Experience with Myerson EMA oral appliance

This forum is for the discussion of approved dental devices.


Experience with Myerson EMA oral appliance

Postby gruntjg36 » Sun Aug 04, 2013 9:34 am

Howdy,

Just completed 3rd night of my new oral appliance, the Dentist chose the Myerson Ema, which had me mad at first since all we ever hear about is the TAP or Somnodent. So far I am starting to notice the difference, I cannot tolerate the CPAP due to the location of my obstruction and ENT confirmed during a sleep endoscopy that oral appliance would keep my airway open, so I am motivated and thinking positive for a change.

Anyways, from the first night, I can tell it will take some time to adjust to this, the EMA feels so tight especially on the top teeth,but the first night I slept 5 straight hours before waking up the first time, this is unusual for me as I generally wake up every 2 hours and look at the clock or something, generally flying out of a Dream since I remember it so well upon waking, Anyways, upon waking I had a very hard time getting the top part to disengage and some pretty heavy tooth pain, I am hoping I learn to disengage it easier as time progresses and pain subsizes.

Night 2, another night 6 hours before I woke up, and woke up refreshed, but it was only 4am, I took out the oral appliance and went back to bed a few hrs, the same problem tooth pain and very hard to get it to disengage. Called the Dentist and they told me to give it the wkend and come back monday if problems persist but claimed this is normal pain as it means its working and i had some crooked teeth so this is why only a few teeth are hurting.

Night 3 another decent night of sleeping, bags are less on my eyes, so I suppose this is beginning to work, I got back in 10 days for adjustment and follow up,
gruntjg36
 
Posts: 35
Joined: Wed Jun 19, 2013 1:13 pm

Re: Experience with Myerson EMA oral appliance

Postby SleepDent » Sun Aug 04, 2013 4:25 pm

I am a dentist working in dental sleep medicine. My view of the Myerson EMA appliance is that it absolutely a legitimate appliance to treat mild to moderate obstructive sleep apnea. The efficacy data which I have seen is mediocre. That being said, it will work satisfactorily for a reasonable number of mild to moderate OSA patients. You may be one. It is rather lightly constructed and the rubber struts make adjustment rather coarse and difficult. They can also stretch over time. On this forum, I am often asked for my opinion of the very best OSA appliances. I would not put the Myerson EMA in that group. However, it is good enough that competent sleep dentists can and do use it. a.b.luisi,d.m.d., username:SleepDent
SleepDent
 
Posts: 159
Joined: Fri Jun 14, 2013 6:44 pm

Re: Experience with Myerson EMA oral appliance

Postby gruntjg36 » Mon Aug 05, 2013 6:36 pm

I have seen this data on the Myerson EMA also from my dentist and it is sufficient and better than average. This appliance was also selected due to the size of my mouth and other measurements, as I was shown when I questioned my Sleep Dentist, my best bet for accepting oral appliance therapy would be the EMA, Somnodent and Tap the two that are echoed over and over again would not be beneficial for me, so anyone reading this ensure you go to a Sleep Dentist, not just your Dentist molding you and sending off for what ever you select. My Sleep Dentist used a program after like 100 measurements and it spit out the ones that would work best with my measurements as not all mouths are created equal.
gruntjg36
 
Posts: 35
Joined: Wed Jun 19, 2013 1:13 pm

Re: Experience with Myerson EMA oral appliance

Postby SleepDent » Mon Aug 05, 2013 8:09 pm

gruntjg36 wrote:I have seen this data on the Myerson EMA also from my dentist and it is sufficient and better than average. This appliance was also selected due to the size of my mouth and other measurements, as I was shown when I questioned my Sleep Dentist, my best bet for accepting oral appliance therapy would be the EMA, Somnodent and Tap the two that are echoed over and over again would not be beneficial for me, so anyone reading this ensure you go to a Sleep Dentist, not just your Dentist molding you and sending off for what ever you select. My Sleep Dentist used a program after like 100 measurements and it spit out the ones that would work best with my measurements as not all mouths are created equal.

