Psst...jencat824 (braces question)

jencat824: I noticed a prior post of yours from last year where you said you were getting braces. I was just wondering what kind you received? (traditional metal or Invisalign?) What pressure level are you currently at in CPAP therapy? And does your therapy contribute to your having to wear braces for a more prolonged period of time?

I have an appointment for Invisalign molds tomorrow. I don't have extreme dental isssues (when I tell people I'm getting Invisalign, they are usually very surprised and tell me I don't need them). But I do have some bottom teeth crowding and a my top incisor that is a little snaggle, and it bugs me. My overbite is pretty extreme too. My CPAP pressure is way high (19), but my ortho doesn't think this will be an issue in my orto treatment, just so long as I wear the molds consistently as I should. She did say my CPAP use could slightly prolong my period of braces wear. What she was adamant about was that once Invisalign treatment was over, I would absolutely need to use a custom-made night guard every single night, or else I would see big shifts in my teeth due to my high CPAP pressures.

What's been your braces/CPAP experience so far? (Anyone else who has had such an experience is also welcome to reply )

WindyCityEsq wrote:jencat824: I noticed a prior post of yours from last year where you said you were getting braces. I was just wondering what kind you received? (traditional metal or Invisalign?) What pressure level are you currently at in CPAP therapy? And does your therapy contribute to your having to wear braces for a more prolonged period of time?

I have an appointment for Invisalign molds tomorrow. I don't have extreme dental isssues, just some bottom teeth crowding and a top incisor that is a little off. My overbite is pretty extreme though. My CPAP pressure is way high (19), but my ortho doesn't think this will be an issue in my orto treatment, just so long as I wear the molds consistently as I should. She did say my CPAP use could slightly prolong my period of braces wear. What she was adamant about was that once Invisalign treatment was over, I would absolutely need to use a custom-made night guard every single night, or else I would see big shifts in my teeth due to my high CPAP pressures.

What's been your braces/CPAP experience so far? (Anyone else who has had such an experience is also welcome to reply )

Well, I'm about half way thru orthodontic treatment. I have Invisalign on the botton & a device call a Holly on the top (seems like an old fashioned retainer, with the pink molded to the roof of my mouth & with wires that connect to 2 braces on my back teeth). Reason for the top device is to move the upper teeth faster than the bottom. Bottom suffered some misalignment due to pressure, but upper teeth were the worse affected.

My pressure for about 12 of the last 14 years has been 19cm, but I'm now using the auto, and my pressure ranges from 15-20cm as an average.

My orthodontist is certain that after we get these teeth back in line, I won't have future problems as long as I sleep in a night 'retainer' which will basically be made for top & bottom of a material like Invisalign, but with the intent to keep the teeth in that position, not to move them further.

The reason your orthodontist is adamant about you wearing a nightly device is because at the high pressure your teeth could move again, undoing all the work you are undergoing right now. Sounds like timing was good for you, since you are having some minor work now anyway, you know in time you will need a retainer/device to keep the work in place. If someone had told me at the start of my therapy, I could have had such a device made them & not going thru the expense & discomfort of having my teeth moved back into alignment. I really don't mine wearing the device at night part, I just wish I'd know this sooner.

I have switched primary dentist as well, he should have known this, at the very least should have commented on the movement of my teeth with some type of recommendation. I've been to a couple of dentist who said, 'Oh, CPAP therapy, well your teeth may suffer, you may not want to continue to do that every night' & I just pretty much wrote them off as stupid - they were indicating CPAP therapy not worth doing, like I'd really stop CPAP therapy on the advice of a dentist!

It was thru this forum that someone suggested I should visit the dentist for a retainer. My new dentist said it was too late for the retainer stage, so that's how I wound up where I am now. I 'interviewed' 3 orthodontist before selecting the one I went with. All were similar in price & my dental insurance was paying a set amount anyway ($2,000), but I wanted to select someone I felt had the best plan of attack. I feel I made the right choice, since I'm about half way thru and treatment for me is going faster than originally predicted.

A tip for wearing Invisialign, I was told to remove them while eating & not to drink anything other than water while wearing them (if you doubt this, eat a brownie while wearing the Invisalignm then look in the mirror - gross). I keep the cases & a travel toothbrush/toothpaste kit in my purse & visit the ladies room after eating out to brush & reinsert my 'mouth friends''. I have found that this process is keeping my teeth cleaner & whiter than ever before. I was a twice a day teeth brusher. Now I brush 4 - 6 times a day & I no longer snack on junk food, if I'm going to take the whole get up out & reinsert then I only do that for healthy food. This has proven to be a good diet 'cue' for me.

I hope the process goes well for you, let me know if there is anything I can help with.

Jen

Thank you so much for taking the time to share all of this with me. It’s really helpful to be going into it with my eyes wide open.

Like you, my dental insurance also pays a flat rate of 2K for ortho treatment, and the patient is left carrying the balance. For me, that left a $3500 balance. I negotiated a reduction w/my dr based on the fact that I was a cash buyer and paying the full amount upfront, so my final bill was reduced to $2899. That includes all the X-rays, impressions, unlimited doctor visits and Invisalign aligners until whenever orthodontic treatment is concluded, and she even threw in a free teeth whitening at the end. Once the treatment is over, the night retainer (which I have to wear on both top and bottom teeth every night).

I’m really happy with my orthodontist. She didn’t write off my CPAP concerns at all. She was actually very convinced that CPAP therapy has a definite effect on the shifting of one’s teeth due both the mask worn and the pressures. She said that high pressured CPAPers are especially prone to teeth shifting. I felt assured that she was taking the issue seriously.

