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I have been using a dental appliance for several years succesfully. I would be interested in knowing if anyone else has experiences with dental appliances. Did it cause any change in your bite? Did it lose effectiveness over time?

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I haven't used it so can't speak from firsthand experience. I bet one of our members, Dr. Lawler (http://www.sleepguide.com/profile/DavidELawlerDDSDABDSM) will have some views on this.
Cuddleydoc, I don't use a dental appliance, but I understand from others that they can be effective. As for determining their continued effectiveness for you, the only way to really know would be to go get another sleep study done and wear the device overnight while you are being tested.
I have not used a dental device -- but have read where others have complained about the change in bite. I would have a dentist keep an eye out for any changes in bite, loose teeth, and any other conditions that may exist while using a dental appliance.

If you are worried about it becoming less effective schedule another sleep study to comfirm that the treatment is working for you.
I would like to try an oral appliance. How do you know if it is successful? How do you know you are not still having apneas while using it?
In my opinion -- and I have not used a dental device -- would be to have another sleep study done while wearing the device. I think that would be the best way to make sure the treatment was preventing apneas.
now that we have more dentists/members on this forum, we should revisit this issue. it seems as if CPAP is the first line therapy for most patients, and that sometimes oral appliances are considered by many clinicians as the "ugly stepchild" to CPAP treatment. Is that view shared by the members of this forum --- why/why not?
I was tried on one before I got C-Pap. I ended up with aching teeth and some TMJ that took a couple of years to clear up, so I am not a fan of them. My bite did change slightly and it did go back to what feels like normal to me after a while when I stopped using it. However, I understand how work and for some that can tolerate them, they could be an option.
I was tried on one before I got C-Pap. I ended up with aching teeth and some TMJ that took a couple of years to clear up, so I am not a big fan of them. My bite did change slightly and it did go back to what feels like normal to me after a while when I stopped using it. However, I understand how they work and for some that can tolerate them, they could be an option.
Mike said:
now that we have more dentists/members on this forum, we should revisit this issue. it seems as if CPAP is the first line therapy for most patients, and that sometimes oral appliances are considered by many clinicians as the "ugly stepchild" to CPAP treatment. Is that view shared by the members of this forum --- why/why not?

Mike,

I would guess this is very individualized according to the anatomy of each patient. In my case, I only have a small overbite, which leads me to believe there is not much room to advance the jaw with an oral appliance. Combine this with a small airway and a severe OSA case, and I think the probability that an oral device would control my apnea is very low.

Nonetheless, I would have a device fitted if the cost wern't so high. I am currently in negotiations on a business deal that could bring me a significant lump sum payout. If this comes through, I may take a part of that and gamble it on a device.

Regarding pricing, a family dentist friend locally will fit one for $1700. Or I can drive over to the city and have one of several sleep dentists do a turnkey job for around $5000. The turnkey job includes an analysis to estimate whether the device would be effective (if the estimate is "No", I believe you pay $200 and walk away), a followup sleep study to verify effectiveness, and two followup visits to check on fit and tooth movement.

So much of life is economics and I don't mean that as a complaint!
Hopefully this can answer some of your questions with sleep apnea and dental appliances.
If you have bruxism [grind or clench your teeth] an intra-oral appliance is difficult for the patient to get used to. In lieu of a sleep study an anti snoring appliance can be made. If you have had a sleep study and are diagnosed with sleep apnea you can have a more substantial appliance made you can wear while you are sleeping that may be paid by your medical insurance. Dental benefit plans usually do not pay for either sleep apnea or snoring appliances. Your TMJ should be in good health as your lower jaw will be pulled forward much the same way you would open the airway during CPR,- thrusting the lower jaw forward to open the airway. Fees for an anti-snoring appliance will run $450-650 and for sleep apnea $1200-1500. Any other fees or tests are not neceesary assuming the patient has had a complete set of radiographs and a comprehensive exam to eliminate any restorative and periodontal issues.
see below
Thanks for your comments on this issue. I originally posed the question about side effects because I am experiencing a change in my bite, movement of my teeth, and possibly some TMJ (clicking on one side when chewing but no pain). The appliance works great for my sleep apnea but I wonder if it is safe to continue using in spite of these side effects. Put another way, how severe do the side effects need to become before it would be recommended to stop using the appliance (a TAP appliance)?


Cuddleydoc said:
John J Sullivan IV, DMD said:
Hopefully this can answer some of your questions with sleep apnea and dental appliances.
If you have bruxism [grind or clench your teeth] an intra-oral appliance is difficult for the patient to get used to. In lieu of a sleep study an anti snoring appliance can be made. If you have had a sleep study and are diagnosed with sleep apnea you can have a more substantial appliance made you can wear while you are sleeping that may be paid by your medical insurance. Dental benefit plans usually do not pay for either sleep apnea or snoring appliances. Your TMJ should be in good health as your lower jaw will be pulled forward much the same way you would open the airway during CPR,- thrusting the lower jaw forward to open the airway. Fees for an anti-snoring appliance will run $450-650 and for sleep apnea $1200-1500. Any other fees or tests are not neceesary assuming the patient has had a complete set of radiographs and a comprehensive exam to eliminate any restorative and periodontal issues.

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