Not adjusting to CPAP, TMJD and sinus problems, seeking advice

[palerider]

quest for pretty smiles...

I think my parents could tell at my birth that I would never have one of those, but I'm glad they paid for three years of braces for me during junior high anyway.

And until it is known exactly what the interplay is in order to know how to do orthodontic work better, all we can do is the best we can do with such decisions in the present. A trillion bucks wouldn't be enough to do a double-blind with control groups for this sort of thing.

Straightened things is one thing, pulling teeth because they're inconvenient...

[jnk...]

When there literally isn't enough room for the teeth because of a small mouth, what do you propose as a healthy solution? It is rarely a matter of mere cosmetics in those circumstances, right? Teeth need to align to function optimally, as I understand it from the MMA people's point of view. Surgically enlarging the mouth with MMA is much more drastic than simply pulling teeth. Jaw health and bite health are real considerations beyond "nice smiles." And using MMA for every kid with a small mouth, for OSA prevention, doesn't sound like a workable solution to me.

[sleepy-programmer]

When there literally isn't enough room for the teeth because of a small mouth, what do you propose as a healthy solution? It is rarely a matter of mere cosmetics in those circumstances, right? Teeth need to align to function optimally, as I understand it from the MMA people's point of view. Surgically enlarging the mouth with MMA is much more drastic than simply pulling teeth. Jaw health and bite health are real considerations beyond "nice smiles." And using MMA for every kid with a small mouth, for OSA prevention, doesn't sound like a workable solution to me.

Orthodontics may be able to expand my jaw still and find the right bite alignment. I've got an evaluation coming up for this Monday. Even if it's small, I had more space to work with before braces. So going back to when I was a teen, I've been told braces could have been done by attempting to expand the mouth instead of shrinking it. My braces probably did not take my bite alignment into consideration either.

I'm not advocating for MMA surgery and neither is my dentist. It's drastic. Apparently, according to my ENT and my jaw surgeon, though problematic the MMA surgery is very effective for my type of OSA only. Not for my pain. Though if I did it, they would take their time and do the surgery in a way that keeps my bite alignment optimal. Overall I'm viewing MMA as the nuclear option. Nowhere near that yet.

[sleepy-programmer]

Dentist recently says when I had braces, I had 4 molars removed, which shrank my jaw and gave my mouth no room for my tongue.

THAT is complete and total nonsense, you need a new dentist!!

This is how he explained it to me: pretend this "U" is your jaw. Remove two molars, one from each side, from the bottom jaw. The "U" will become slightly smaller ("less circumference" is what he said exactly) as the remaining teeth crowd in together. I already have a large tongue, I already have a small mouth. My tongue doesn't fit between my bottom teeth at all, he showed me this with a picture. The point was this way of doing my braces was unnecessary, unhelpful, and potentially harmful.

The bone in your jaw DOES NOT change shape if teeth are removed. Again, just simply unscientific nonsense.

It's not the jaw bone. It's the teeth. On the bone. They moved in, I mean think about it. I don't have a tooth-shaped hole where my molars used to be. All my teeth touch. I strongly encourage criticism because as JNK says, when it comes to jaw crap, we're in the land of the largely anecdotal. There's no way my dentist has research to backup what he said. There is none, for or against. Maybe it's impossible I don't know. But the logic makes sense to me. Can you explain how it doesn't?

[sleepy-programmer]

Anyway. Slightly derailed here, but last night was another 1.5hrrs of CPAP sleep again. It's actually quite consistent. I have data going back to Jan 1st that I don't sleep more than 1.5-2.5hrs a night with CPAP without interruption. I don't think these charts are giving me any other useful information. I attached last night's reading below.

The best night of sleep I have recorded is Jan 4th, 3.45hrs sleep. AHI 0.45. CPAP 8.0, EPR 1. Don't remember the humidity settings. Sleepyhead can only get a summary of this day, no graphs.

Screenshot (13).png (141.54 KiB) Viewed 4693 times

[sleepy-programmer]

Dentist recently says when I had braces, I had 4 molars removed, which shrank my jaw and gave my mouth no room for my tongue.

