Oral Appliance SIDE EFFECTS ??

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Oral Appliance SIDE EFFECTS ??

Postby Young Aussie » Fri Jun 10, 2011 2:39 am

Hey All

Just wondering if anyone might have any experiences with side effects from their snore guard ?

After surgery did nothing at all for me my GP suggested I try the snore guards he had heard of, so I made an appointment and went to my dentist (Who is an expensive big busy practise) and he did the teeth moulds and within a few weeks I got mine - it worked well so the wife said !!

After a year I noticed I was getting tension headaches nearly every day - went to chiropractors, massages, osteopaths and multiple other places before I noticed food was getting stuck in my bottom back teeth.

Long story short, I wore the snore guard every night, even though I was told there were no side effects and it would not change my bite it did exactly that. My bottom teeth now line up perfectly with my top teeth - meaning when I bite together my back teeth do not meet instead they meet at the front teeth ! Along with that the dentist also thinks that the snore guard might have been the reason I was having headaches - which I had never had before.

I would suggest that if you go this way that you should go back to your dentist after a few months just to ensure nothing has changed or moved on you - wish my dentist had of thought about that !!

PLUS - I had never had a filling until I started using the snore guard, dentist said this is common as the saliva is not moving around your teeth when you are wearing the guard, instead if you have any bugs on your teeth and you wear the guard then those bugs can really work on the teeth and start cavities very quickly !

Just wanted to share my experience to make sure others are fully aware of what these oral devices can do to you, I now need braces on my bottom teeth to push them back and get rid of the gaps the snore guard caused.
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Oral appliance-SIDE EFFECTS?

Postby a.b.luisi,d.m.d. » Fri Jun 10, 2011 8:51 pm

I am a dentist working in dental sleep medicine. There is no question that tooth movement is a well-established side effect of oral appliance therapy. The AADSM has a disclosure form which I give to all my patients and it is right in there. Fortunately, it happens rather rarely and is usually very mild if it happens, but that is no help to the unfortunate few who have major problems with it. One thing patients should check very well before they get an appliance is the bone support of their teeth and whether or not they have periodontal(gum) disease. If you have solid bone support, you tend not to have tooth movement problems. On a more philosophical level, one has to weigh the side effects of CPAP and oral appliances(both have side effects) vs. the damage to your body from obstructive sleep apnea. Usually, the trade-off is worth while, but each patient has to decide for himself.
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Postby Young Aussie » Fri Jun 10, 2011 9:51 pm

Thanks for your post, yes I guess I am one of the unlucky ones who has had these problems ! Lucky me I guess but at least I now know about it.

Weird that I never had to sign anything when I initially got my device.

I had (and will have again) a perfect bite and very healthy teeth before this device - afterwards I still have great teeth and hopefully after these braces go on and do their job I will be back to where I was before apart from some fillings that I never had but oh well.

Side effects of CPAP are nothing as far as I am aware - apart from discomfort associated with the masks which takes a bit of trial and error - are there any other side effects at all from CPAP machines that I am not aware of ?

If it is only discomfort then wait till you have to try and sleep with your jaw locked in an un-natural position - bottom jaw pulled forward like a Pitbull !! haha
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Postby a.b.luisi,d.m.d. » Sat Jun 11, 2011 4:19 pm

Dental sleep medicine dentist again. In any medical treatment, some few get a less then desireable result. In this case you were one of them. Since you know that you have some difficulty with oral appliances, my best advice is to approach the CPAP with an open mind and a positive attitude. A lot of people have good success with it and you need to also. Good luck!
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Re: Oral Appliance SIDE EFFECTS ??

Postby Doceric » Sat Oct 01, 2011 12:40 pm

Hi!

I am a licensed psychologist who was dxed with sleep apnea which is in the mild to moderate range. I was prescribed the CPAP and after a few months of faithful use, could not tolerate it developing severe neck problems and ironically I could not sleep well with it on! So I got a dental appliance. Two problems emerged:

One, my teeth no longer lined up--front teeth did but back teeth would not touch. I even partially chipped a front tooth because of this problem! So according to the manual I was given by Somnadent (?), I was supposed to bite on a plastic bit that came with the the appliance to align the back ones. The plastic bit was included in the kit. My dentist who also uses an appliance told me he never had to use the plastic bit for himself. Since I was having bite problems, I did and it would work for a few hours but ended up really straining the jaw muscles and I developed problem number two--tinnitus, which involves a distracting ringing in both ears! So imagine, if you are a psychologist trying to listen to subtleties that a patient is telling you involving their greatest insecurities, and instead you are distracted by a constant ringing! How might that affect your ability to tune into what people are saying? Well it does and that is what has happend. There was no warning that using the bit to correct the teeth bite issue could cause tinnitus or other problems or I would have been more careful.

