Replies to This Discussion

Permalink Reply by Marianne Kleminski on February 1, 2012 at 12:25pm

I spent $300 for NTI and really had no luck with it.  then found a Jaw Pain dentist and she said that nti's actually cause a lot of damage (cannot remember what she said but that there are studies out there).  I have been fitted for 2 splints and wear them, one is for day time and one for night time.  I can say it has helped a lot.  I would say do not go to a regular dentist to diagnose the problem.  Go to a specialist and they are out there.  They deal with TMJ, clinching etc. 
 
Henning said:

I can recommend you a small NTI device.

http://www.nti-tss.com/index.php?option=com_content&task=view&a...

This device took away my TMJ problems within a few days.

Henning


Sandra Ford said:

Henning, I agree...even though I wear a mouth guard, seem like I do clench my teeth even more.

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Permalink Reply by Donna Smith on February 1, 2012 at 1:35pm

I taught middle school for 30 years.  I had nightmares beginning in August. Any nightmare I had was school related.  My cure ? RETIREMENT !  Plan for it now.

Donna

Bradley Dean Moffatt said:

I am a mess. I am a music teacher and it's only the end of October. Once again I awoke at 3:30 - 4:30 a.m. with songs going through my head. I want to pound my head against a wall to make the songs stop. My wife says to try counting. Because I am a musician, I end up counting in rhythym, alternating songs with the tempos.

In addition, my jaw and head aches from my teeth grinding again. I thought with my CPAP machine I would be able to make it through the year. But's only October. My last concert is June 6th 2010. I do sleep well for about 4-5 hours now (instead of the 1-2 hours I was getting before being diagnosed with APNEA.) I can't take this night after night of waking too soon, then lying there with songs in my head and waiting for the 6:20 alarm going off. In the summer my blood pressure had dropped to 127/78. Last weekend it was back up to 148/92 with andrenaline running for no reason at all. 34 years of music coaching has taken its toll, I fear. I really don't know where to turn to. Sorry folks, don't mean to dump.

dr. martin bassiur said:

many patients who have UARS and OSA and primary snoring do have parafunctional bruxing habits- it is very common to have both- but- either case could be present alone- patients who have sleep apnea and bruxism may benefit from a mandibular advancement appliance (MAA) that would improve the OSA and UAR and serve as a bruxism appliance at the same time- patients who make a MAA would not wear their older bruxing appliance-

hope this is helpful-

Dr. Martin Bassiur

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Permalink Reply by Maryann on February 1, 2012 at 1:38pm

I have always ground my teeth when I sleep. I also have never felt very good or energetic. So I think I must have had sleep apnea all of my life. I do not wear a mouth guard but I need to get one. Just recently I can tell that I have ground my front teeth down. The dentist said that I have some hairline cracks from teeth grinding.

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Permalink Reply by Clueless in Redwood Shores on February 1, 2012 at 1:53pm

Maryann, I wanted to share my own experience, just in case  budget is a consideration.  I've used night guard for 30 years.  My second one wore out a few months ago and the replacement was going to cost a small fortune (insurance won't cover).  My dentist! told me that his clients have had good success with guards purchased from the website called Sparkling White Smiles:  http://www.sparklingwhitesmiles.com/ . They send you putty to mix and a tray to take the impression.  Follow the instructions carefully!

I ordered the dual laminate guard and did not have good success.  The guard worked fine but started to delaminate. 

The dentist suggested either the hard or the soft as a replacement -- I ordered the soft, have worn it for the last four months, and I am very happy with it.  I went with an upper on the theory that the lower didn't help with the apnea.  Even with the false start, I am at baout 30% of what I would have spent with a dentist

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Permalink Reply by Henning on February 1, 2012 at 1:53pm

I was actually at a Jaw Pain dentist where I was recommended a NTI device.

Today I use it only on rare occasions, but each time it helps within a few days.

Perhaps there may be problems if the teeth can not hold it in place.

It would be great if you could refer to any studies out there. I have not seen any.

Henning

Marianne Kleminski said:

I spent $300 for NTI and really had no luck with it.  then found a Jaw Pain dentist and she said that nti's actually cause a lot of damage (cannot remember what she said but that there are studies out there).  I have been fitted for 2 splints and wear them, one is for day time and one for night time.  I can say it has helped a lot.  I would say do not go to a regular dentist to diagnose the problem.  Go to a specialist and they are out there.  They deal with TMJ, clinching etc. 
 
Henning said:

I can recommend you a small NTI device.

http://www.nti-tss.com/index.php?option=com_content&task=view&a...

This device took away my TMJ problems within a few days.

Henning


Sandra Ford said:

Henning, I agree...even though I wear a mouth guard, seem like I do clench my teeth even more.

• ▶ Reply

Permalink Reply by Louise on February 1, 2012 at 1:53pm

I so wondered if they were related. I have ground my teeth for years & stress does make it worse. I have an appliance, and now after 20+ years only need to wear it occasionally to retrain my mouth to hang open. I finally came to the awareness that my migraines were being cause from the TMJ, and that was only a few months ago. I have been diagnosed with sleep apnea about 1 1/2 years, but am sure I've had it for at least 35 years. I have fibromyalgia, so have taken a sleep aide for a number of years. Since getting my CPAP machine I now have many nights of uninterrupted sleep. It's wonderful! Now for missing, cracked, or crowned teeth. What a mess!