It sounds like you have a very good sleep dentist, as I have told you previously in a PM. When a person has mild to moderate sleep apnea, especially mild, you do have a fairly wide choice of reasonable sleep appliances. The TAP is the only one really rated to treat severe OSA, although, recently, the Somnodent has also been stating that it is rated for severe. I happen to treat a lot of hospital cases that are severe and I appreciate the extra capability of the TAP. I think that your dentist should be commended for going the extra mile to maximize your comfort. No doubt the Myerson EMA is one of the more comfortable designs. I just happen to have a different philosophy. My goal is to maximize success for my patients while minimizing cost. My fees are quite reasonable by national standards and one of the ways I accomplish this is by letting the patients work on adjusting the TAPS at home on their own. Patients can easily self-adjust the TAPS with phone directions from me. I t eliminates some office visits and the cost can come down. I would admit that some of the patients using the TAP would probably be more comfortable using something else. But I can modify the TAPS in custom ways that can make them comfortable enough for each one. I am privileged to know another sleep dentist who is generally considered to be the finest sleep dentist in the world. His success rate is probably unequalled by anyone else. He uses nothing but TAPS. The key is that he is extremely skilled in moulding and modifying them to fit each patient well. Pretty much the same thing I do. And the patients are very appreciative of the affordability of my appliances. Different philosophy/different approach. Neither wrong. a.b.luisi,d.m.d., username-SleepDent.
SleepDent
 
Posts: 159
Joined: Fri Jun 14, 2013 6:44 pm

Re: Experience with Myerson EMA oral appliance

Postby gruntjg36 » Mon Aug 05, 2013 9:07 pm

Yeah, we shall see, after finding out how cheap I can get the EMA, I def know I was overcharged, but the Dentist is also Chief Surgeon at the Hospital, so I suppose you get what you pay for, Im only on the 4th night of the appliance, so hope all is well, I may request a change to tap, i like the adjust ability factor, the straps on the EMA kinda have me worried, but at least the EMA will be a fine cheap break in device, I guess like you say gotta crawl before you walk :), thanks for your time you put in on the boards Dr. Luisi, If I was in Florida I def would stop by and use your practice.
gruntjg36
 
Posts: 35
Joined: Wed Jun 19, 2013 1:13 pm

Re: Experience with Myerson EMA oral appliance

Postby gruntjg36 » Tue Aug 06, 2013 11:04 am

Night 5 under my belt, got to bed very late due to late night Jog, and and a 4am alarm doesn't help, so tired today, but that is blamed on the 5 hours of sleep I got not the appliance. past two nights the upper teeth pain/soreness has subsided, so that is good, another week before I go in for adjustments, saw the Straps available online and being my impatient self ordered a few, but will put off until the Sleep Doc tells me to add the next level of strap to pull lower jaw more forward. Hoping only a few adjustments and then just worry about replacing the straps every couple of months. But, will def be upgrading to a oral appliance that doesn't require straps, as replacing the straps every 6 weeks or as needed will be a pain in the butt, I see why it is one of the less popular ones in that aspect. If anyone reading these posts have a EMA please give a brief summary of your experience or PM me, curious on how long the straps lasted for you and if it has been successful for you.
gruntjg36
 
Posts: 35
Joined: Wed Jun 19, 2013 1:13 pm

Re: Experience with Myerson EMA oral appliance

Postby apneaappliance-09 » Tue Aug 13, 2013 2:58 pm

I have had many problems with the EMA, it took two molds, and 4 times back to the lab to start using it. IT does give the tongue a lot of room but the adjustments made by changing the elastic tabs are not in small enough increments to avoid serious jaw pain from TMJ. The tabs have to be replaced on my appliance every 2 weeks due to stretching. I previously had an early version of the Herbts by Great Lakes. The incremental adjustments were smaller and it allowed me to get use to it without agravating my TMJ but the wires that were exposed kept my tongue pushed back and sore. It cracked frequently due to the constant need to heat the plastic each night.

I suffer a lot of jaw pain to use the EMA. Over time using the appliances my bite changed to the point that my molars do not match up anymore and I can not masticate food even if my jaws stopped hurting enough to chew. So that is the price for me to pay to use dental appliances. I have no other option at this point that I know of. I have failed with CPAP (chronic nasal obstruction & aerophasia) and will not consider any serious surgery due to fibromyalgia syndrome. I am ready to move onto another appliance and do not know what to consider, either in appliances or practitioners in the Philadelphia area.
apneaappliance-09
 
Posts: 1
Joined: Tue Aug 13, 2013 2:37 pm

Re: Experience with Myerson EMA oral appliance

Postby gruntjg36 » Wed Aug 14, 2013 9:52 am

Thanks for your response. Did you happen to have a sleep study with your ema? I ordered straps and advanced myself last night from 20mm to 18mm, prob not the smartest Idea, but I felt I could def go more fwd, i feel sore today... My appt with Sleep Dentist is tomorrow so I will reattach the 20mm ones and see what he says,
gruntjg36
 
