Bruxism ( teeth grinding and clenching) solutions?

[grumpygirl]

Good Morning Everyone- I am currently experiencing gum recession that my dentist thinks may be a result of teeth grinding during the night. He says that the constant pressure may be creating too much stress on the teeth and therefore mayking the gums receed. I have my doubts about this theory but cannot afford another gum graft ( $ 1,400 for one tooth) so I am checking out other alternatives to possibly keep the gums from receeding further.

My problem is this: I use an Opus mask that I am able to tolerate over FFM (which I was prescribed by my sleep doc) and tape my face to keep my lips closed during the night. So this method has been my "go to" therapy for the last 5 yrs. and because of problems with a small face structure etc. I have an almost impossible time finding a FFM to fit and be comfortable. I also have LOTS of trouble with aerophagia and FF masks seem to ad to the problem.

So, I have a pile of problems to consider when making changes to my cpap therapy and I just purchased a new Opus mask about 3 mos. ago and cannot afford to buy another mask. I am currently working limited hours since the company I work for has had a decrease in work.

My question is this: has anyone had similar troubles with bruxism and what solutions did you try. I know there are OTC appliances that one can purchase and I have tried them but because I have some crooked teeth in the from they do not comform to my bite and therfore were a waste of money. I've tried two different brands. I am at a loss as to what to do- I have an appt. with my periodontist next week to assess the gum recession problem but he has already recommended another gum graft-another $1,400 that I can ill afford and I am considering an appt. with my regular dentist to assess the cost of a custom dental appliance to help with the clenching of my jaws but I doubt that I will be able to use the Opus and tape my lips if the idea of the appliance is to keep my jaw open during the night. Won't that increase my apneas???
WHAT TO DO???? Any suggestions out there??????? Thanks-GG

[The Sheikh]

GG,

I, too, grind my teeth during sleep and sometimes during the day. The dentist sees the wear and has commented.

The enamel wear is obvious, but personally, I find it a stretch to blame gum recession on grinding too. My gums are fine.

Years ago I had one of those dental gaurds made by a dentist. It cost about $600 twenty years ago. Kinda a scam if ya ask me.
It was essentially an athletic mouth guard but with harder plastic.

Do this: Go to the store and buy a standard athletic mouth piece. They cost about $5 and you put them in boiling water and then "suck in" a custom fit in minutes. I use one nightly and it works fine.

Keep the long stem on it for safety. I also keep it in a glass of water with 5% rubbing alcohol during the day. Wash it with soap and water every day after use too. Do this and you will never have a bacterial infection from it.

BTW, it works great with a nasal mask or pillows, but a FF mask may interfere with the mouthpiece stem.

You want a tight mouth gaurd fit. It can be done if you push the hot mouthpiece into the teeth when hot so it makes bigger teeth imprints. It will not fall out if fitted well. You could also cut off the stem and add a piece of string that hangs out and maybe gets tied to the cpap hose, etc, for more safety from swallowing.

Cheap and effective. Give it a try and report back...

Tom

[guest nan]

I have used the athletic mouth guard too and it doesn't stop you from grinding....but you are now grinding the guard and not your teeth I get the one without the long tab..since you use tape you would do the same. I clean it everyday by keeping it in a container full of mouthwash and give it a good scrub every week when I do my cpap gear. I don't swallow the gum receeding theory either... sounds more like a money in the dentists pocket theory to me.
Cheers
Nan...ooppps forgot to log in again .

[sleeplessinaz]

Hi GG--
I went to see my regular dentist and I did get a custom dental appliance to help me with the clenching of my jaws. It was about 600.00 and I got it for the lower jaw instead of the upper jaw. It REALLY does help relax the jaws. You will still clentch but the custom made mouth guard will keep your jaws from hurting sicne you are pressing on the guards instead of your teeth. As far as receding gums? i would get to a new dentist ASAP!! I don't think the mouth guards would ever help with gum loss---in my opinion.

I did go to a Sleep Apnea dentist as well and they suggested the same custom mouth guards to help my jaw and teeth. Don't waste your money on the OTC boil and bite ones--they are not going to work for you as the fit will be off and may interfere with your sleep mask. The custome ones fit over your regular teeth, are very comfy, and do not interfere at all with my sleep apnea or my mask.

