Teeth Grinding and Sleep Apnea

[hookedonstitch]

Daytime mouth guards are for people that unconsciously grind or clinch their teeth during the day.

I started using a mouth guard when I first found out I was grinding away surface of my teeth.  There is bigger issue that can develop, which is tmj or craniofacial issues from clinching.  That's the most important reason for me to wear a mouth guard, so that my jaws can last longer.  Splints for tmj is much more complex to get right.  Because if the splint is not right for the person, problems can develop.

My jaw hurts more on the left side than the right side.  I get headaches and I am grinding.  I have arthritis in the jaw sockets.  I just think it must not be adjusted properly.

[hookedonstitch]

I have a severe TMJ disorder, and have had TMJ for over 35 years. I wear a dental appliance, similar to a nightguard, to stabilize my bite and my jaw joints. I wear it 24/7, including for eating. It is only out of my mouth to brush it and my teeth.

There is a period of getting used to a dental appliance. However, you should NOT be having problems with a gag reflex or severe pain when wearing it. 

The gag reflex means that the appliance is too big, it goes too far back on the back teeth, or that it is covering too much of the roof of your mouth (again, going too far back). 

The pain means that the appliance is not adjusted correctly for your bite. Did the dentist just hand it to you and say "Here it is. Wear it"? Or did he place it in your mouth, and then check and adjust your bite using two-sided paper that leaves marks on the appliance, so he can see how your teeth hit the appliance? If your dentist did not/does not adjust your appliance, fire him immediately and get a new dentist with more training and experience!! Even if he did adjust it, it is obviously not right and you need to insist that he works with you to make it right.

I started CPAP treatment about 9 months ago. I have found that since I can now breathe at night, I am grinding and clenching my teeth at night much less. My dentist can tell the difference when I go in for adjustments, because I don't have grinding marks on my appliance! I hope the same happens for you. 

Best,
Robin

Hi Robin, it's even difficult for me to get a dental x-ray done due to gagging.  It was awful having my teeth scanned for the nightguard too.  I don't know why it's so bad but it is.  This is my 2nd visit for adjustments, I have another one in a couple of week s but will probably call to come in sooner.  I feel like it is too bulky in my mouth and my teeth don't sit right especially when I am laying down.  My Dentist has fit it in my mouth, filed it down in parts and had me tap on some paper but it still feels awful.  I have put off getting one for years because I had a feeling it would be a difficult thing for me to adjust to.  Having anxiety issues isn't helping.  

I will keep at it, hopefully it will be like adjusting to CPAP.  Horrid at first but now I wouldn't sleep without it.  I appreciate everyone's feedback!

[readingteacher]

Hi Robin, it's even difficult for me to get a dental x-ray done due to gagging.  It was awful having my teeth scanned for the nightguard too.  I don't know why it's so bad but it is.  This is my 2nd visit for adjustments, I have another one in a couple of week s but will probably call to come in sooner.  I feel like it is too bulky in my mouth and my teeth don't sit right especially when I am laying down.  My Dentist has fit it in my mouth, filed it down in parts and had me tap on some paper but it still feels awful.  I have put off getting one for years because I had a feeling it would be a difficult thing for me to adjust to.  Having anxiety issues isn't helping.  

I will keep at it, hopefully it will be like adjusting to CPAP.  Horrid at first but now I wouldn't sleep without it.  I appreciate everyone's feedback!

It sounds like your dentist has some expertise in this area, which is good. Many don't have enough expertise but do these appliances anyway!

The position of your jaw drops back when you lie down, so the appliance needs to be adjusted both when you are sitting upright and when you are lying down. My dentist (who is the best I have ever had in all these years of dealing with TMJ) makes the main adjustments first when I am sitting upright.  Then, he reclines me in the chair and has me relax and let my jaw fall back, and makes any further adjustments needed for lying down. Works like a charm. So if your dentist is not doing that, you might give it a try.

Wishing you the best. Hang in there!

[Doublereeder2]

I've worn a night guard for many years. The first one didn't fit well and I couldn't keep it in my mouth so I gave up (I was in my 20's). Years later and a different dentist, I have one that fits great. Now I never sleep without it or the CPAP. 
I hope you can find one that works for you.

[Rice95]

I wear a mouth guard. I've heard that when using a cpap the grinding may diminish or stop. I don't know why this would be true? I wear a FFM and my mouth is 'blown open" at night because I'm a mouth breather. I don't know if the air pressure is reducing my chances of closing my mouth and grinding or not?

I would love not having to use it. It's one more thing on my face so to speak. 

[CorruptAlligator]

@rice: It makes sense for mouth breathers. But, I don't know how body reacts by grinding or clinching when deprived of oxygen? How did they figure this out?

It's interesting that so many of you on this board uses mouth guards. I wonder how common it is for members that use CPAP or has mild or worse sleep apnea has had issues with grinding or clinching?

[gettingbetter]

Just speaking from my own personal experience.  I've had TMJ dysfunction for 30 years, and have tried several different mouthguards, Invisalign braces to align the bite, and physical therapy.  Also, I'm currently trialing a Mandibular Advancement Device to stabilize my bite/TMJ dysfunction (not to replace CPAP but used in conjunction with CPAP).  Not sure I'm all that sold on the MAD.

Over the years, one of the biggest things that has helped my TMJ dysfunction is physical therapy.  MY TMD seems to occur in conjunction with forward head posture and weak/tight upper back/shoulder/neck muscles.  In my situation, all of these muscles play a role in stabilizing the position of the TMJ joint.   I will say that introduction of CPAP and use of the FFM has flared the TMJ pain.  Hopefully we will all experience less grinding as we use CPAP for a longer period of time.

[CorruptAlligator]

@gettingbetter

I've been reading quite a bit about the negative effects regarding Invisalign and how it can exasperate TMJ issues or create one.

I've noticed variations in splint devices used for TMJ purposes. I've seen splints of various thickness from very thick to really thin. I've seen splints made of different material types. I've seen splints molded to have shape of the top teeth at the bottom surface, flat surfaces, etc... Regular dental appliances for grindings are generally similar.

I've realized different clinics have differences in how they approach treatment it's based on what they believe would help. An orthodontist would tell me correcting the bite by aligning the teeth will solve it, but this may either be due to his area of focus or for business.

Another TMJ doc would have you see a neurologist and phycologist.

I understand the upper-back around neck area muscles effect head tension and headaches, with the craniofacial symptoms. I have a strong upper-back, and I was told not to strength exercises. Told me swimming is best for me. I generally do cardio mainly.

[gettingbetter]

@corruptalligator:

It's an inexact science.  What works for one person, may not necessarily work for another person....hence a multitude of treatment options.  Here's to hoping we all find that thing that works to alleviate our jaw pain and headaches.

[RNeil]

I have worn the same guard on my upper teeth for about 40 years. My dentist explained that the guard on the uppers also protects the lower teeth. If I go on a trip and forget the guard, it feels odd to go without it.