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Permalink Reply by Mike on February 2, 2009 at 4:13pm

Henning, I grind my teeth, but didn't know of the correlation with sleep apnea. Thanks for sharing that. Also, I've tried mouth guards in the past, but have pretty much written them off since the diagnosis of sleep apnea. The tissue in my mouth already crowds the airway as it is, i'd hate to add another contraption in there that might make it more difficult to breathe. But maybe I'm off the mark on that one. Anybody have any thoughts?

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Permalink Reply by Henning on February 2, 2009 at 4:29pm

I use such a “little thing” (the NTI device) on and off, and even with my CPAP I cannot feel when I wear it. But maybe some don't know the symptoms of TMJ, even if they have it, so here are the most common symptoms.

Symptoms of TMJ:
Pain is the most common symptom. TMJ pain is often described as a dull aching pain in the jaw joint and nearby areas, including the ear, which comes and goes. Some people, however, report no pain, but still have problems using their jaws. Other symptoms can include:

- Being unable to open the mouth comfortably
- Clicking, popping or grating sounds in the jaw joint
- Locking of the jaw when attempting to open the mouth
- Headaches
- A bite that feels uncomfortable or “off”
- Neck, shoulder and back pain
- Swelling on the side of the face

Additional symptoms may include: ringing in the ears, ear pain, decreased hearing, dizziness and vision problems.

Henning

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Permalink Reply by Cindy Cook on February 2, 2009 at 4:52pm

I also use a mouth guard. The dentist took an impression of my two front teeth and it has a thick back preventing me from closing my mouth or clenching my teeth. This particular mouth guard needed to be made of stronger material due to the fact that I broke my other three. I do have TMJ...extremely painful and I can also say it has made a negative impact on my life and that of my families life as well. Also to make mention here in NY it's a gray zone or area as far as insurance coverage goes...the big question is who will cover medical or dental. In my case the answer is myself.

I also go to the chiropractor every third week. I exercise at least three times a week, I try to eat healthy and I also try to limit the amount of painkillers that I can talk within a given day.

Cindy

I've had this problem now for 24 years...I would love to leave it in the past.

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Permalink Reply by Henning on February 2, 2009 at 5:14pm

This device you can’t destroy.

But I think that the problem is the same all over the world, that this kind of devices is not covered by any insurance.

Here in Denmark I paid about $325 for this device specially made for me. I believe that it is cheaper in the US.

IMO this device is the best on the market for treatment of TMJ. Have you tried the experiment with the wooden pencil?

Henning

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Permalink Reply by Henning on February 3, 2009 at 3:23pm

Hi Cindy,
I have just looked at your profile, and seen that you use a dental device. Is this for treatment of your SA?

If so, you cannot use the nti device, as this is not for treatment of SA.

Then you should consider a TAP appliance that has somewhat of an NTI design. With a TAP device, any clenching forces are transferred to front teeth, and therefore work like the nti device.

Take a look of this link, and scroll down to the TAB device: http://www.centerforsoundsleep.com/pdf/oralAppliances.pdf

Henning

Cindy Cook said:

I also use a mouth guard. The dentist took an impression of my two front teeth and it has a thick back preventing me from closing my mouth or clenching my teeth. This particular mouth guard needed to be made of stronger material due to the fact that I broke my other three. I do have TMJ...extremely painful and I can also say it has made a negative impact on my life and that of my families life as well. Also to make mention here in NY it's a gray zone or area as far as insurance coverage goes...the big question is who will cover medical or dental. In my case the answer is myself.

I also go to the chiropractor every third week. I exercise at least three times a week, I try to eat healthy and I also try to limit the amount of painkillers that I can talk within a given day.

Cindy

I've had this problem now for 24 years...I would love to leave it in the past.

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Permalink Reply by Banyon on February 9, 2009 at 8:52am

I had horrible bruxism while asleep. My jaw muscles would be hurting when I awoke in the morning. The dentist told me that eventually all my crowns would need to be replaced because I was wearing them down.

Then I found out I had severe obstructive sleep apnea and started CPAP therapy. The bruxism immediately went away. The dentist kept measurements and now says the wearing down of my crowns is not proceeding further.

I believe during the struggle to breathe (pre CPAP), I was reflexively grinding my teeth. Dentists should be trained to recognize bruxism as one indicators of the possibility of obstructive sleep apnea. Bruxism patients should be adviced to be screened for sleep apnea.

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Permalink Reply by Henning on February 9, 2009 at 3:43pm

I think you are right.

But I also think that a lot of new CPAP users have this problem, especially in the start of the treatment. Maybe this is because of mouth breathing.

But in general I believe that dentists should have a much greater role in the treatment of Sleep Apnea.

Henning

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Permalink Reply by Henning on February 15, 2009 at 4:23pm

In one week, I have tested a "boil-and-bite" appliance to see if it works. It has actually worked well against expectations until today when I got really serious TMJ problems. I do not know what went wrong last night.

Right now I am very happy my NTI device. It works quickly, so within a few days, I am probably normal again. But it is clear to me that a normal mouth Guard cannot solve TMJ problems.

Henning

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Permalink Reply by Juanita on February 25, 2009 at 6:12pm

I'm not sure how long I've been grinding, but it was only pointed out to me (by my dental hygenist) 3 years after I'd been using my CPAP. One observation is that I had to train myself to keep my mouth closed while using the CPAP. I'm not sure if I also trained myself to clench at the same time or not. I must mention however, that at that time it was one of the most stressful times of my life.

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Permalink Reply by sleepycarol on February 25, 2009 at 7:58pm

I have cracked my teeth to the point that I had to have one crowned due to the cracks -- all due to mouth clenching / grinding. With cpap treatment mine seems to have gotten better.

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