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Update on my braces:

Doc wants to start with upper braces only to move those front teeth into a more vertical position. I'll wear those for 6 months before adding lower braces. I'll go back every 6 weeks for adjustments. He will reassess what I need as we go. He said I may need rubber bands or a special appliance to push my lower jaw forward. I will wear braces likely for 2 years total and then a retainer indefinitley, at night only, to make sure my teeth don't move. This is common.

Seeing the mold of my teeth on the table. Wow. It was very surprising to see them without my face, gums and lips in the way. Shocking to say the least at how small my mouth is. Looks like it belongs in a kids mouth. Folks--I'm a 6 foot tall woman. I've been called a big mouth because I have such a loud voice, vivacious personality. I guess I just figured that my mouth was supersized along with the rest of me. Not so. Why? See the link Rooster posted 2 posts back.

Ok, total cost for all this orthodontia? $5,400. We thought at first we were going to have to pay this from savings because our current dental coverage does not cover braces for adults (wankers). Then last week my husbands company suddenly changed hands (was bought by bigger company)--so we decided to wait a little bit to see how things will fall out insurance-wise. We just found out that the new company DOES provide benefits for adult braces. So even though I would like to have them put on ASAP, it behooves me to wait and see when this new plan will be put in place. For now, I have a standing appointment in early January. If nothing else, we can use our flexible spending account to pay then.

I have spent thousands on health care this year because of the diagnosis of chronic fatigue syndrome earlier this year. Saving a few pennies seems prudent.

So, that is my update for now. I'll let you know more when this gets underway!

Jen

Is this the Damon System you were talking about, Jen?

That sounds good, Jan. Yes, both my kids and all my nieces and nephews are supposed to wear their retainers for life.

Apparantly the Damon system braces are just one type of self-ligating braces (maybe it was the first or most famous, I'm not sure) and now there are many brands on the market. I will be getting a mixture of self-ligating and traditional braces. My ortho doesn't use the Damon brand that much anymore according to the technician who presented my plan to me. I'm guessing with the different brands on the market they either get a favorite for some reason or use whatever is cheapest, I'm not sure. Maybe some are better for some applications than others. I will try to remember to ask next time.

They will use traditional braces for the "torque" to pull those teeth out and self-ligating braces for the rest, as is my understanding. So its a mixture of traditional and self-ligating. These will not be the camoflaged or nearly invisible braces a lot of adults get. They need to get a lot of movement so I have to use the hard core ones, lol.

I did learn something I didn't know. Every tooth is surrounded by a muscle. When the braces are put on and each time they are adjusted, you get "sore tooth muscles" and then, just like when you overwork any other muscle, it calms down in a few days.

Hey socknitster, Are you still following? Any updates for us?

I'm eager to hear how Socknitster is doing, too!

My daughter finished her phase one with the Damon system last year and her mouth is beautiful. She was still losing teeth, and there was plenty of room for the new ones to come in, but they will need some straightening in about a year. Her maxillary and mandibular arches are beautifully wide and her pediatric dentist just could not get over how much room has been added in her mouth! As a result, she's able to do a great job flossing and brushing and he was just gushing over how good her teeth are.

My daughter tolerated the Damon system very well. The first few days she didn't complain of pain, only that her teeth felt "funny" and she had no difficulty at all with subsequent wire changes. The wire changes are infrequent (every 2 months) so, even if there was some pain, it's not too often. She does have a very high pain threshold, so I'm not positive just how painfree it really is. I remember days of soreness every time my traditional braces were adjusted, and sometimes it was every week or two. The first phase was supposed to take 18 months, but my daughter was done in only 12.

My daughter's next phase will begin in about a year, and they will use the Herbst appliance to bring the lower jaw forward, while realigning the bite to accomodate it. I'm crossing my fingers that she will avoid any issues with apnea thanks to this orthodontia. My orthodontia, we now know, did the opposite. They pulled teeth which caused my jaw to become even MORE narrow and pushed my front teeth BACK which further narrowed my airway. I know it was "state of the art" for the times, but thanks a lot for nothing! It's great that Socknitster is able to do this as an adult. My daughter's orthodontist said it would help me, too, even now, but with one kid on her way to college it's just not financilally feasible.

