tmj/dental appliance - worth considering?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
awakeinnj
Posts: 25
Joined: Sun Jul 20, 2014 1:20 am

tmj/dental appliance - worth considering?

Post by awakeinnj » Thu Jul 24, 2014 7:35 pm

Hi. I have much improved numbers (AHI) on CPAP but I'm still very tired -- for months now. I have a touch of TMJ disorder, untreated. Should I consider getting a dental appliance that might treat both the TMJ problem and the sleep apnea? I've read some other posts and am unable to tell on my own whether the two problems are related in my case -- especially since my AHI has been pretty good on most nights. I visit the dentist and the pulmonologist for check-ups in August and am tempted to bring it up, but I didn't want to sound stupid. Thanks.

_________________
Mask: Wisp Nasal CPAP Mask with Headgear - Fit Pack
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: pressure = 8; humidity = 2.5 (0 to 6 scale)

User avatar
Julie
Posts: 19898
Joined: Tue Feb 28, 2006 12:58 pm

Re: tmj/dental appliance - worth considering?

Post by Julie » Thu Jul 24, 2014 7:50 pm

From what I've heard, some dental appliances actually lead to TMJ, not help it... maybe you'll get other opinions, but be very careful. Cpap is a nightly thing, but is not invasive, has no side effects once initial adjustments are made and doesn't start new problems.

User avatar
photonic
Posts: 261
Joined: Fri Jun 27, 2014 7:42 pm

Re: tmj/dental appliance - worth considering?

Post by photonic » Thu Jul 24, 2014 8:35 pm

I have now used a MAD (Mandibular Advancement Device) for many months and it has helped a bit with my OSA. But the device is designed to give you an underbite, that is protrude your jaw, by stretching out the ligaments of your TMJ to get the jaw into that position. The problem is that by morning, it can be very difficult to get your jaw back in alignment so that your natural bite is reestablished. You use a bite plate that was made before you started therapy to help stretch you back into the proper place. My experience is that while this works, during the day your jaw wants to slide back into the forward position and I have to use the bite plate several times a day. Also the device has a screw like control that dials in the amount of stretch. I had to seriously back mine off due to increased clicking and clunking of my right TMJ which I have never had before. If you have any TMJ symptoms now, they are likely to be exacerbated by the device.

Also the home tests that are usually used to see how you are responding to MAD therapy tend to underestimate the actual AHI and RDI that is going on. So in my case, my at home study with the MAD showed an AHI of 5, but my in lab sleep study with the device in use showed an AHI of 14.2 and an RDI of 51.1. I started this journey with a home test that told me I had an AHI of 8, but clearly this WAY underestimated my problem.

Hope all of this was helpful.
ResMed AirCurve 10 ASV
8 years with F&P Oracle mouth mask now changing to
F&P Evora Full with S-M size
Hozer hose management device (a miracle!)
OSCAR software