I have a chiropractor who I told my story too and he educated me on the jaw. If you chronically tighten jaw muscles it can cause the whole area to go into a "crisis mode" which can result in the little muscles in the ear to tighten and cause tinnitus. His advice was not to strain the area any further so as to let the jaw adapt. Since apnea is a problem and he knew that I was developing neck issues with CPAP, he encouraged me to keep using the appliance but to just tolerate the jaw not aligning and that in my case after a while it should relax and accept the change. After one week of not using the plastic bit my jaw is a little better aligned but the ringing continues! I do not know what to do and I am really afraid of it becomming permement.

Any thoughts or advise would be greatly appreciated!!!!

Sincerely,

Doceric
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Re: Oral Appliance SIDE EFFECTS ??

Postby Young Aussie » Sat Oct 01, 2011 6:37 pm

Hey Doceric

Thanks for your reply and I can fully understand what you are going through and how it effects everything going on in your life !

I am no expert and can only talk about what happened to me, I guess I was the opposite to you in that I went from the oral device to the CPAP and while the CPAP is not perfect at least it allows me to get the sleep we all need!

Just a question, how did the CPAP cause your neck problems if you don't mind me asking, it is because you were sleeping in different positions ? I have bad upper neck and back issues and I usually slept in what I now understand is the featal position, which is bad for your back so I have been trying to sleep as much as possible on my back with a low pillow not one that pushes your neck and head up - along with massage, stretching and not sitting for too long a periods I am hoping this will be the cure that I am searching for with my neck and back issues. I am just wondering if the above might solve yours too, from all my research all of the above suggestions are what everyone reports as being the only way to fix upper back and neck pains ?

As for the oral devices, I am really against them, it is not natural to lock your jaw into a different position for 8 or so hours every night, if you think about it for any amount of time you will realise that too. If I was to lock my leg into a position and hold that for 8+ hrs a night I am sure I would wake with muscle aches and hip problems too I imagine. I know they work for some but not for me and by the sounds of it not for you either !! For your muscles to be that tight that they are effecting your hearing with tinnitus that must be very tight !! I would suggest massages for your jaw, neck and upper back muscles and you will need a lot of them weekly for a fair while I would say !! After that I would drop them back to every other week and then maybe monthly for a few months - but in the mean time I would stop wearing that oral device - that is what is causing the muscle tightness and you can tell that because your back teeth do not touch.

This is exactly what happened to me and I eventually had to have braces fitted to my lower teeth with an anchor point on my top back teeth to pull my lower teeth backwards where they once were before using the oral device. For a chiropractor to say you will get used to it is great for him to say, but there is no way of knowing how long that will take you - it could take years to for your muscles to get used to it AND THEN you still have the problem that your front teeth are taking all the pressure of you chewing your food every day. I was told and completely agree with two dentists that if you continue on like that, that my front teeth would eventually crack under the pressure !

My advice and this is not coming from anyone with a degree in anything, just someone who has been in your position - is to get rid of the cause of your problem. If you had a thorn stuck in your finger it is going to hurt, sure in a heap of time your body might get used to it and heal around the thorn, but why not just pull the thorn out and let the body heal the damage that has been caused?

You are going to need braces to get bite back to how it was beforehand also, sorry to say - I only had mine on for 2 months if that is any positive for you to take?? Go back to the CPAP and try to find a mask that makes it more comfortable for you to sleep, this will allow you to get the rest you need, will take away the pressure that the oral device is causing and the braces will take your teeth back to where they are supposed to be. I would also talk to your dentist about the costs for braces, mine said before I had the device "no this will not change your bite" so 2 years later when I was back in the chair and he could see that yes it had in fact changed my bite he was in the wrong ! So I only paid about $40 out of pocket for my braces and he should be lucky that I did not complain about that - the braces were so uncomfortable it was not funny - but it is only for 2 months !! haha

Hope this helps you a little, like I said by staying with the oral device it is only going to keep the pressure, tension and pain going for a long time I would say ! Plus your teeth will start to crack under the pressure of your bite - so how can this be a solution from a chiropractor and dentist to suggest ?? Common sense says fix the cause and the problem will go surely ?

Hope that this helps your out and others in the same position, CPAP is just continual air flow, it can not cause any ongoing problems, it is just a comfort thing that is going to be individual to each of us at to what we like and prefer - once again just my take on it all !

Cheers
Chris
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Re: Oral Appliance SIDE EFFECTS ??