What a coincidence. I just went to jaw/facial doctor today on the recommendation of my dentist because my sleep doctor said my mouth was crowded. Doc today did a nasal endoscopy and said my airway was pretty restricted at the base of my tongue and recommended braces and the possibility of jaw surgery to bring my jaw out and open up my airway. I had braces as a child, probably doing more harm than good, and had them again as an adult to deal with TMJ problems. Quite a lot to think about and very eye opening.

Hi guys,

I've had the braces about 6 months now. First they put on the top brackets and wires and I had those for about 4 months. Because of the shape of my teeth, they couldn't put the lower brackets and wire on until recently (no room!). I have some discomfort with the initial installation of brackets due to rubbing inside of mouth/lips and each wire change makes my teeth ache, but it really isn't that bad. Adjusting to the bottom set went much faster and easier than adjusting to the top set. I really don't mind them at all except I have to spend more time on a daily basis cleaning my teeth.

In the short time that I've had the braces, my upper front teeth have gone from being tilted inward to being in a more vertical position and my upper arch is now much straighter and is starting to widen. I still have on the original light arch wire in the top. Because many of my teeth are rotated inward or pivoted on their central axis I have a few springs on the arch wire pushing horizontally to try to achieve the correct position. Now that the bottom arch wire is installed and things have settled in, I think they will be replacing the top arch wire with a heavier duty one that will create more rapid expansion. They had to wait for some of the teeth on top to rotate as well as for the front teeth to make room for the bottom brackets before they can put on the heavier wire on too.

It is clear to me that it is working. I can already see a difference and for the moment, my upper arch is slightly wider than the lower, but that is not causing problems with chewing. The only problem I had with chewing was right after they put on the lower brackets. He was very careful and painstaking with placement so that my molars would still meet. And they did when he put them on, but after about an hour out of the chair, swelling must have done something because my molars wouldn't meet anymore. Almost, but not quite. I thought about going back, but since chewing is pretty gingerly in the first week after installation anyway, I decided to give it a while to see what would happen. After about a week, it was fine again. I just had to eat softer foods for that week.

It has not helped with my OSA as if yet because the brackets themselves take up the room and dont let my lower jaw come forward too much so far (when teeth are together). But it's still very early and I've caught myself many times a day with my teeth slightly parted in a closed mouth with the jaw forward, without any conscious thought about it. So, I feel confident that this is going to work.

I want to remind everyone where I started. I was originally diagnosed with severe OSA. The only anatomical fault the ENT could find was 3+ sized tonsils that touched during allergy season, so I had them removed. A very difficult but worthwhile surgery. Months later, after all the healing was done and swelling had gone down, I was left with very mild OSA. In fact my most recent titration study showed no events related to respiratory events. However I have many arousals per hour, which I believe are due to flow limitations that the lab doesn't measure (this is a relatively new finding in sleep medicine and most labs in the country have not adopted the technology needed to measure this yet) OR there is something wrong with my brain chemistry--I have chronic fatigue syndrome which is related to fibromyalgia and can sometimes presents with the same sleep unknown, unstudied sleep disturbances. The sleep doctor passes this off with meaningless gobledygook because he doesn't have a clue. He says that the sleep/wake center of my brain is damaged, blah, blah.

I'm still doing the braces for two reasons. One as insurance. If I can get rid of the OSA, I don't want it to come back. So I want to be sure that if these flow limitations are the problem, that I can get more airflow. I still (rarely) wake up with an apneic snort and yes I do use CPAP 100% of the time. Second, I have narrow sinuses and nasal pasages which should enlarge with the expansion of the upper arch and make colds and allergies a little more bearable. And I would like a healthier and more beautiful smile. My teeth didn't look too bad, but my arches were child sized. Kind of ridiculous in a 6' tall woman.