Hope this helps,
Carrie

[feeling_better]

There is something like the athletic teeth guard made of softer material, which sold as a anti-snoring device. Some types are thermo-plastic material. These types can be custom fit to your teeth by heating in hot water, and they are about $30-$40 online. I do not have any web page to give you, but you may find them easily. I have been using one of these for a few years, not for preventing teeth grinding, but they reduce apnea as well (or allow you to use lower cpap pressure for the same AHI); but because of the soft material they would reduce the effects of sleep grinding a lot too. The custom one a dentist will make for you costs in the $500-1500 range, but these self fit ones are almost as good as the ones the dentists make IMO.

[infntyx2]

GG -

I clench my teeth when I sleep and can tell in the morning by the tightness in my jaws. I don't believe I grind at all. I recently went to see my dentist for a semi-annual checkup. I did report severe heat/cold sensitivity on an upper molar and was aware that I had noticeable gum recession there. I also had chewing sensitivity on another adjacent molar when chewing hard foods (chips, apples, etc). I was told that both issues could be directly linked to clenching or grinding. I was aware of the gum recession on my prior checkup but wasn't experiencing any heat/cold sensitivity. He suggested having a custom night guard made to alleviate the problem cause. The estimate to have one made was just under $500. Since insurance doesn't cover it, I was hesitant to get one made since I sleep with a nasal mask or nasal pillows. I had a much older style night guard prior (many years ago prior to CPAP) and it tended to cause my mouth to open during sleeping at times. Now with the nasal mask, I would think that would go badly very quickly.

My dentist did do two things to address the heat/cold sensitivity. Firstly, he tried to "paint" the area with flouride treatment. The process helped with the heat/cold sensitivity for several days but did not last. He had told me that for some patients, this did the trick. The next thing he did was to do some dental bonding. If you search on the internet, you'll see that this is a comon solution for some gum recession. They mix a claylike compound, put it on the exposed area, color it to match, shape it, and use special lights uv lights to harden it. They then did some small grinding/shaping on the dental bonding material (which was painless) to blend the area with the rest of the tooth. The cost was about the same as a filling and took about 10-15 minutes. I've had this done for about a month now and the sensitivity issue has been greatly addressed. There still is some sensitivity between the teeth (where he could not get to) but the greatest area on the side was addressed.

His only other suggestions were to use a very soft tootbrush to avoid pushing on the gums or to use a sonic care toothbrush.

Hope this helps!

Ted

[Unsuspected sleep apnea]

I've been wearing the custom lower teeth dental guard for the last eight years. The boil and bite was not comfortable with my small mouth. The appliance is mimimal and not problem with either the mask or pillow. In retrospect, this grinding indicated how severe my OSA was---not sure I even need it now, but I don't want to find out with chipped teeth. Just before my diagnosis, I bit a crown off! I agree with the posts that the gum disease is not typically grinding related, but sensitive gums might benefit even more from a customed devise.

[chunkyfrog]

I used to grind my teeth; but not since I changed careers 24 years ago.

[robysue]

I have to say that I'd go with a custom-made guard. They are typically smaller and less bulky in the mouth than the boil-and-bite OTC ones. Unless your grinding is really intense, a custom-made guard should easily last for many years. (Unfortunately, if your grinding resembles a rodent's gnawing on everything, you can go through the custom-made guards much more rapidly. In that case, a referral to a TMJ specialist may be worth the money.)

You should have no trouble using your CPAP mask and continuing with the taping while wearing the guard: If it is properly made and fitted, you should be able to easily close your mouth and lips completely.

[AnnieLA]

The OTC "one size fit all" night guard may seems like a good solution, but it isn't for most people. For the night guard to protect your teeth and gum without causing additional problems, it needs to be thin and cover all your teeth. And that is usually not the case for boil and bite night guard. And thick night guard will cause extra pain in your jaw. It has even been proven that a thick night guard increases grinding. I found this bruxism support group that explain it with more info:
http://www.cureyourbruxism.com/best-mou ... -grinding/

They suggested I replaced my old custom night guard by ordering it online instead of going back to my dentist. It saved me more than $300.

