grinding/clenching teeth

NyNurse33 · Post by **NyNurse33** » Wed Aug 30, 2006 3:48 pm

Had my cpap for 3 weeks now and even though I'm convinced that I've developed this new lovely habit of bruxism because of it, I will not stop using the machine. I feel too good to do that. I went to the dentist yesterday and told him of my theory, having the obvious symptoms of a painful front bottom tooth and slightly more tightness in my jaw, how could he have argued? He wanted me to come in when I get my fillings repaired to make impressions for a night guard. Knowing full well that my dental insurance (as good as it is..100%) would not cover the night guard, I inquired how much would it cost. "oh just 300$". !!!!!!. Well needless to say, I will not be having the impressions done at this time. I realize how much my dental work can cost me in the future if I don't protect my teeth, but for now I'm going to try a plain, cheap ol' sports mouthguard and see if that helps any. Anyone with similar problems with grinding? What were your remedies?[/quote]Life is something that happens when you can't get to sleep. ~Fran Lebowitz

Snoredog · Post by **Snoredog** » Wed Aug 30, 2006 3:58 pm

that is sort of the chicken or the egg thingee, but most who have OSA also have some form of bruxism. Sort of like green eggs and ham.

the important thing is to keep your teeth from grinding together if it wears off that enamel decay can set in fast. Next time your in to see your dentist ask him/her which teet are most at risk from bruxism, for example if you have any inlays they can make your tooth weaker and with the grinding actually split your tooth. If you have any of those I would invest in a crown.

Those sports guards would be better than nothing. Stress can also cause bruxism.

NyNurse33 · Post by **NyNurse33** » Wed Aug 30, 2006 4:00 pm

Thanks for the info..but how come I never noticed the bruxism before I started using the cpap? I used to always sleep with my mouth open and on my side or stomach. Now I'm very conscientious of sleeping on my back and keeping my mouth closed.

linda b · Post by **linda b** » Wed Aug 30, 2006 4:55 pm

First of all, why can't you continue to sleep on your side. There should be no reason not to do that. In fact, many people find their apnea is worse on their backs.

You may be too "fixated" on keeping your mouth closed, causing you to clinch and grind your teeth. I use Poligrip Strips on my lips to keep my lips sealed together. (Many use various kinds of tape, but I really like the strips because if I really need to, I can pop open my mouth.) The seal is strong enough to keep the lips together, but not so strong that I can't open my mouth if I really need to. Therefore, I don't have to even think about keeping my mouth closed.

I do find, however, that sometimes when I lay down at night I feel myself with clinched jaws. I've started reminding myself just as I lay down to relax the jaws, let the tip of my tongue rest just behind my upper teeth and even relax enough to let the cheeks puff out a little. This has become just one more step in the "getting ready to sleep" ritual. Once in awhile I'll wake up with that tight feeling in the jaws that tells me I was clinching overnight, but that very seldom happens now.

While a mouth guard might keep your teeth apart, I would be afraid it would make it even harder to keep the lips together.

Good luck, and welcome to the forum.

NyNurse33 · Post by **NyNurse33** » Wed Aug 30, 2006 5:06 pm

Thanks for your info Linda. My sleep apnea is worse when I'm on my back, according to the sleep lab. Which is funny, b/c I always intentionally slept on my side or stomach. But who knows what happens when you are sleeping. I have been trying to sleep on my side, but have been experiencing some leaks around the nasal piece. I've tried tightening it, but then it becomes too tight and I'll wake up with the area above my upper lip hurting. On a good note, I'm not waking up until early morning a little before its time to get up anyway. I think you may be right about the mouthguard preventing my lips to stay closed. I'm wondering if I may need to go to a full face mask after my two months is up with this mask. I was given 3..nose pillow, ultra mirage 2 and flexi fit, but I find the mirage one to be the most comfortable but ironically the most bulky and getting in the way of turning on my side. Well I'll keep trying different techniques and all of your help is appreciated.