I could and probably should get another sleep study. But here is the thing. I have tried sleeping without CPAP and was utterly miserable those days--just exhausted, which says to me that I need it and supports the flow limitation theory. However if I go get a study and the study, with the inferior technology says I do not have OSA, then my insurance will not pay for my supplies anymore. A sleep technician told me that if I found a lab that does this specialized testing and got that diagnosis, my CPAP supplies wouldnt be covered. So I'm waiting until such a time as the insurance makes me or I can sleep without it and feel good first. I would like to get off CPAP because I continue to occasionally have issues with aerophagia.

So, that is my update. So far, I'm ahead of schedule on the braces. So I'm hoping to finish up before the 2 year mark which was the original estimate.

Jen

socknitster wrote: So, I feel confident that this is going to work.

That is exactly what I was hoping to hear.

Thanks and good luck.

Jen, you should listen to Dr. Gold's teleseminar about UARS and functional somatic syndromes (with your mild OSA, it may very well apply to you).

https://www.dropbox.com/s/bms7pthhdvx7a ... m.Gold.mp3

Glad to hear it, Jen! It gives me great hope for my daughter.

If I were younger and richer . . .

SleepingUgly wrote:Jen, you should listen to Dr. Gold's teleseminar about UARS and functional somatic syndromes (with your mild OSA, it may very well apply to you).

https://www.dropbox.com/s/bms7pthhdvx7a ... m.Gold.mp3

Thanks, SleepingUgly. UARS is what I think I have and was describing above (sorry I couldn't think of the term at the time). I will check this out. Maybe it will help me. As I said, I was told that UARS is a non-diagnosis and doesn't qualify for treatment, which is why I'm holding off on another sleep study. I have done the research and there are NO facilities in Indiana that test for this. My next place to look was going to be University of Illinois at Champaign/Urbana. They have a pretty decent sleep lab that recently published a paper that I ran across. I thought it might be a good place to be re-evaluated.

Jen

SleepinUgly,

I listened to that teleseminar and WOW! Kind of blew my mind. I know now I am definitly on the right track. I clearly have a somatic syndrome, which has become worse even with CPAP, so clearly I'm not being treated adequately. It was exciting to hear him say that with the correct titration I could see a significant relief of symptoms (within two weeks!) as they have become much worse since the stress of having my second child.

They spoke at length that the real problem here is small mouths. Achieving a larger oral volume is best during childhood, but if that isn't possible, there is still hope for us old codgers. The kind of orthodontics in am receiving clearly falls under the heading of possible solutions. It takes far longer than surgery, but sounds like as long as oral volume is increased, it doesn't matter what method is used. For children the answer is rapid palatial expansion.

To me, this makes far more sense. A real solution. To me, CPAP is a band aid. What we need is real long term solutions. They mentioned the narrow arches and super large tongue that is scalloped. That is me.

From this, I now am resolved to try harder to find a lab that tests for UARS and to have both of my children evaluated and treated orthodontically as young as possible. My oldest is 7 and already had tonsils out due to sleep apnea. He will be going to an orthodontist for evaluation pronto because some of his sleep issues continue to creep up--his sleep study shows the same as mine--arousals unrelated to respiratory events. He does not handle stress well and is often tired and emotional.

My youngest is almost 3 and we were told last week his tonsils are 3+ and will probably need removal if he starts to have any sleep issues. He is getting tubes in his ears on Friday which is a very fast and simple procedure. We talked about doing the tonsils at the same time, but decided to wait and see because that procedure is so much more involved and he doesn't seem to have the sleep issues at this point. Maybe that was the wrong decision. His teeth are clearly a mess already.

Thanks so much from the bottom of my heart for posting that! This will certainly impact my family's future. Even with the thousands of hours of research I have done into my health problems i have neve come across some of these terms. Thank you and bless you!

