If you have Apnoea it might be time to see a Lawyer!

[Podd]

I had never heard of 'Smashed Face Syndrome' or Temporomandibular disorder but it was 'hinted to' in conversation a while ago, I was talking to a nurse about Sleep Apnoea and I mentioned some of the 'Visual' signs that sometimes accompany the condition like a shirt collar size, overweight (Sometimes) and a receeding chin (It does seem a high proportion of men with Apnoea have a beard, vanity I guess, I have one I must confess).
She then asked if the receeding chin came before or after treatment?, this puzzled me somewhat as I thought it was an odd question but I didn't attach any significance to it.
Well, until now that is as it would appear that the CPAP mask can act as a sort of orthodontic headgear and move the teeth and the upper and/or lower jaw backwards. This effect can get progressively worse over time and may cause Temporomandibular disorders in some patients.
Some of these facial changes have rather creully been dubbed "Smashed Face Syndrome" which may also be associated with the following issues and just one of them may be a sign of Temporomandibular disorder:

Pain in your face, ears, below or in front of your ears or headaches for which your doctor has not found a cause?

Your ears sound muffled or feel blocked?

Your jaw joints located in front of your ears, hurt when you chew and do they make clicking or crackling noises?

Your facial muscles feel tired or stiff when you awaken, during the day, after a lot of speaking or when yawning?

You clench your teeth together while sleeping or awake? A spouse can often tell you about your jaw muscle activity during sleeping.

You have headaches in the your temples?

Are you able to open your mouth freely, smoothly and as wide as you are accustomed to doing?

You can move your jaw from side to side with your mouth open?

You experience episodes when your jaw feels that it locks open or shut?

You feel that your upper and lower teeth don't fit together as they usually do?

Is your bite comfortable? Is chewing tough foods uncomfortable or painful?

You experience dental pain in lots of teeth for which your dentist has found no cause?

Are your teeth chipping and are the front teeth worn flat on their edges?

Do your upper front teeth completely cover the lower teeth when you bite together?

Have your teeth been shifting, creating spaces or crowding for no apparent reason?

So, I suppose the natural conclusion is that Cpap can and in some instances actually alter the way you look and can cause you a whole heap of grief, if this is the case is it time to see a Lawyer?

Disclaimer: I accept no liability whatsoever if you embark along a long and costly litigation and get stung, I do however suggest if you win you make a substantial contribution to this website as it is run by donations.:grin:

P.S I wouldn't insult your generosity by refusing a share either!:grin:

Reference: Chest. 2010 Oct;138(4):870–4. Epub 2010 Jul 8. Craniofacial changes after 2 years of nasal continuous positive airway pressure use in patients with obstructive sleep apnea. Tsuda H, Almeida FR, Tsuda T, Moritsuchi Y, Lowe AA.

[PaulaO2]

Sounds like a crock of bull to me.

This would only apply to those who use chin straps improperly. Else, every US NFL player would have this. Or any kid who has played football since elementary school. Even then, it would only apply to those who wear theirs too tight and for a long time. How long do kids have to have braces? That's a higher and more constant force but even then, it is years. And then they wear a retainer for several more years after that.

This would not apply at all to those whose headgear is, you know, on their head vs under the chin.

I would think that the air forcing the throat open night after night after night would result in the lower jaw going FORWARD, not backward.

I had a much longer post here but deleted it. It became more of a rant that it should have been. (never post faster than your guardian angel can read)

[Podd]

Hi Paula02,
The original article is actually a medical paper (I put a reference at the end of the post just incase anybody wanted to research it)
It was also in reference to masks, not chin straps.

It does however mention noticible changes over two years (At eight hours per night over a two year period comes to 5840 hours)

I cannot see how the jaw can be forced forward under Cpap pressure, biologically I don't think this is possible?

We are all entitled to our opinion, which I respect but 'Sounds like a crock of Bull to me' seemed a bit harsh, but hey that's my opinion!

Podd XXX

[zonk]

where do I sign-up for the class action

[PaulaO2]

Sorry, I didn't mean you were a crock, I meant the theory and the paper were. Just because it is a medical paper does not mean it is 100% the way it is. Give it a year and someone will write a paper saying the opposite. A year later, someone will 'prove' both are wrong. Then add in the variables such as funding source, group parameters, and all that? And don't be so sensitive. Surely you knew that a thread about a medical study was going to either get no response or would be debunked. Most of the time, we read of studies done and just laugh. My money is they find out these folks have this condition because of a common secondary event or condition.

I have used nasal masks, nasal pillows, and tried a hybrid mask. Only the hybrid mask every had anything to do with my mouth and chin. All the others were on or in the nose. I used one for a long time that sat on my upper lip (Swift maybe?) and there was no way it pressed hard enough to move my teeth, even over years worth of use. All of the headgear was on the top of my head or the back. Many of the straps went across the TMJ but I don't see how that minimal pressure would have pushed my jaw back.