Postby jimg24 » Sat Oct 01, 2011 7:07 pm

Ihave been using my suad oral appliance for 5 nights.I have been able to keep it in my mouth all night and have not had much jaw pain,I have had a feeling that my ears need to pop like when landing in a plane but will not.I also have had a little ringing in my right ear.I have been very tired this week.After reading this post and seeing some of the side effects some of you have had i am starting to get nervous.I have used the c pap machine for 5 years and did not like it muvh and am now trying the oral way.my question is some of my side effects after 5 days something most have had and does it get better? I do not want to have to get braces at the age of 50. Thanks, Jim
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Re: Oral Appliance SIDE EFFECTS ??

Postby Young Aussie » Sat Oct 01, 2011 7:22 pm

Hahaha Jim I had to have my braces at the age of 33 - which I thought I was way too old for them then - I felt like an idiot !!

I am very biased after having had all the above happen to me, but think about it your jaw is locked in an un-natural position for 8+ hrs a night....... no wonder we all feel the pain and tension in the morning from the oral devices !!

My advice, throw that bloody oral device in the BIN, where they belong and go back to the CPAP, yeah they are annoying at times but they don't cause any long term side effects where as the oral devices can !! Maybe see if there is a better machine and mask for you that might make it all more comfortable - maybe that is all you need - the oral devices from what I have heard from some of the companies selling them are only meant for very short term use, sleeping in a plane, or for a night of camping etc not everyday like some other people and places suggest.

Good luck with it, but unless you want some of the above problems, get the hell rid of that nightmare bit of plastic and save yourself a lot of dramas !
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Re: Oral Appliance SIDE EFFECTS ??

Postby a.b.luisi,d.m.d. » Sun Oct 02, 2011 3:56 pm

I am a dentist working in dental sleep medicine. The tinnitus eposode related by Doceric must be very rare because I have a solid background and have literally NEVER heard of another case like it. It is not listed as one of the side effects we would expect with oral appliance therapy. The best advice I could give is to discontinue the OAT temporarily and see if the tinnitus goes away and also consult with an ENT to see if something else might have caused it coincidentally. Incidentally, tinnitus is DEFINITELY, a side effect of CPAP and that is well-documented. The air pressure can bother your sensitive inner ear. The bottom line in that both OAT and CPAP have their side effects. In most cases, the side effects can be managed and the good outweighs the bad. Both treatments are very valuable and have helped many people. I am very sorry when someone has a bad outcome, but we can not discourage people from getting the treatment that they desparately need because of a few unusual cases. I hope that you would agree. Also, I studied the appliance that Young Aussie used and, in my opinion, the design might have contributed to his exceesive tooth movement.Doceric's Somnodent is a much better design because all the teeth are held firmly within the confines of the appliance. With this design, the tooth movement that Young Aussie got is HIGHLY unlikely. Never-the-less, one of the basic requirements for oral appliance therapy is that the patient have healthy TMJ's. The dentist must always make a judgement call whether or not the patient's TMJ's are good enough. People vary so much and sometimes the TMJs prove to be not as good as thought. In this case the OAT must regretfully be discontinued.
Last edited by a.b.luisi,d.m.d. on Sun Oct 02, 2011 6:20 pm, edited 1 time in total.
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Re: Oral Appliance SIDE EFFECTS ??

Postby a.b.luisi,d.m.d. » Sun Oct 02, 2011 4:28 pm

jimg24 wrote:Ihave been using my suad oral appliance for 5 nights.I have been able to keep it in my mouth all night and have not had much jaw pain,I have had a feeling that my ears need to pop like when landing in a plane but will not.I also have had a little ringing in my right ear.I have been very tired this week.After reading this post and seeing some of the side effects some of you have had i am starting to get nervous.I have used the c pap machine for 5 years and did not like it muvh and am now trying the oral way.my question is some of my side effects after 5 days something most have had and does it get better? I do not want to have to get braces at the age of 50. Thanks, Jim

I am a dentist working in dental sleep medicine. In all fairness, the Suad is not one of the appliances I use in my practice, but I am familiar with the design. Young Aussies appliance is a design that would possibly pre-dispose the teeth to move, but yours fully encloses and holds your teeth in place making much tooth movement highly unlikely. The fact that you feel tired is of concern, possibly your appliance is not treating your OSA well enough now. It usually becomes more efficient over time and with more adjustment(you may need more mandibular protrusion). You should have some morning exercises to help your jaw muscles and TMJ relax and reset after using the appliance at night. Of course, you should have had a reasonably healthy TMJ(jaw joint). Ask you dentist for morning exercises or an a.m. aligner appliance to help you if you don't have them. So far your progress seems pretty routine, but the reaction of the TMJ to oral appliance therapy is always something of a wait and see thing. If the tinnitus persists, by all means contact your dentist. Fortunately, you do have the option to go back to CPAP if absolutely necessary. My guess though is that your oral appliance will work out well enough. Good luck to you!
Last edited by a.b.luisi,d.m.d. on Sun Oct 02, 2011 6:28 pm, edited 1 time in total.
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Re: Oral Appliance SIDE EFFECTS ??

