to oral appliances, but it doesn't mean that you won't respond at all. There was even a Korean study a few years ago that showed that oral appliances worked very well in people with severe sleep apnea. The only way to tell if you're going to respond is to try it.
Ultimately, it's all in your anatomy. There are ways of seeing what happens to your airway when you thrust your lower jaw forward while flat on your back using an endoscope, but not many ENTs will do this. Dentists can take x-rays. Unfortunately, sleep doctors can only see in your mouth, but not your airway behind the tongue.
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Permalink Reply by Bex on
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Thank you, I may try it.
Steven Y. Park, MD said:Although dental devices don't work as well for people with severe sleep apnea, it doesn't mean that it won't work for YOU. Research studies report averages and statistical significance. If you look at these studies, there were some people with severe obstructive sleep apnea that did respond to oral appliances. What this means is that you have a lower chance of responding to oral appliances, but it doesn't mean that you won't respond at all. There was even a Korean study a few years ago that showed that oral appliances worked very well in people with severe sleep apnea. The only way to tell if you're going to respond is to try it.
Ultimately, it's all in your anatomy. There are ways of seeing what happens to your airway when you thrust your lower jaw forward while flat on your back using an endoscope, but not many ENTs will do this. Dentists can take x-rays. Unfortunately, sleep doctors can only see in your mouth, but not your airway behind the tongue.
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Permalink Reply by Dave on
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I recommend being very scientific about any treatment you get. Do a sleep study without appliance and then one with the appliance!
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Permalink Reply by Chris H on
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Bex , Getting the right set up can be frusterating.....Their are many masks, machines, and doctors to choose from. Not all of them are a good fit so, find new ones. Put your vanity ,distain and frustration in your pocket and get figured out. What ever you choose to do .....Do something not nothing. Good Sleep,Chris
Ps it it means comming to nyc to see Dr Park find the courage to do it.
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Permalink Reply by Ginny Edmundson on
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I would love to go to NYC to see Dr. Park. But I doubt if MY insurance would cover someone "out of network"!!! I am plagued with leaks in to my eyes. VERY uncomfortable. GOing to try the Quietus liner tonight but I am not hopeful. I sleep good before CPAP. Now my nights are hell. Almost seems like the "cure" is worse than the other outcome if not using CPAP.
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Hi Ginny ,How did the Quietus work? The mask should be fitted while at pressure lying down. Your DME and or sleep center should help you with a proper fit. What ever you would spend on a vacation could be used to pay for a visit to NYC.....or have a yard sale ,bake sale ,any old jewlery you dont wear....resources are arround you. DO Not Give UP you can do it ,it is difficult, not fun but the alternatives are worse. Good Sleep,Chris
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The RT at the DME had me put the mask on then turn machine on and tighten. Seems like I still have to look in a mirror to put on to make sure it is JUST right. SEcond night with quietus liner last night and only got up once due to nose being all stuffed up on one side. Attended to that and then slept well. The past two nights I have been able to use my down & feather favorite pillow with luck too. So much more comfortable than the hard Contour, Much less leaks in eyes with Quietus so they do help a lot. Thanks!
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I have been planning to write a post about my experience with a dental device, but was waiting until I have another sleep study to have measurable proof. For now, let me say that it works! I have moderate hypopnea (severe during REM sleep). I was using a CPAP and my sleep improved immensely, but I continued to have issues with masks leaking and causing skin irritations. My regular dentist happened to also fit for sleep devices so I went for it. I feel as good as I did with the CPAP and I don't have to struggle with masks, and don't have to worry about packing an extra suitcase when I travel. I highly recommend giving it a try.
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Bex,
I use a mandibular advancement device for my UARS. My husband, who also has UARS, chose to go to an in-network dentist, who happens to "do devices", versus my out-of-network sleep-dentist, who specializes. The knowledge, care, and outcome have been very different. I could not tolerate the CPAP, and I get such good sleep with the device (I can tell a difference with and without). I actually love my device. With that said, if you pursue it, please see a specialist who does a thorough evaluation. I also agree with doing a sleep study follow up, especially if you have severe apnea.
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I also have severe Sleep Apnea, I use ResMed Elite II CPAP, I use to pull the mask off after about 4 hours of sleep if I wore it at all due to discomfort. Once I began using the dental device I was able to wear the CPAP all night without issue. I have not asked my sleep doctor about this however I figure if it allows me to wear the CPAP all night that its a good thing.
Bryan
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I tried a dental device, cpap pro. While it seemed like a good idea, and probably is - I followed all directions for proper fitting of mouthpiece, etc. My teeth hurt while using this - my dentist says that these devices can cause your teeth to realign themselves. Also, since I had to clamp my mouth shut and try to keep my mouth closed all night, I would wake up after a few hours with the appliance having moved from off my bottom teeth and with my mouth open and saliva having run down the side of my mouth to the point where my pillow was saturated. So, this did not work for me. I actually felt that with this new alignment of my lower jaw and teeth, it hurt too much for me. Maybe for someone else it would work just fine, that person just isn't me.
So, back to the full-face mask for me.
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Permalink Reply by Jeffrey Donaldson on
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In the beginning, My insurance wouldn't cover a c-pap machine. I was put on a dental device. It worked to some degree, however it did cause some TMJ, so I stopped using it. I did evenually go on c-pap and that was and still is much better. The TMJ cleared up very slowly. Try and give c-pap another try. Post what your issues are with it. I'm sure that the people out here can be of help.
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