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I've been given a mouthguard by my dentist.  Actually my dentists have been on me for years to do this because i grind my teeth and I've been reluctant because i already use so much stuff -- CPAP, chin strap -- and because i'm worried that taking up space in my mouth with that extra piece of plastic will be counterproductive for CPAP.  Anyone have any experience combining the two and can give me their feeling about it?

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How's it going with the mouthguard, Mike?

Due to my bruxism, I had two episodes of chipped front teeth, so I had a custom-made mouthguard ($600---7 years ago). This mouthguard fits on my lower teeth like a thin clear invisalign brace. Barely noticeable to me or others. The problem might be that using this mouthguard had "moved my bite 2-3mm" and I'm wondering if this worsened my OSA just recently dx. Just before dx, I had two episodes of cracking off a veneer and a recent filling---all due to bruxism despite the mouthguard. This was all due to OSA. 

I would wear the mouthguard, get a custom one, but insist on reassurance that the guard doesn't move your bite. Still you're on CPAP, just watch your numbers. You need to protect your teeth.

the key is if it is moving your bite forward or back.  if forward it should help with
osa but you can see bite changes in the back teeth.  the front teeth are probly hitting secondary to deprogramming of the muscles and fluid build up in the backside of the jaw joints.  short answer to a complicated question.  no offense to your dentist but a 7/y/o/ "biteguard as thin as an invisalign tray will not help with your bruxism.  find someone qualified to evaluate and construct.  tim mickiewicz, d.d.s.
K. S. said:

Due to my bruxism, I had two episodes of chipped front teeth, so I had a custom-made mouthguard ($600---7 years ago). This mouthguard fits on my lower teeth like a thin clear invisalign brace. Barely noticeable to me or others. The problem might be that using this mouthguard had "moved my bite 2-3mm" and I'm wondering if this worsened my OSA just recently dx. Just before dx, I had two episodes of cracking off a veneer and a recent filling---all due to bruxism despite the mouthguard. This was all due to OSA. 

I would wear the mouthguard, get a custom one, but insist on reassurance that the guard doesn't move your bite. Still you're on CPAP, just watch your numbers. You need to protect your teeth.

Well, the teeth aren't chipping, so either the bruxism has resolved with CPAP (this is what I think) or the night guard is still useful. I don't have TMJ pain or current complaints. Why should I have my night guard re-constructed?

gladd the teeth arent chipping now but you said they were before.  cpap and bruxism...interesting when i have some time i wioll address the physiology....if you are having no symptoms, why wear anything at all??  hard to know without photos.  key is are your back teeth touching?, i will try to post a bit more later, have some thoughts.  just trying to help you out so please don't take offense.  respectfully, tm

K. S. said:

Well, the teeth aren't chipping, so either the bruxism has resolved with CPAP (this is what I think) or the night guard is still useful. I don't have TMJ pain or current complaints. Why should I have my night guard re-constructed?

Interesting that you bought up "if my back teeth are touching".  I changed from the mouth guard dentist back to my previous dentist, due to a job re-location, and this dentist thought "the mouth guard changed my bite and my back teeth weren't touching" precisely. He thought the guard moved my bite 2mm. If this were 2mm backwards, that would not be good for the OSA. He made this statement 2 years before OSA.

I think the OSA was the culprit for the bruxism, but now that I invested in veneers, I don't want to chance porcelain  hitting against each other. You might be right about why wear the guard---but the movement has occurred so why take the risk?

I use a mouthguard, custom formed by my dentist because of bruxism.  This is essential for me, to prevent my wearing down the enamel, and probably preventing chips as well, though I've never had chips occur.  I wear the guard on my bottom teeth, along with my nasal pillows mask and chin strap.  I can't say it is totally comfortable, but I'm mostly used to it.  Wearing the chin strap made my bruxism worse, along with stress, and I often have jaw tension, exacerbated by the combination of the chin strap and the guard.  It does keep my teeth in tact, so I consider it essential.  I would like to find a dentist who knew more about this and maybe even get one of those dental devises designed to treat sleep apnea, to use with my CPAP, instead of the regular mouth guard.  I wondered if such a device would make it so I would not need the chin strap.

My understanding is that the dental devises are reserved for mild/moderate OSA, not severe. Since husband is in that category, not me, he tried the devise and thought the knobs and thrusting the jaw forward to be intolerable. Although he wore the devise only a few nights, he thinks it caused trauma to the root of one of his front teeth which needed a root canal. Over the past 4 years, perhaps, the devises have improved.

I'm confused...are you using mouthguard verbiiage = OSA (oral sleep appliance or obstructive sleep apnea?)    Somnomed keeps the pressure off of the front teeth.  so in my hard core grinders it's my appliance of choice.  also I get 3-D imaging on all cases to check the health of the joints as wearing any appliance in the presence of arthritis coud affect a bite change
the bite change could be a result of reprogramming of the muscles, or intrusion of the back teeth.  please verify your definitions and i can be more clear.  from the perspective of "did obstructive sleep apnea cause bruxism"?  physiologically there should be no reason, bruxism has many facets,  please dont release any personal stuff on this site, this is for info only and i'm not implying anything! stress , medications (especially antidepressants and some blood pressure meds) .   Oxygen deprivation secondary to obstruction, periodic limb movements and parafunctional activity can all be related to sleep apnea, but that causing bruxism?????can't fathom the physiology yet, but will think about it.  so do me a fave and clear up the definitions and i can give you a mor clear answer...happy sleeping, tm

K. S. said:

Interesting that you bought up "if my back teeth are touching".  I changed from the mouth guard dentist back to my previous dentist, due to a job re-location, and this dentist thought "the mouth guard changed my bite and my back teeth weren't touching" precisely. He thought the guard moved my bite 2mm. If this were 2mm backwards, that would not be good for the OSA. He made this statement 2 years before OSA.

I think the OSA was the culprit for the bruxism, but now that I invested in veneers, I don't want to chance porcelain  hitting against each other. You might be right about why wear the guard---but the movement has occurred so why take the risk?

there are many types of appliances ...yes its best for under 25-30 ahi could be the design or anatomy.  what brand??

K. S. said:

My understanding is that the dental devises are reserved for mild/moderate OSA, not severe. Since husband is in that category, not me, he tried the devise and thought the knobs and thrusting the jaw forward to be intolerable. Although he wore the devise only a few nights, he thinks it caused trauma to the root of one of his front teeth which needed a root canal. Over the past 4 years, perhaps, the devises have improved.

I thought grinding my teeth was likely to be a result of OSA (obstructive sleep apnea) since when I had oxygen desats down to the 60s, I probably struggled/stressed for air. In fact, some think dental hygienist should screen for OSA, as they see the small jaw, big tongue, dental wear of grinding, cracked dental work,etc...

As to the positioning of the bite, I'll take your suggestion and have this fully evaluated. I fear that it has been moved backwards, the opposite of what an appliance would do.

My hygienists are taught what to look for. In CA they can't diagnosebut they are a great resource. Get you bite checked by the dentist. A Full eval. Need no include anything more than astute observation And measurments for sleep apnea only a physician can dignose with a full psg. That is the standard. You can screen but the md needs to read the study. The dentist is the adjunct and needs a team approach. I am fortunate to have board certifiedsleep docs at my disposal. Includng one that comes to my office and doe virtual consulting. This is the way I think medecine should be. Its a gray area so we need each other. Look at your profile from the side put a pencil from tip of nose to chin. Your lips should touch. If you had braces with a bunch of teeth removed that is a red flag. Your dentist should eaisly be able to explain. Tm

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