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Permalink Reply by Maryann on February 1, 2012 at 2:00pm

Thanks for the info, I'll have try that

Clueless in Redwood Shores said:

Maryann, I wanted to share my own experience, just in case  budget is a consideration.  I've used night guard for 30 years.  My second one wore out a few months ago and the replacement was going to cost a small fortune (insurance won't cover).  My dentist! told me that his clients have had good success with guards purchased from the website called Sparkling White Smiles:  http://www.sparklingwhitesmiles.com/ . They send you putty to mix and a tray to take the impression.  Follow the instructions carefully!

I ordered the dual laminate guard and did not have good success.  The guard worked fine but started to delaminate. 

The dentist suggested either the hard or the soft as a replacement -- I ordered the soft, have worn it for the last four months, and I am very happy with it.  I went with an upper on the theory that the lower didn't help with the apnea.  Even with the false start, I am at baout 30% of what I would have spent with a dentist

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Permalink Reply by Todd Morgan, DMD on February 1, 2012 at 2:31pm

There is strong evidence to support the notion that clenching/brux events are associated with the arousal process due to OSA. A bruxing event is triggered by a peak sub-glottic pressure around -30cm H2o. in those subjects studied, which stiffens pharyngeal tissues and opens airway. Although you're awake, you can try this yourself by breathing gently in thru the nose and then clench for the next breath in. You'll sense better flow/uptake while clenching. This may be why studies have shown decrease in bruxism and not necessarily othe limb movements (that are independent of respiratort arousal) to go away with treatment (airway supported). By themselves, upper night guards aggravated OSA while lower ones did not.

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Permalink Reply by Jay Polatnick on February 1, 2012 at 2:40pm

What would be the problem with 'closing your mouth' when nasal breathing is so much more efficient ?  I'm interested in your case/experience.

Sincerely,

Jay

Henning said:

In my opinion there also is a strong link between CPAP use and Bruxism / TMJ.

I personally never had problems in that direction before I went to CPAP treatment. Then I got big problems with TMJ. I think I unconsciously have closed my mouth in order not to have problems with leaks.

In fact I bite my teeth hard together. This gave me also other serious problems.

Henning

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Permalink Reply by Steven on February 1, 2012 at 2:59pm

When I clench my jaw, I have a noticeable reduction in nasal resistance (almost like a breathe-rite strip. Try it). It also seems like it would be less likely for the tongue to detach from the hard palate and shift back when clenching.   (The "air-lock" that the tongue creates against the hard palate also makes nasal breathing easier).  Maybe a reach, but It is possible that the brain works to maintain airflow at other cost.  

Clenching would also keep the jaw in a forward position.

Good topic.

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Permalink Reply by Louise on February 1, 2012 at 3:10pm

I will keep that link in mind. I too got my first with insurance, before the change over. Then I wore through it and needed another. Waited until close to the end of the insurance year & used flex to pay for another. Now several years later this one is wearing down in spots. I have seen the generic ones, but haven't researched the internet. Thanks

Clueless in Redwood Shores said:

Maryann, I wanted to share my own experience, just in case  budget is a consideration.  I've used night guard for 30 years.  My second one wore out a few months ago and the replacement was going to cost a small fortune (insurance won't cover).  My dentist! told me that his clients have had good success with guards purchased from the website called Sparkling White Smiles:  http://www.sparklingwhitesmiles.com/ . They send you putty to mix and a tray to take the impression.  Follow the instructions carefully!

I ordered the dual laminate guard and did not have good success.  The guard worked fine but started to delaminate. 

The dentist suggested either the hard or the soft as a replacement -- I ordered the soft, have worn it for the last four months, and I am very happy with it.  I went with an upper on the theory that the lower didn't help with the apnea.  Even with the false start, I am at baout 30% of what I would have spent with a dentist

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Permalink Reply by David E. Lawler DDS D.ABDSM on February 1, 2012 at 3:43pm

I feel very strongly that the clenching is an instinctive body response to protecting the airway.  We all are aware of the threat to the airway that the tongue provides during sleep, but never really consider the threat to the airway during the swallowing process which occurs during waking hours in patients with varying degrees of swallow impairment. 

To help describe this phenomena, I have posted 3 videos of a patient.  The first one is at her consultation.  At the time of her consultation appointment she was using CPAP.  The second video is an overview of a treatment appointment where she receives an Oral Systemic Balance orthotic to enhance her tongue posture in the mouth and improve swallow mechanics.  Notice the rapid relief of symptoms after the orthotic is placed.  Pay attention to her comments about her jaw being tense without the orthotic in place and relaxed with it in.  The follow-up appointment one week later vividly describes her symptom relief.  At the time of this appointment she is wearing her Oral Systemic Balance orthotic in conjunction with CPAP.

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