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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 Jay Polatnick on
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I have Moderate OSA and the 'Whole Breathe Solution' appliance is very comfortable, but it's not a solution. My dentist explains that it will 'buy me time' as he goes ahead up maxiofacial expansion of my upper palate.
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The CPAP is a life-saving and brain-saving device. It's important to identify the exact reasons you are not using it.
If the issue is anxiety, (1) toughing it out and (2) desensitization training are two options for getting used to it. I did a bit of both in the beginning. My idea of desensitization training would be to turn on the CPAP and put the mask on repeatedly, lie comfortably, and check the air flow. After twenty repetitions of so, your confidence mounts and the conditioned anxiety lessens.
If the issue is nasal congestion, the new sinus rinse products are very helpful, as are prescription nasal sprays. Also, I added a humidifier for winter months.
As others have noted, getting the right set-up is challenging. I finally settled on a nose mask and put a little bit of tape on one side of my mouth to remind me to keep it closed at night.
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Permalink Reply by David E. Lawler DDS D.ABDSM on
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Does your doctor have a specific reason why he is making this statement? The practice parameters established by the American Academy of Sleep Medicine specifically say that oral appliances may be used in the management of severe sleep apnea if patients fail or refuse CPAP. The biggest issue is that the more severe the disorder, the less predictable the outcome. Go to a discussion on SleepGuide here to see an example of a patient with severe sleep apnea with an almost perfect outcome.
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The dental devises need to be custom made. One size does not fit all. The dentist usually needs to adjust the appliance and it might take a few visits. Need to maximize the O2 intake. Concentrate on nasal breathing, enhanced by Google type breathing exercises. Remember it is YOUR PROBLEM so make the effort to breathe... Enhanced by WEIGHT LOSS AND THE ABOVE.
BELV156
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Dave, the problem with your advice is that the dental appliances are very expensive.Unless a person is very rich it will be hard to spend the money on one just to find out it does not work.
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Hi all,
I bought an off the shelf device to see if it would help. I'm in my sixties and only wore it a few times before I had problems with my jaw. I've stopped using it, but the problems have stayed with me. I use the Resmed S9 with LX nasal pillows, and have worked hard to learn to live with it. I quite often sit and watch the TV with it on. I have severe sleep apnea and can get a better result with some of the other masks but they are not comfortable, so I get slightly more apneas with a light mask but the comfort means I stay asleep a bit longer.
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Dear Bex,
Recently, I had a similar experience, but my sleep doctor responded differently.
I also have severe sleep APNEA, I told my sleep doc that I unconsciously take off the mask during sleep, so he recommended that I get a dental brace as a back up plan. He explained that to use it as a back up system. So even if I take the mask off, I still have the dental device, it might just be 50% effective, but will save my day. I thought that was a brilliant idea.
When I met the dentist, she on the other hand was very confident that the dental brace is a "cure it all" for me, so that I don't even need the bi-pap. I told her what the sleep doctor said about the back up, but she seemed to disagree.
Ultimately, i think as the Dr. who replied to you, no ones knows until you try it on yourself, and you would decide based on how you feel. I believe that sometimes, Dr. needs our feedback as well.
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Permalink Reply by Randy Bray on
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I had severe Chronic OSA, apparently had it most or all of my life. I used CPAP for 6 years and got trired of being treated like a terrorist going through airport checkpoints. I saw an ENT Dr and he did a UPPP and ligual tonsilectomy which took care of about 80% of the problems. After going to the sleep lab for a followup they recommended I see a Dentist that did "sleep dentistry" I did and got a "Mandibular Advancer" which I use daily now when sleeping. (No Jaw Problems) The combination theraphy has gotten me off of CPAP I feel rested and alert and I no long have to endure extended inspections at the airport. I would also recommend that people with tiredness and lethargy have their vitamin B12 and D3 checked. I was low in both and supplementing that has helped a lot too.
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Permalink Reply by Bex on
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Actually George, my dentist said it would be about $600, which is worth it to me. Thanks everyone for your help, I think I am going to go "dental"!
George Sibley said:Dave, the problem with your advice is that the dental appliances are very expensive.Unless a person is very rich it will be hard to spend the money on one just to find out it does not work.
