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Bite problems from using oral appliance

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Bite problems from using oral appliance

Postby dyaboliko » Tue Jan 29, 2008 12:31 pm

I got fitted with an oral appliance for my apnea last year, and it's been working very well. The only problem is that when I get up each morning, my bite has shifted so much that I don't have a normal overbite. Instead, my top teeth come down straight onto my bottom teeth at the front of my mouth. My dentist gave me a 'bite tab', which he claims is supposed to realign the bite within 5 minutes.

Yeah, not so much. I end up biting on this tab for 2-3 hours each morning, and sadly, my bite doesn't go back into full alignment until -- wait for it -- the time I have to go to bed! And then the whole process starts all over again.

Does anybody have any advice on a way to solve this issue? I really want to stick with the oral appliance.

Thanks!

Steve
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i think you should talk to

Postby melhajj » Tue Jan 29, 2008 3:26 pm

your doctor again, and explain the problem or look for a second opinion, maybe somebody else knows better how to solve the problem; also, i would like to ask you, do you suffer from severe obstructive sleep apnea or not when you had your oral appliance done? my insurance says that does not cover oral appliance; i have read that some people says that it depends on what code the doctors write on the prescription, then the insurance will decide to pay for it or not; how did you get yours and what kind of insurance do you have, if it is not too much to ask.
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Postby dyaboliko » Wed Jan 30, 2008 12:26 am

Hey Melhajj... Thanks for the reply. Yeah, I had mentioned the problem to my dentist (he specializes in oral appliances -- he actually has apnea himself and uses one), and he didn't have much advice to give me. He provided me with a slightly wider rubber tab to bite down on in the morning, but it hasn't made any difference.

My insurance company is Great West Life, and so far they've been shuffling their feet on the issue of reimbursing me. The device cost me $1500, and I don't expect to see that money back from them. But I'll still be providing them with some extra information to try and sway their opinion, for what it's worth. I'd be curious to know about this mythical code that's so powerful, it can convince a cheap, heartless insurance company to pay for such a device. Haha. That would be great for sure. Amusing that they'll shell out $500 a year for me to get acupuncture or massages, yet likely won't spend a dime on a mouth guard that's saving my life. I have moderate apnea, and the device is working wonders. When I was tested at a sleep clinic while using it, my results were the same as someone without apnea.
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Re: Bite problems from using oral appliance

Postby jltrappedinsd » Wed Jan 30, 2008 2:27 pm

dyaboliko wrote:I got fitted with an oral appliance for my apnea last year, and it's been working very well. The only problem is that when I get up each morning, my bite has shifted so much that I don't have a normal overbite. Instead, my top teeth come down straight onto my bottom teeth at the front of my mouth. My dentist gave me a 'bite tab', which he claims is supposed to realign the bite within 5 minutes.

Yeah, not so much. I end up biting on this tab for 2-3 hours each morning, and sadly, my bite doesn't go back into full alignment until -- wait for it -- the time I have to go to bed! And then the whole process starts all over again.

Does anybody have any advice on a way to solve this issue? I really want to stick with the oral appliance.

Thanks!

Steve


Steve,

I have the same problem. I am using a TAPII appliance. The treatment has not been effective for me, and my bite is out of line now. So, I've switched to CPAP and I've got to find someone who can help me get my teeth lined up again. It's frustrating. The CPAP seems to work better though.

Good luck,

JL
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Postby jltrappedinsd » Wed Jan 30, 2008 2:28 pm

dyaboliko wrote:Hey Melhajj... Thanks for the reply. Yeah, I had mentioned the problem to my dentist (he specializes in oral appliances -- he actually has apnea himself and uses one), and he didn't have much advice to give me. He provided me with a slightly wider rubber tab to bite down on in the morning, but it hasn't made any difference.

My insurance company is Great West Life, and so far they've been shuffling their feet on the issue of reimbursing me. The device cost me $1500, and I don't expect to see that money back from them. But I'll still be providing them with some extra information to try and sway their opinion, for what it's worth. I'd be curious to know about this mythical code that's so powerful, it can convince a cheap, heartless insurance company to pay for such a device. Haha. That would be great for sure. Amusing that they'll shell out $500 a year for me to get acupuncture or massages, yet likely won't spend a dime on a mouth guard that's saving my life. I have moderate apnea, and the device is working wonders. When I was tested at a sleep clinic while using it, my results were the same as someone without apnea.


How do you feel now? Any different?

By the way, my dentist said that he has sleep apnea and uses one of those devices. Is your dentist in Maryland perhaps?
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Postby dyaboliko » Wed Jan 30, 2008 2:36 pm

Hey JL,

Thanks for the info. So you're saying that the appliance has actually permanently messed up your bite? If that's the case, wow. What a drag. You'd figure you could have some legal recourse there. Somehow I doubt the literature that came with the TAPII made any reference to such a possibility.

My dentist is based out of Toronto, where I live. Interesting though that your dentist uses the appliance too.
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Postby jltrappedinsd » Wed Jan 30, 2008 3:02 pm

dyaboliko wrote:Hey JL,

Thanks for the info. So you're saying that the appliance has actually permanently messed up your bite? If that's the case, wow. What a drag. You'd figure you could have some legal recourse there. Somehow I doubt the literature that came with the TAPII made any reference to such a possibility.

My dentist is based out of Toronto, where I live. Interesting though that your dentist uses the appliance too.