I had a really cheap flat band kind of chin strap for about 2 weeks and it held my mouth closed, not pushed the jaw back. It felt more like my jaw couldn't move in any direction.

So I just don't see how CPAP masks would cause a jaw to go backward. How would a mask on the nose cause teeth to shift?

The air pressure from the machine is barely enough to blow up a ballon and not strong enough to actually inflate it. It is blowing down the nose (or mouth) into the throat. That pressure is pushing outward. How would that outward and downward pressure cause the jaw to move TOWARD it?

I have a condition that results in me having hypermobility in joints, tissues, etc. If a mask alone was causing the jaw to move back, then I would know because my TMJ would reflect that. If anything, the opposite has happened. I wake up a lot of nights with my teeth hurting because my jaw is too far forward. My lower teeth are pressing against the upper teeth. Is it from the CPAP? I doubt it.

We have become a sue happy world that rewards people for having no common sense. While at the same time, we are surrounded by objects that assume we have no common sense so for the vast majority of the world, their common sense muscles are atrophied.

Coffee cups that say "contents may be hot". We are apparently universally too stupid to remember the coffee we just bought is, you know, hot.
Riding mowers that won't mow if the transmission is in reverse. Because we are too stupid to know that kids shouldn't be walking behind us while we are mowing.
Step one: remove baby from carriage. No comment on this one.

So when a study comes out that implies something like this? I find it hard to believe.

[Podd]

Ahhh, I totally agree with you, it does seem some papers and reports miss the point entirely.
Have a look at the 'Blurb' for a microwave oven 'Not to be used for drying pets' or on my Fridge Freezer ' Do not stand or balance on appliance' (its over 2metres high?)
I did however find this report quite interesting as it was 'backed up' with X-rays and scans, in a before and after scenario.
A search on Google for 'Smashed Face Syndrome' or 'Bashed Face Syndrome' does reveal a wealth of data, some buy into it, others debunk it, the correlation with Cpap is IMHO 'overwhelming'.
I think the 'risk' is quite small but still a risk all the same, anyway I had to find an excuse for my wrinkles as I don't believe too many late nights on the internet or my ever increasing age could be to blame!!!
I bought a 'George Foreman' lean mean grilling machine years ago and was amazed at the fats that 'Oozed' out of the meat cooked in it, I read a report a couple of week ago that meat cooked this way should be banned as it doubles your risk of Diabetes and Cancer, I have T2 Diabetes already, should I be concerned??
Regarding the Temporomandibular disorder, I think I may be able to sue as I have a beard (To Hide a receeding chin) and as we all 'Know' most women don't trust people with beards as the think they have something to hide. Added to the fact that some HR personell are women, I think this is why I cannot get a job! (Mmm, 90 million dollars at least). Although my facial issues may have been caused by falling flat on my face after seeing if I could fit on top of my Fridge Freezer?
More to the point though, my dog (A Rottweiler) dosn't actually fit in the microwave so that's a pretty stupid thing to put on the instructions? (What is good for dog bites?)
Sometimes I am 'Serious' other times 'Stupid', never ever 'Sensitive' (Ask my wife?)

[PaulaO2]

Off topic: I love love love Rottweilers. I have one and a half right now. Joella is full breed and Mike is half Rottie half something else. I used to not like any full breed dog but got Joella as a rescue adoption to try and train as my service dog. She did great and I fell in love with the breed. Mike is being trained as Jo is now 12.

[Podd]

Back on topic: Well Blade isn't a full blown Rottweiler either, he appears to be crossed with a Retriever although most people can't tell, he isn't a 'Wide' as a Rotty but all the colouring is the same, just not enough body mass, still about 30kg'ish so quite big.
We had just 'Lost' our Boxer through a brain tumour so were a bit depressed as we had to make the 'Call' at the vets.
We visited a friend and a four month old Pup bounded out of the house, my wife enquired whose he was and the friend said 'Yours'. He is just over three years old now, very well trained and takes me for walks every day, he snores like crazy and I actually think he has a form of Dog Apnoea (I really am serious about that), I had to have his 'Buds' nipped as he was a 'Humpaholic' this really calmed him down and he 'Bonded' with one of my Step-Daughters, I am just the dude who feeds and walks him. This was taken on a recent holiday in Wales, he's being fed by a relative (Something I frown on, as he tends to 'Worry' you when you are eating)


Blade being fed by OriginalPodd, on Flickr

[PaulaO2]

We had a cat that I swear needed a kittyPAP. His snore was extremely loud. The vet checked him for polyps and the like but nothing was found. Our big Catahoula mix is a snorer too.

[PollCat]

Maybe that study only covered British CPAP users.