Tooth Pain and CPAP

[Trenacker]

I’m curious whether tooth pain in the back of the mouth is a common symptom of people who use CPAP and BiPAP therapy.

I am a 30-year-old severely obese male and have been diagnosed with severe sleep apnea. I must use a BiPAP machine to sleep safely. The level of pressure is set quite high, although I tolerate the machine very well and have 99% compliance. According to my sleep doctor, I achieve normal levels of blood oxygenation during use. Instead of more than one hundred breathing events per night, I am down in the “safe” range of <10. In the absence of treatment, however, I was advised that I would run a very high risk of a heart attack. I have since having good progress losing weight, but that journey is just starting.

I wear a Quattro Air full-face mask (large). I find it comfortable and experience minimal leakage, although it must be made fairly tight. I do get frequent pink eye, although this is partly related to a very bad bout of the infection in graduate school. My ophthalmologist has advised that it will not affect my vision long-term, and treatment is generally effective. Recently, however, I have experience some persistent nasal congestion so that I am much more dependent upon breathing through my mouth.

My dental hygiene has never been good. In October of last year, shortly after I began using CPAP, I cracked a lower back molar on the left side of my mouth. The dentist decided to introduce a crown. I experienced very bad pain after placement of a temporary crown, but the endodontist diagnosed temporary nerve agitation and advised that I go ahead with the permanent crown. When the pain did not diminish, I received a root canal that turned into an emergency extraction. With the molar gone, I healed quickly, and was off BiPAP for only two days during recovery (so as not to get dry socket).

Recently, I arranged to see a new dentist. Earlier this month, I had extensive X-Rays taken, along with an aggressive oral cleaning. About two weeks ago, an old filling broke, although there was no discomfort. Last Thursday, I had four cavities filled on the lower right side of my jaw. These included a cavity in one of my molars. I very rarely experience pain after fillings, and never for more than 24 hours after the procedure, even when I receive multiple fillings during a single visit.

Within hours of receiving the new fillings, I was in significant pain. I took 800mg Advil as recommended and, after a short nap (with BiPAP) was feeling reasonably well. However, the pain continued during the weekend and I was still taking about 800mg of Advil every 12 hours. I arranged to go back to the dentist on Monday. He ground down the filled molar and applied a fluoride treatment (which I assume was for hygienic rather than therapeutic purposes). He told me that pain after so many fillings is “not uncommon” and advised that I take a week to see whether the nerves would settle down. I received instructions to keep his office appraised of my condition, especially if the pain did not begin to recede.

After a relatively decent day yesterday, with up to 10 hours between doses of Advil, I went to bed early. I woke up an hour later in intense pain. I immediately sat up in bed and took my mask off. To my surprise, the pain diminished noticeably within 30 minutes. I began to wonder whether, if the nerve(s) in my lower jaw was inflamed, the pressure of the strap might be preventing it from settling down.

Has anyone else experienced this sort of problem? I don't want to engage in wishful thinking. However, given that the dentist recently took X-Rays and we did not talk about the possibility of a root canal, I don't think that nerve agitation is an entirely unwarranted hypothesis.

Thanks for your help!

[Michelle-OH]

I am guessing, no real knowledge, but since new fillings can sometimes be sensitive to hot/cold air it might be possible that your cpap air flow is resulting in the pain. That said, I just had a crown placed 1 week ago and haven't had any pain, no root canal so I do still have feeling...but I also use pillows, so my airflow is different than yours if you are a mouth breather. Hope that makes sense? I wouldn't hesitate to call the dentist though!

[49er]

I am guessing, no real knowledge, but since new fillings can sometimes be sensitive to hot/cold air it might be possible that your cpap air flow is resulting in the pain. That said, I just had a crown placed 1 week ago and haven't had any pain, no root canal so I do still have feeling...but I also use pillows, so my airflow is different than yours if you are a mouth breather. Hope that makes sense? I wouldn't hesitate to call the dentist though!

I had two teeth extracted on Monday and once I got through the initial pain from the surgery, I was fine and haven't taken any pain meds. Using the machine did not cause any pain. I use a cloth nasal mask and am wondering too about my airflow being different from yours.

Definitely call the dentist though and be persistent about getting your needs met. Pain should not be part of the equation.

49er

[chunkyfrog]

Historically, almost "painless" dentistry used to be a novelty; now it is fair to expect it.
Good dental hygiene and preventive dentistry can reduce or even eliminate trauma and unnecessary expense.
A spiffy clean mouth can also be used as motivation to make better snack choices.
And it sure helps with toxic morning mouth.

[49er]

Historically, almost "painless" dentistry used to be a novelty; now it is fair to expect it.
Good dental hygiene and preventive dentistry can reduce or even eliminate trauma and unnecessary expense.
A spiffy clean mouth can also be used as motivation to make better snack choices.
And it sure helps with toxic morning mouth.

That is the truth CF.

I have unfortunately learned those lessons the hard way.

Sorry, I know I am off topic. Back to the OP's issues.

49er

[JustBreath]

I have not had tooth pain, however, I have had my gums hurting a bit in the roof of my mouth...so like behind my teeth. I was also curious to know if others have gum pain. I think its from the dry air since I am a mouth breather. I plan to go to a dentist this week as well. Good luck!

[Marciaf]

PLEASE RESPOND TRENACKER!!!!

Your post could have been written by my son!!!!! I ACTUALLY had to call him and ask if he had written it! Can you please tell me if your condition has resolved? Do you know what the problem was? Please answer me, I am getting so worried. This has been going on for more than a year.

Thank you so much
MarciaF

[Pugsy]

PLEASE RESPOND TRENACKER!!!!

Your post could have been written by my son!!!!! I ACTUALLY had to call him and ask if he had written it! Can you please tell me if your condition has resolved? Do you know what the problem was? Please answer me, I am getting so worried. This has been going on for more than a year.

Thank you so much
MarciaF

I doubt you will hear from Trenacker....the only time he has visited the forum was the day he wrote the above post.
Hasn't been back in over 2 years now.