Snoozing Gonzo · Post by **Snoozing Gonzo** » Wed Aug 30, 2006 5:09 pm

Before CPAP I had actually broken a dentist-made variety of mouthpiece during the night. The sports type is bulkier but cheaper and doesn't splinter (most dentist versions don't either). Just the opposite of your experience, within weeks after starting CPAP, I stopped grinding and clenching. The tooth and jaw pain went away.

I wonder if, as mentioned above, you used a sports mouthgaurd for a while and then backed off after you got used to the pressure it may get you past your new-found habit. I bet it does.

Depending on your mask, you will have to make adjustments for the extra stuff under your upper lip.

Good Luck!

Chris

linda b · Post by **linda b** » Wed Aug 30, 2006 6:15 pm

I am totally a side sleeper and have used the ComfortLite 2 with the simple cushion since I started on APAP this past May 11th. I can highly recommend this mask. It does require an extra strap, something like the pantyhose fix developed by Rested Gal. Do a search, there are tons of posts about the fix. It helps to stabilize almost any mask of this type, the Breeze, the Aura, even some full face masks. I tried the nasal pillows first, but found them too painful on my nose. NO PAIN of any kind with the simple cushion, no facial marks, either.

OSAGuy · Post by **OSAGuy** » Wed Aug 30, 2006 6:59 pm

I also grind my teeth and have been wearing a bite guard at night for five yeara. Works great. I'm a little surprised your insurance doesn;t cover it. However, a word to the wise on the grinding. My previous dentists had not recognized the problem for what it was, but when I changed dentists when I relocated to a different city the new dentist spotted it immediately. Lots of abfractions, so needed a complete reconstruction. Actual cause was TMJ. Had it been caught sooner it cood have been avoided. It cost me (my insurance company $20,000+ to fix it. Fortunately my insurance company covered it under medical instaed of dental, as dental was limited to $2,000 per year. Just an example of how expensive not having a $300 bite guard can get.

LC2 · Post by **LC2** » Wed Aug 30, 2006 7:04 pm

I've been following dentist-only forums for a few years and the best solution to the clenching/grinding problem appears to be the NTI guard. You can find more info here:
http://www.nti-tss.com/
http://www.headacheprevention.com/ (this one has a database of dentists who offer the NTI-TSS device)

The cost is anything from about $200 to 450 (but it'll save you a lot of money in the long run).

The nightguards you can buy over-the-counter are a waste of money and won't work.

Mac · Post by **Mac** » Wed Aug 30, 2006 7:24 pm

I like Snoozing Gonzo had bruxism before cpap.when ever I quit breathing I would grind my teeth.Now I dont use my mouth guard anymore.

Jere · Post by **Jere** » Wed Aug 30, 2006 8:19 pm

I have been using the NTI nightguard for a few years. It's just a small piece of plastic fitted over the front few teeth. It works better (and is more comfortable) to the retainer-type guard I had been using for a decade. Regardless of the type, it is a small price to pay to avoid cracked teeth and all that goes with it.

droyal · Post by **droyal** » Wed Aug 30, 2006 8:52 pm

Hi,

You can really damage your teeth if you don't do something to address the problem. I did.

Now, I use a night guard.

Your jaw muscles are REALLY powerful, and you can really hurt your teeth. I fractured one MOLAR, that had to then come out, and I wacked a good piece out of another one, requiring a gold crown. The costs of each of these dental events was way, way more than the cost of a night guard. How about 15 times more?

BTW, if you do have a custom made one, insist on the lab making two or three for you. The extra cost should be very, very small. If not, have your dentist go somewhere else. Reason: if you lose it or bite through it, they will charge you the whole $300 all over again and you will be without the guard for a couple weeks.

Best,
David

Jerimoth · Post by **Jerimoth** » Wed Aug 30, 2006 9:46 pm

If you get a full face mask it will work with a night guard. Nigh guard is extremely important- spend the 300. Not only will you chip teeth, as mentioned above, but the alignment of the teeth change, because of the pressure. The misalignment results in periodontal disease, because the angled tooth opens up a pocket. Far more serious (and expensive) than chipped teeth.

When I've forgotten my night guard I've used the pressure from the CPAP to keep my mouth expanded, so the teeth don't touch each other- works very well.

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