Jen

Jen,

Stanford takes most insurance. If there is SDB, they will find it (sometimes I wonder if they find it even if it isn't there... No chance of a false negative from Stanford!). Perhaps you should go there, and even take your son.

I have a hard time believing that they don't test for UARS anywhere by you, although admittedly HOW labs test is a big question mark. Perhaps you want to go to Dr. Gold?!

I have kids ages 7 and 5. My oldest has ADHD and we had his tonsils and adenoids removed after SDB was found on a sleep study at age 5. We hoped it would cure him of his ADHD, but alas, it did not. We have been taking him for consultations with two orthodontists regarding maxillary expansion. He is very slow losing his teeth, however, and they do not want to make any decisions about whether he needs it until more of his permanent teeth are in, including minimally his 6-year molars, which are just coming in now. In California they do rapid maxillary expansion even in 3 year olds, although I'm not sure how that works, as they may have to do it all over again when the permanent teeth come in. I think most of the rest of the country is more conservative and don't do it except on permanent teeth, and for particular indications. I liked how Dr. Gold talked about doing it in teens, as it made me feel less stressed knowing that we didn't have to do it immediately. From our standpoint, we can't do it unless there are orthodontic reasons for doing so. For example, if his maxilla is the right size, why expand it? It can cause a host of difficulties, such as the lower mandible not meeting the top, etc. I admit that I have only read enough so as to be confused! So we're waiting right now. I am almost hoping that he will need it for orthodontic reasons, so this decision can be made for us easily.

Actually, let me clarify one thing you said. Dr. Gold is big on nasal breathing. He does not want kids to be mouth breathing, particularly at night, because, as many know, it affects the craniofacial development and increases risk of SDB in the future. Maxillary expansion doesn't just deal with a "small mouth". It widens the nasal vault, as the nasal vault is the ceiling of the mouth (if that makes sense).

SU

SU,

That makes total sense to me. The top of the mouth is clearly the bottom of the nose. It explains why my ENT says my nasal passages and sinus openings are so narrow.

I started a new search this morning for a lab that will test for UARS with a nasal/oral transducer. The last time I searched thru all the local labs, then tried university hospitals in Indianapolis, believing that would be the next logical step. All those were dead ends. I became overwhelmed and gave up. When I looked again this morning I found a new lab had recently opened in a new hospital in my town and they indeed do this. In fact, the tech I spoke to said she thought it was standard of care and questioned me about the other two labs in town and I said, no, I'd been tested at both of those and they don't do it. There is also a lab about an hour away that also does it, I found. So I guess it really depends on the age and education of the clinic and staff!

I have an appt with a new sleep doctor (this will be my 4th in 5 years--ENT, neurologist, pulmonologist and now another pulm). I'm really, really trying not to get my hopes up, but it's hard. The braces are going to take time to work and I am really, really suffering now. I have been so desperate I've been trying various drugs (antidepressants and stimulents) for relief and seen all kinds of doctors, some of whome are clearly quacks. I've read all kinds of books about mood problems, chronic fatigue, perimenopause etc etc trying to find something that will help me feel more alive and less like cardboard. Sleepy and very, very tired and weak cardboard. My kids need me to be better, like yesterday.

I made an appt for my oldest to be evaluated for orthodontia in a couple of weeks when I go for a braces adjustment. Like you, I'm actually hoping they want to do something for him.

Before I decided to have children, my mother had breast cancer and I honestly at that time considered not having my own children because I didn't want to expose another generation to the litany of health problems that my mother and her family has. Everyone convinced me I was being silly, that every family has their own set of problems. Now I think of that and watch my oldest son suffer. Watch them both struggle to grow up with the shadow of the mother I should be (and desperately try to be) and all I can do is cry. Then I think that maybe it's better to have the devil you know and not be completely clueless.

One final comment. My oldest has mild attention problems that were much worse before his tonsillectomy. I suspect we have UARS to blame for much of the ADHD this country is seeing now. It was, after all, discovered in children first.

Jen