Morning tooth pain - At my wits end

[GlowGal]

Hi all.

Has anyone else woken up with bad tooth pain from their tongue pushing against their teeth during sleep?

I tape my mouth to keep it closed during sleep but have found that my tongue is forced up against my teeth even harder than if I didn't tape because the pressure has nowhere to go. I woke up one morning this past week and one of my front teeth was so sore that I started crying. I've woken up other mornings with pain but this episode really hurt. Now I'm worried that the tongue thrust caused by the air pressure is causing damage to the roots of my teeth. The tongue thrusting has already caused a gap in between my top teeth.

I guess I just need to hear that someone else on CPAP therapy has experienced this and that I'm not alone.

I actually stopped using my machine after this happened because I'm petrified of waking up with this pain again.

[RogerSC]

I wonder if a night guard could help protect your front teeth from pressure from your tongue? Have you talked with your dentist about it?

I'm sure that you'll get past this, though, one way or the other. If you haven't considered a night guard, that might be a help.

[kteague]

Do you think that wearing just a basic upper mouth guard would distribute some of the pressure? I doubt the tongue pressure would be enough to shift the upper teeth as a whole. If you do try this, let us know if it helps. Good info to have on record. I understand about that tooth pain. When I started using the TapPap mask my teeth hurt for a couple weeks. Finally stopped hurting, but it was painful at first. Good luck.

EDIT: Got sidetracked before I posted now see someone beat me. Great minds think alike, right? Consider this a co-sign.

[Julie]

I must have missed the part where you definitively ruled out various full face masks... If your method of keeping your mouth closed (which very many people do not use) is causing problems, do something different. Like trying a full face mask. Or taping.

[DAT-DDS]

Glo Gal; I am a dentist who treats people with sleep apnea, snoring, and other airway issues. I think that stabilizing your teeth with a bite guard is a good first choice. We often see that people who have sleep apnea also clench and or grind their teeth. Sometimes, we do combination therapy, with an oral appliance and CPAP. this stabilizes the jaw and teeth, and often allows for a reduction in the air pressure to achieve the same therapeutic results. This appliance should be covered under your medical insurance DME coverage. Find a DDS that is a member of the American Academy of Dental Sleep Medicine, and they can work with your sleep physician to help you.

[ChicagoGranny]

The tongue thrusting has already caused a gap in between my top teeth.

How long have you been using CPAP and how old are you?

[archangle]

I wonder if you might be grinding your teeth. A mouth guard might help.

[GlowGal]

In response to some of your questions, I'm 50 years old and have been on CPAP therapy for about 5 years.

I do clench and grind and wear a custom nightguard from my dentist but it's on my bottom teeth. After seeing the gap and overheat of my teeth she said that in retrospect she should have given me an upper guard. I don't blame her because how was she to know my teeth would shift.

The day that I woke up with that tooth pain....I actually had my mouth taped and I was thinking that because my tongue had nowhere to go except against my front teeth, that just forced it even harder against them. Now that I stopped using my machine I've noticed that my tongue stays on the roof of my mouth. It's only when I use the machine that the air forces my tongue off the roof of my mouth. Of course I'm not sleeping well but at least my teeth don't hurt.

I never thought of a full face mask. Do you think that would help disperse the pressure?

I deal with a Respiratory Clinic for my therapy and have sent them an email asking if they can recommend a dentist who specializes in OSA and CPAP therapy who can work with my dentist and I in tandem.

I just want to be sure that I haven't damaged my tooth roots from my tongue pushing against my front teeth from the CPAP air pressure. The pain this week was enough and scared the bejeebus out of me.

[Julie]

Full face masks are standard for people who mouth breathe and lose pap air that way... it's just a question of finding one that works for you - look at Cpap.com for ideas.

[DAT-DDS]

The type of oral appliance that I referred to earlier, covers both the upper and lower teeth and provides a place for your tongue to go. I hope your sleep lab can help you find a properly trained dentist. Unfortunately, many sleep labs, and sleep physicians, for that matter, do not know a dentist that makes these devices. The American Academy of Dental Sleep Medicine keeps a referral list for those who go to their site. They have a wealth of information. I wish you all the best, and a pain-free nights sleep.

[GlowGal]

DAT-DDS, thank you for your responses. I'm actually in Canada but I will definitely check out the website to which you referred.

[Maria_Maraki]

Glow,
Do you have the kind of machine that breathes with you or one that just pushes air? I had the constant pressure type and I switched to the kind of machine that stops the pressure when I go to exhale. I am not sure but I think this is called "c-flex". My pressures are not too high but this is more comfortable.

Also, I had a chin strap that I find very useful and that keeps your mouth closed in most cases. I don't use it all the time but when I had used it, it was very helpful.

I also wonder if you have tooth grinding or clenching that should be addressed by a dentist, since most dentists that do sleep appliance fitting would work with your medical provider. These conditions are related and should be addressed comprehensively. I don't grind or clench but I do have a mandibular advancement device for times when I fly the red-eye flights and I nod out. It is a lot easier than using the machine. My dentist actually went to the sleep lab at night to fit my device for me and the sleep staff thought that was pretty cool.

Either way, it sounds like you need immediate dental intervention.

Maria

[Maria_Maraki]

DAT-DDS, thank you for your responses. I'm actually in Canada but I will definitely check out the website to which you referred.

Glow, I am not sure where you are but I live near Canada and I have had some testing on my airway that was never done in the US. No one had isolated WHERE my obstruction was until I had the test there in Ontario. That just freaks me out that sleep clinics and pulmonologists would be so crude in their approach and this was a university based group of ICU physicians. I think it is all too common for the physicians and clinics to not see these issues as a multifactorial issue and try to solve the issues without the balanced team approach that dentists and PT can provide.

I am 99 percent sure that Canada has dental sleep medicine practitioners that are at least as well organized as the US. I think there is a clinic in London (near where I got the airway testing around 2008) that does huge seminars for apnea devices for folks all over the USA and Canada. His name Rondeau or Rhondeau... not sure but he was an icon back then. In many instances they are actually ahead of us in the USA. (I see this with medication sometimes too since I live on the Canadian border).

Good luck!

[Nyre]

You can buy a Double sided Mouth guard locally at a local pharmacy or sporting good store. Make sure you get one you can mold by boiling it and putting it in your mouth and biting down on it. I heard these work very well and worth trying before spending over 3000 on a device from a dentist.

[Maria_Maraki]

You can buy a Double sided Mouth guard locally at a local pharmacy or sporting good store. Make sure you get one you can mold by boiling it and putting it in your mouth and biting down on it. I heard these work very well and worth trying before spending over 3000 on a device from a dentist.

I got the drug store kind of device but the issue of tooth pain that severe really scares me. The generic drug store device I got was also too large for my bite, as many of us who suffer from apnea do not have much room for oversized bite guards.