Chanelle wrote:My issues: mild sleep apnea, jaw clenching.
Options: Mouth guard with cpap OR oral appliance.
History: 3.5 years on CPAP, which brings my AHI from 13 to 2.9. Sleep quality is so-so, as I wake up 2-3 times per night with leaks, nasal pillow shifting, tubing tangles, etc.
Now that the jaw clenching is becoming a real issue (earaches, headaches, jaw soreness), I need some sort of something to protect my teeth & decrease/prevent clenching. My dentist has recommended an oral appliance because he's had great success with them with regard to sleep apnea AND clenching/grinding in many patients.
My step-sister orthodontist told me about the patients she sees who need ortho after years of oral appliances have shifted their teeth.
I've done some online looking, but haven't been able to find recent research on oral appliances & teeth shifting & whether to be concerned about this or not.
I don't know what to decide. Any comments would be much appreciated!!
I am a dentist working in dental sleep medicine. There has actually been a great deal of discussion of the tooth movement question and some research has been done. My sense of the present consensus among the dental sleep medicine profession would be the following: Oral appliance therapy does cause some movement of the teeth but it tends to be minor(i.e., maybe 1 or 2 millimeters over time). This level of movement could be detected by professionals, i.e., dentists/orthodontists and a few very perceptive patients. It generally does not effect the patient's esthetics or function. This all assumes a few things: 1. You are a legitimate candidate for an OA, i.e., adequate complement of upper and lower teeth(at least 8 teeth in each arch), strong teeth anchored in sturdy, well-formed jaw-bones with good bone support and little or no periodontal(gum) disease, well-designed and properly adjusted oral appliances, like TAP3, Somnodent, Herbst, etc., daily use of A.M. aligner to re-position teeth and mandible every morning, periodic check-up with sleep dentist. Obviously, with check-ups, no one need suffer huge tooth movement because a sensible patient/dentist would discontinue treatment if the rare instance of major tooth movement is happening. Major tooth movement is a recognized side-effect of oral appliance therapy, but it is so rare that it is out-weighed by the medical benefits of treatment of OSA. Again, this is one man's opinion. I can not speak for the whole profession. It would be interesting for you to ask your orthodontist relative whether the patients needing orthodontic correction had less than robust bone support. Remember, I am offering generic information to serve as possible topics of discussion between you and your health care professionals only. The ultimate decisions must be weighed by you and the doctors who have examined you. Good luck to you.