Postby a.b.luisi,d.m.d. » Sun Oct 02, 2011 5:10 pm

As to the subject of tinnitus and oral appliance therapy. After re-consulting my literature, I would say that tinnitus has not been associated with oral appliance therapy. However, obstructive sleep apnea has been associated with TMJ(jaw joint problems) and jaw joint(TMJ) problems do have tinnitus as one of the symptoms. Since both oral appliance therapy and CPAP could theoretically disturb the TMJ or inner ear, I would say that either might possibly set off tinnitus if a person has a questionable inner ear and jaw joint. This has been noted with CPAP and whether oral appliances would be able to do it is just speculation on my part, but logically possible. Obviously would be rare in both cases, but no solice if you are the one who gets it. The best protection would be to try to use oral appliance therapy with a healthy TMJ, but sometimes you can't be certain. This is the best I can do. Any other patients had tinnitus with oral appliances? We would love to hear from you.
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Re: Oral Appliance SIDE EFFECTS ??

Postby Young Aussie » Sun Oct 02, 2011 6:18 pm

Interestingly enough, after reading that my device might be of "poor design" I decided to actually find out what device I was actually using.

I went to probably the most expensive, biggest practises in my city and was custom fit for ... you guessed it a Somnoguard type device, it looks similar to the images I could find on google, perhaps the previous version as I got mine around 3 years ago. I paid around $650 for it at the time which I thought was madly expensive but what do you do.

I think at the end of the day you need to be aware of what potential side effects you can develop and this is my biggest gripe of all, I was told there were no side effects at all, it will not change your bite etc etc - which in my case was incorrect and even my dentist agreed that he had heard of many other cases happening but I was his first. He is no longer my dentist needless to say !

SO just be aware of what side effects these oral devices can cause, once again thinking about all the pressure it is creating my forcing your lower jaw forward all night it just is not natural in my opinion. If you google CPAP and Tinnitus nothing actually comes up which is weird if it is linked to CPAP therapy but if you google Oral Sleep Device and Tinnitus a fair bit comes up about it mainly relating to TMJ issues??

I agree that CPAP is not perfect but I am still unaware of any permanent side effects that it can cause, unlike what the oral devices can do to people causing ongoing issues, at least in my case.
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Re: Oral Appliance SIDE EFFECTS ??

Postby a.b.luisi,d.m.d. » Sun Oct 02, 2011 6:45 pm

To Young Aussie: Please correct me if I am wrong. What I think you had for an oral appliance was kind of a ramp-type thing that touched only the front teeth and kind of pushed the lower teeth forward. I don't remember seeing that type in the U.S., but I do see it on the internet, I think. The appliances in the U.S. generally cover all of the teeth and enclose them so that they can't move. Maybe I misunderstood what you had? Actually, both CPAP and oral appliances have side effects. Google the side effects of CPAP and Google the side effects of oral appliances and see which one has more. You might be surprised. But that isn't the point. The point is that CPAP works well for you and that is all that matters. And I can tell you from experience that some oral appliances work well for many people.- and not so well for others. It is very individual. No right, no wrong. Different strokes for different folks. Good luck to you!
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Re: Oral Appliance SIDE EFFECTS ??

Postby SleepyToo » Sun Oct 02, 2011 10:56 pm

Re the discussion on tinnitus: I have had tinnitus for some time, including before diagnosis with sleep apnea. I did have it checked out by a hearing specialist some years ago (again, before diagnosis). It does seem to be better when I have slept well, and gets worse when I am tired. Therefore the question should probably not be does the treatment of the night cause tinnitus, but does sleep apnea cause it and can consistent treatment with CPAP reduce the severity? I cannot give any answers to these questions for anyone else but they may be worth asking!
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Re: Oral Appliance SIDE EFFECTS ??

Postby irish4pixie » Sun Dec 25, 2011 12:54 pm

I received my Somnomed device, and started wearing it on Monday Dec. 19. While I was able to tolerate the appliance, I awoke with neck pain below the base of my head. I wore it Tuesday, Wednesday and Thursday sleeping through the night. The neck pain has become so severe I can barely move my head, swallow etc. I also experienced some significant ringing in my ears. I have not worn the appliance for two nights now and the severe neck pain below the base of my head persists. Does anyone know what is going on here?
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