I doubt that there's legal anything now, or anything that I have the patience for right now. My dentist told me up front that this is a possibility. I just didn't know that the change in bite would be long-term. I have confirmed that my teeth have not moved out of place. It is the jaw/mandible that is messed up. Now I need to find a doctor to change this. Any recommendations for who I can go to see?
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Postby dyaboliko » Wed Jan 30, 2008 3:06 pm

I'd recommend checking out this web site, JL.

http://www.aaoms.org/

Hopefully you won't rule out litigation, especially if you need to have surgery done. I bet you they'd settle before it ever went to trial. And no doubt there are a zillion lawyers out there who'd jump at the chance.
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Re: Bite problems from using oral appliance

Postby shorr » Mon Apr 23, 2012 12:11 pm

I have the same problem. Approx. 1 year with Herbst appliance w/ excellent sleep apnea results. Bite does not re-align despite extended use of re-aligner every morning. Sometimes I even use the re-aligner multiple times throughout the day. Often, after extended re-alignment, my bite feels like it's almost normal, then shifts back out-of-place within a minute or two.

What is the solution? (lawsuit isn't a solution -- it's a way to pay for the solution if the solution is expensive).
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Re: Bite problems from using oral appliance

Postby jltrappedinsd » Mon Apr 23, 2012 8:45 pm

It is part of the game. Misaligned bites are a common side effect of these appliances. I am still working on this one. It seems that going to an orthodontist can help with the bite issue, but it is a long annoying expensive road. And who knows what the consequences will be? I am not doing this just yet. I am still having pain issues, perhaps related to UPPP and hyoid advancement.
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Re: Bite problems from using oral appliance

Postby a.b.luisi,d.m.d. » Wed Apr 25, 2012 8:38 pm

dyaboliko wrote:I got fitted with an oral appliance for my apnea last year, and it's been working very well. The only problem is that when I get up each morning, my bite has shifted so much that I don't have a normal overbite. Instead, my top teeth come down straight onto my bottom teeth at the front of my mouth. My dentist gave me a 'bite tab', which he claims is supposed to realign the bite within 5 minutes.

Yeah, not so much. I end up biting on this tab for 2-3 hours each morning, and sadly, my bite doesn't go back into full alignment until -- wait for it -- the time I have to go to bed! And then the whole process starts all over again.

Does anybody have any advice on a way to solve this issue? I really want to stick with the oral appliance.

Thanks!

Steve
I am a dentist working in dental sleep medicine. At the outset, I must state that I have not had the benefit of examining you, any advice I may give is generic, and that you must consult with your dentist and obtain his approval before acting on any information provided. I assume that your oral appliance is one of the TAP series. Although it is true that oral appliances can cause tooth movement, it is usually minor. It is extremely rare to get major tooth movement. The key to the problem may be your statment that, although it takes a long time(all day), your bite can go back to normal. This leads me to suspect that your problem may be muscular, specifically, over-stretched muscles due to a long period of protrusion. In my experience, if you discontinue use of the appliance for a week or two(with the approval of your sleep doctor and sleep dentist,of course) your bite will most probably return to completely normal. After it has returned to normal, you and your dentist can cautiously proceed to re-establish use of your appliance. Your dentist can make you an AM aligner to use in the morning which works better than the bite tabs. The key is to monitor the effect of the appliance VERY carefully. Your AM aligner should take only five or ten minutes to re-align your jaw in the morning. At the first sign that it is starting to take longer, STOP USE of the appliance briefly BEFORE your bite has a chance to get out of wack again. Again, these suggestions should be used as topics of discussion between you and your dentist and should never be attempted without professional oversight. Good luck to you!
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Re: Bite problems from using oral appliance

Postby elleno85 » Wed May 02, 2012 2:23 pm

Oh gosh it sounds like you have quite the dilemma there! Is there a way that your doctor and your orthodontist/dentist could collaborate and talk about a customized dental device that might help both your sleep apnea and the overbite? Otherwise this could just be a wild goose chase of trying different masks that end up screwing up your bite in all sorts of different directions! And thanks for injecting a bit of humor into your post, too. It certainly made me laugh!
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Re: Bite problems from using oral appliance

Postby Sallynla » Sun Jul 22, 2012 4:37 pm

I've been using an appliance for about six months now and am having the same problem. AM adjuster, bite tabs, nothing worked. So, the dentist showed me how to manipulate my jaw by hand. Doesn't seem like a great long-term solution, but it works for now. I can basically push my jaw back into line in about 3 minutes by assuming the position with my jaw and hand (I sort of look like the statue of The Thinker when I do it). I came to this Forum, though, because I'm worried about long-term injury.
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Re: Bite problems from using oral appliance

Postby tasha_c » Mon Jul 23, 2012 12:44 pm

After eight months with the Silencer, I've been noticing a change in my bite & smile as well. I was also given the bite tabs, but that doesn't seem to work.

What I have been doing, which seems to work, is alternating between CPAP & the Silencer. I used the CPAP for 2 weeks straight and my bite & smile are back to normal.
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Re: Bite problems from using oral appliance

Postby Gt108 » Thu Sep 27, 2012 1:38 am

Bite changes are irrelevant as long as you can eat and function normally and mouth looks normal to an observer. Sleep Apnea is a serious disease and speeds up your trip to the hospital and cemetery. It's a small trade off or would you rather have the best bite in the cemetery.
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