[archangle]

You might try the oracle oral mask:

https://www.cpap.com/productpage/fisher ... -mask.html

It seals up your lips and the tip of it goes between your teeth. It would tend to avoid mouth leaks.

There is a little bit of the mask that will end up fitting between your upper and lower incisors. I don't know if you'd end up grinding the front teeth with this mask, but your back teeth wouldn't be touching.

I'm beginning to sound like a salesman for this mask, but it's not that it's really great or easy to use. It's just that it's a lot different from other masks and has a different set of problems.

It is a bit hard to use for me. I never really slept well with it due to the feeling of it in my mouth and the degree that mouth only breathing dried me out. Luckily, I get along pretty well with my nasal mask.

A Hybrid mask might also be worth trying.

Any kind of mouth breathing, even with a FFM or oral mask, will tend to dry your mouth out at night, and that may make your gum problems worse.

Have you tried chin straps with a nasal mask?

[Suddenly Worn Out]

My bruxism got better after starting CPAP. I used to wake up with my jaws sore as heck before CPAP. Now I still grind my teeth in my sleep but not as severely. Different strokes for different folks, I guess.

Just some ideas, maybe your pressure is too high? Or too low? Either one I could imagine teeth grinding developing.

Eric

[grumpygirl]

Thanks everyone for the helpful posts. I think that maybe my pressure may currently be too low but with the severe issues I have with aerophagia I am miserable with a higher pressure. I have an appt. next week with my dentist to discuss an appliance for the clenching. I am aware that it will probably be very expensive but I am not going to have the grafting done again before I get this issue solved,it would be a total waste of money again. I did a little research and did find that clenching the teeth can lead to gum recession due to the constant heavy pressure put on the teeth. It does make sense when you read the experts explanations. Thanks-GG

[avi123]

I don't see how any solid sleep guard could eliminate the force on the lower teeth and preventing the teeth from receeding into the lower gum? The question is what causes this force on the teeth? See this report on it:

http://www.webmd.com/oral-health/guide/ ... -disorders


I think that in my case this seems to be my problem (color marked):


What Causes TMD?

The cause of TMD is not clear, but dentists believe that symptoms arise from problems with the muscles of the jaw or with the parts of the joint itself.

Injury to the jaw, temporomandibular joint, or muscles of the head and neck – such as from a heavy blow or whiplash – can cause TMD.

Other possible causes include:
Grinding or clenching the teeth, which puts a lot of pressure on the TMJ
Dislocation of the soft cushion or disc between the ball and socket
Presence of osteoarthritis or rheumatoid arthritis in the TMJ
Stress, which can cause a person to tighten facial and jaw muscles or clench the teeth

And I think that this should be my treatment:


Learning relaxation techniques to help control muscle tension in the jaw. Ask your dentist about the need for physical therapy or massage. Consider stress reduction therapy, including biofeedback.

p.s. may be biting on a sponge during the day and night could help.

[mon]

I also have problems with Bruxism. I was diagnosed with OSA on the 3rd of August this year and went to the dentist the following day as I had sensitivity in one of my back teeth. The dentist told me that I had cracked a tooth through grinding and clenching. He told me he could make a guard to protect my teeth. Because the tooth I had damaged required a crown which cost me approximately $1800 and I had to purchase a CPAP the thought of the cost a guard was too much, so I purchased an off the shelf sports mouth guard with heat molding. It didn't work because I couldn't keep my mouth shut for any extended time so CPAP therapy with a nasal mask wouldn't work. I will have to fork out for the custom made ripoff in the near future.

I also have had trouble with aerophagia but have now put it down to the fact I have a very active salivary gland and need to swallow regularly. I don't know for a fact that this is the problem but remember that when my dentist did my crown, he mentioned that I have a very active salivary gland and I have noted since using the CPAP I certainly need to swallow regularly all the time.

I ask the question, Could swallowing saliva regularly during sleep cause aerophagia?