Posts: 35
Joined: Wed Jun 19, 2013 1:13 pm

Re: Experience with Myerson EMA oral appliance

Postby gruntjg36 » Tue Aug 20, 2013 12:45 pm

Update: The Dentist moved me to Blue straps 19mm, so much more firm , its redic, I was soaking my ema every night in luke warm water with effordent, I was advised not to do this everynight, and take the straps off if I did, which is why my 20MM yellow(medium) straps stretched soo much, to the point my jaw would fall open. the blue has stopped that problem, i keep finding myself waking up attempting to close my mouth biting down hard, which the ema does not allow full closure due to the raised portion on the lower mouth piece, so I have tender teeth in the morning, the Dentist prescribed me Klonapin to take 30 mins before bed, to relax this issue, but I probably will not fill the script after reading up on the pill, the dentist did say he only wanted me to take for short period in the beginning stages of therapy. Overall, I have great days where I actually make it through the night without waking out, and nights where I wake up every hour on the hour, so hopefully as the adjustments progress, I find that sweet spot, in the meantime, just invested in a split king adjustable bed, so sleeping in the zero grav position has seemed to help alot with the tooth pain since gravity is centered for the most part and all the weight of lower jaw is not falling back. Heres to more good days than bad in the near future.... now if I can just fix the chronic night clogg of my right nose.... two turbinite and a septoplasty later still clogs at night.
gruntjg36
 
Posts: 35
Joined: Wed Jun 19, 2013 1:13 pm

Re: Experience with Myerson EMA oral appliance

Postby gruntjg36 » Tue Aug 27, 2013 6:46 pm

Been 7 days, just had my 2nd follow-up appointment, the EMA appears to be working, I have good days and bad, more good than bad, the dentist remolded me today and sent off for a new EMA with tongue depressers, after putting me on the CT scanner with appliance in and measuring airway volume there and listening to my symptoms he believes I am still swallowing my tongue some nights, but for the most part, I sleep well just wake up with the occasional dry eyes a few times a by product of my Lasik surgery from a few years ago, will start using heavy gel at nights. The dentist/doc wanted me to try Klonapin since I am still waking up from time to time, not choking and heart rate is normal, just clinching real hard on the appliance, I declined the pills after a quick google search on my phone, I do not like meds of any sort. I have been on length 19 blue, medium firm. I assumed I was going to 18 blue, but was given clear 19... they are much shorter, and so firm, broke a nail putting them on. We shall see how 19 super firm feels in a few hours...hopefully at my next follow up in 2 weeks the new EMA with tongue depressers will be there waiting for me. Good luck all who are using or thinking about using oral appliances.
gruntjg36
 
Posts: 35
Joined: Wed Jun 19, 2013 1:13 pm

Re: Experience with Myerson EMA oral appliance

Postby gruntjg36 » Fri Sep 06, 2013 12:46 pm

Sorry for the late updates, been hectic with work and 8 month pregnant wife. Super Firm Clear 19 level strap has been on for going on 10 days now. Wearing the mouth piece has become normal and natural , I don't wake up anymore biting down as hard as I can and hurting teeth, the swallowing issue with it in that woke me up a few times has gone away, and I am waking up refreshed, clear headed and dizzy spells are gone, so I think I am close to the level I am needed. Since I started my weight loss journey I've gone from 240 pounds to 172 pounds now, so this has probably helped the cause. My nasal issue comes and goes still, so keeping a food diary to see if maybe a food intolerance is causing the nose clog since I was tested for all known allergins and came back negative. I also have received a new mattress, the tempur pedic cloud breeze sumpreme and have a adjustable base so sleep a little upright, so all these new changes are probably factoring in. My sleep doc wanted me to slowly go back to complete supine sleeping, but after 8 months of sleeping propped up, it does not feel natural and I can feel significant amount of pressure on teeth when i try. Going on a trip to Atlantic city next week so I will be forced to sleep on hotel bed, so will find out then, probably should follow the advice so i can get the proper titration of the device, but I didn't realize how much a good nights sleep feels, so scared to break routine.

Go next thursday 12 Sept for next appt, will be 6 in all before I do a sleep study to verify the results, but just by the way I feel now, I know it is working and like many despise the sleep test, I have ordered a finger oxgen monitor that plugs into my ipad to record my oxygen levels at night while sleeping, but do not want to try it just yet in fear of seeing bad results and letting the mind anxiety take over again. Anyways, hope all is well for everyone,

Grunt
gruntjg36
 
Posts: 35
Joined: Wed Jun 19, 2013 1:13 pm



  • Site Supporter

Return to Sleep Apnea Oral Appliance discussion

Who is online

Users browsing this forum: No registered users and 1 guest

cron