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Randy - what kind of experiences have you had with airport security with your CPAP unit? I have not yet flown since I got the CPAP and I wonder about this. I certainly do not want anyone else touching my CPAP equipment - just the thought of that sends shivers up my spine, especially the mask. How did the airport screeners handle this with you? Did you have to take everything out and put it into that box to push through the x-ray machine? Or, did they just scan the bag, etc?
Randy Bray said:I had severe Chronic OSA, apparently had it most or all of my life. I used CPAP for 6 years and got trired of being treated like a terrorist going through airport checkpoints. I saw an ENT Dr and he did a UPPP and ligual tonsilectomy which took care of about 80% of the problems. After going to the sleep lab for a followup they recommended I see a Dentist that did "sleep dentistry" I did and got a "Mandibular Advancer" which I use daily now when sleeping. (No Jaw Problems) The combination theraphy has gotten me off of CPAP I feel rested and alert and I no long have to endure extended inspections at the airport. I would also recommend that people with tiredness and lethargy have their vitamin B12 and D3 checked. I was low in both and supplementing that has helped a lot too.
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My experience first, followed by my advice:
I used a herps-type dental device for years for complex sleep apnea when the CPAP masks/machines available at the time did not work for me. The sleep studies before and after showed a drop of 44 arousals per hr. down to 9 per hour. Still had sleep apnea but I could immediately feel the difference. The appliance lasted for years, just required daily cleaning, and was easy to travel with.
I was also told by the sleep clinic doc that a dental appliance was not effective for many people. She acknowledged it worked for me - because I have a small lower jaw and small airway that was being obstructed by my tongue falling back.
The appliance made it possible for me to function. There were down sides. When my nasal allergies flared up (frequently), the apnea became worse. Secondly, at best there were still complex (central and obstructive) apneas with disturbed sleep. Finally, my teeth and jaw changed position, so the top and bottom front teeth hit directly thus preventing the back molars from touching - I couldn't completely close my mouth to chew food. It was a trade-off - and I needed to be alert and healthy.
New masks, hose types, and improved CPAP machines evolved. Tried many masks and machines. I now use a Quattro (full face) mask with a non-vented setup and a ResMed S9 CPAP machine/humidifier which has a very light flexible hose (little to no hose 'drag'). This allows me to sleep with slightly over 1 obstructive apnea per hour...and the central apneas are GONE. The nasal allergies are under control - an optional allergen filter on the CPAP macine means 8 hours of no allergens and the humidifier helps with inflamation too.
Downside on the CPAP setup is the daily dismantling, cleaning and/or airdrying of many parts (no matter where I am) along with replacement of mask/hose components every 6 months. It is not possible to travel 'light' and I am planning on adding another piece of equipment - a battery backup. This all adds up to much luggage when flying. Oh, and I need distilled water for the humidifier waiting at every hotel stop. Fortunately, the problem closing my mouth is being corrected with orthodontics (expensive).
Bex, Here's my advice - make sure you have tried several masks and different CPAP machines before throwing in the towel on CPAP. Consult a sleep specialist at a large teaching hospital to see if there may be issues that are complicating CPAP use. Then - if still no success - get an appliance from a dentist specializing in dental devices for sleep apnea (not the local orthodontist). The device should not cause pain - but you may still sacrifice a normal bite even with a good fitting. The devices are infrequently covered by any insurance; otherwise expect to pay close to $2000 for the dental appliance.
Hope you find a solution and sleep well!
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For Mary T...
Traveling through airport security has not been much of an issue. You put the unopened CPAP case through the x-ray machine. Following that the security folks like you to open the CPAP carrying case. They take the CPAP machine out and spot test it quickly on a separate table (I think for chemical markers) - then hand it back. I keep my hose and mask in large clear zip-lock bags in the CPAP case, so they can immediately see what they are. Security never bothers touching them. Sometimes I pack another back-up mask (in zip-lock bag) in my standard carry-on.
The only 'hassle' I ever have is if security doesn't realize it is a CPAP case and reminds me I have one too many carry-on luggage pieces. (CPAP are medically necessary devices and exempt from that rule.) I just tell them it is a medical device...and they say "Oh, CPAP?" Yeah, security is used to these now.
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