THAT is complete and total nonsense, you need a new dentist!!

Or... is it? https://www.apnea.today/can-orthodontic ... ould-know/

Thanks for sharing this. You are appreciated.

[SDBud]

It's not the jaw bone. It's the teeth. On the bone. They moved in, I mean think about it. I don't have a tooth-shaped hole where my molars used to be. All my teeth touch. I strongly encourage criticism because as JNK says, when it comes to jaw crap, we're in the land of the largely anecdotal. There's no way my dentist has research to backup what he said. There is none, for or against. Maybe it's impossible I don't know. But the logic makes sense to me. Can you explain how it doesn't?
[/quote]

Teeth and jaws are two DIFFERENT things. Yes, a tight headgear, under some conditions, might cause problems with your teeth.
But that IS NOT THE SAME as saying your JAW narrowed so much that it would be noticeable or have a medical effect on you.

I WILL NOT argue with you or anyone else about this any longer, it IS nonsense, and you just need to accept that.

[SDBud]

I'm not advocating for MMA surgery and neither is my dentist. It's drastic.

MMA surgery appears to shorten, but NOT widen, your lower jaw.

https://www.mayoclinic.org/medical-prof ... c-20430404

[palerider]

I'm not advocating for MMA surgery and neither is my dentist. It's drastic.

MMA surgery appears to shorten, but NOT widen, your lower jaw.

https://www.mayoclinic.org/medical-prof ... c-20430404

Um, no, MMA *lengthens* the jaw. (that's the A part of MMA)

[Keeska]

Hi SDBud. You were dealt a tough hand to play. I'm sorry your teeth were too big for your mouth. My brother had the same problem (and the same solution). And I'm very sorry about your TMJD. I know how extremely painful that is. I hope you find a workable, tolerable solution for your CPAP therapy. Fingers crossed for you.

[sleepy-programmer]

Teeth and jaws are two DIFFERENT things. Yes, a tight headgear, under some conditions, might cause problems with your teeth.
But that IS NOT THE SAME as saying your JAW narrowed so much that it would be noticeable or have a medical effect on you.

I WILL NOT argue with you or anyone else about this any longer, it IS nonsense, and you just need to accept that.

My point was I didn't read into what my dentist said as to mean the actual bone of the jaw. I feel like that's pretty obvious. The only one arguing here, hostilely I'll add, is you. Without any provocation *or* explanation. I even just asked you to explain why, I *welcome* any facts or knowledge around this. Given how this exchange has gone I'm quite grateful you've decided you're done!

[sleepy-programmer]

Hi SDBud. You were dealt a tough hand to play. I'm sorry your teeth were too big for your mouth. My brother had the same problem (and the same solution). And I'm very sorry about your TMJD. I know how extremely painful that is. I hope you find a workable, tolerable solution for your CPAP therapy. Fingers crossed for you.

What was the solution for your brother?

[palerider]

Teeth and jaws are two DIFFERENT things. Yes, a tight headgear, under some conditions, might cause problems with your teeth.
But that IS NOT THE SAME as saying your JAW narrowed so much that it would be noticeable or have a medical effect on you.

I WILL NOT argue with you or anyone else about this any longer, it IS nonsense, and you just need to accept that.

My point was I didn't read into what my dentist said as to mean the actual bone of the jaw. I feel like that's pretty obvious. The only one arguing here, hostilely I'll add, is you. Without any provocation *or* explanation. I even just asked you to explain why, I *welcome* any facts or knowledge around this. Given how this exchange has gone I'm quite grateful you've decided you're done!

unfortunately, we still get trolls here, and if you go back through SDBud's (short) posting history, I think you'll find that it's clear what you're dealing with... unfortunately.

[sleepy-programmer]

So it goes. Meanwhile, I'll give my current CPAP settings a week and see if I adjust. Arousals are my biggest problem right now. Wish me luck!

[palerider]

So it goes. Meanwhile, I'll give my current CPAP settings a week and see if I adjust. Arousals are my biggest problem right now. Wish me luck!

Absolutely! Good luck!