She estimated my wear time to be 9-12 months, with regular Invisalign aligners on both top and bottom. Normally, each set of aligners are worn for 2 weeks, but she said that she is going to keep a watchful eye on me bc I’m a high-pressure CPAPer. She said that she may have to modify my treatment a bit and have me wear certain aligners for 3 weeks instead of 2 weeks bc the high CPAP pressure may counterpose the direction of the aligners and prolong the length of the ortho course a bit. So I feel very taken care of, it’s good. She said that most people have to wear a night retainer every single night for the first year after orthodontic treatment is over… then they can get away with wearing them only 3 nights a week. “But not for you” she said, haha - I will have to wear a night retainer every single night for as long as I’m using CPAP.

You touched on one thing I am def not looking forward to: the having to take out the aligners every time you eat or drink anything (other than water). I keep thinking… “Man, I can’t even enjoy a Diet Coke on a long car drive anymore!” Can’t eat on the run either. And then there’s the business of always having to excuse myself from the table when I’m dining out to remove the aligners in the restroom (I’m not about to plop them out of my mouth dripping with drool in front of others), and then having to return to the restroom when it’s over to brush my teeth and put them back in. Sounds like SUCH a hassle! Not looking forward to that one bit. But I do think it will curb my snacking, like you mentioned, so that’s good. And hopefully, my teeth will be a little whiter from all those brushing sessions, haha!

The thing I’m most concerned about is the lisping. I hear it’s common in the beginning, but that most people get used to it and stop lisping after a few weeks. But some don’t and they continue to lisp throughout. What was your experience? I am very concerned bc I’m an attorney, so I regularly give oral arguments in front of judges and juries, and I don’t want anyone to be focusing on a lisp instead of the content of what I’m saying.

Do your braces interfere with the placement of your tongue? I’m concerned that it may cause some crowding in my mouth, and my tongue will be forced into a spot that causes reduced airflow and increased apneas. And at 19 pressure, I do NOT want to go any higher. I know you feel me on this one, since we’re at similar numbers.

Thanks for sharing your story. I should get my aligners in 5 weeks, or around the end of April. Since I just started CPAP on March 13 of this year, I feel good that I’m nipping this in the bud now as opposed to later when things got worse.

Thanks again, Jen!

You negotiated a good price. Geographically I am in a lower cost-of-living area than you (I think - since you live in a bigger city) and my total was ins 2K, my part $2,800. You'll love the teeth whitening, I have a friend who had it done & what a difference it makes!

Sounds like you got a great orthodontist, she obviously understands CPAP therapy & the effect it has on our teeth.

You estimated wear time sounds similar to mine, I was originally projected 18 months & it looks like I'll be finished in 12. He projected that for me due CPAP counteracting some of the moving of the teeth because I am a higher pressure, as you are. I get new aligners at 3 week intervals, and my uppers tightened as well. Wearing them at night will become easy, just routine, like CPAP therapy.

The eating out becomes easier. If you travel by car, alone or with a spouse, you can remove them before entering the restaurant, it saves one trip to the restroom. Otherwise, it becomes routine to excuse yourself twice. Everyone just thinks you potty a lot - ha ha!

Lisping - in your line of work, this might be a tiny problem in the beginning. My hubby said when I first got them I sounded like his grandma with her teeth out. Not very flattering, but it was true. After about a day or two of wear, this decreased for me. Within a week I sounded like me again. Unless you leave them our for a period of time, say a family emergency makes you leave during a meal without time to reinsert (happened to me), the lisping stays gone. If you remove them & leave them out for longer than just a normal meal, the lisp returns. So, being true to your dental therapy solves the lisp problem, at least it has for me.

If you have any other questions, let me know. If you need any help with tricks & tips when you begin therapy let me know that too. I'd say PM me, but I think posting it here gives others in our situation some knowledge base if they come to the forum for answers & do a search. I think education & knowledge gives us power over our lives, I'm a big believer in that.

Good luck!

I'm in the orthodontic treatment boat too. Right now, my ortho has me wearing a flat plane splint so we can see where my bite really is. It's pretty tall; something like 12mm and prevents me from getting to the point I can clench my teeth. I've been clenching and grinding a bit. That caused some teeth to shift and makes my lower jaw move back a couple mm when fully closed. Possibly influencing my sleep apnea by restricting my airway a little more. It also lead to TMJ issues, which was the initial reason I went to see him.

I've decided to go with ceramic braces on top and traditional metal on the bottoms. The ceramics are less noticeable than metal. I know I wouldn't do too well with invisalign; for reasons you've mentioned. Somewhere down the line, I'll have jaw surgery too. I have a small(er) lower jaw that pushes my tongue back. And, when I have the surgery, I won't have to have braces put on just so they can band my jaws together.

Nosselnut,

Sorry to hear you are in our boat too. Your choice of braces sounds like you've done some research & decided what's best for you. Your bite sounds like its really bad, but I don't see if any of your issues have been influenced by CPAP air flow. If they haven't been yet, they will be. Just make sure at end of treatment you get a retainer so you won't have the CPAP undo all that hard work. I know the jaw surgery is quite serious, I had a friend who had TMJ surgery a number of years ago, she did very well. She eventually became a CPAP user and was still sleeping with her retainer so had no teeth moving complications. I always thought the relationship between TMJ & OSA with eventual CPAP use is strong. Some folks think I'm nuts when I bring that up, but if our jaws are out of line, that contributes to obstruction which hence leads to the apnea. Funny how one small thing out of line in our bodies has so much cause & effect on the outcome of our daily lives.

Good luck on your teeth & jaw journey, let us know how you do.