Tender teeth

[Cpapian]

Hi all,

I have been using APAP consistently for five months now.   Things have gone really well for me.  I slept the first night for ten hours and have never missed a night.  My first mask worked fine

 I wear a dentist provided night guard on my lower  and have for 30+ years (not the same one). I grind my teeth and have TMJ

Since starting APAP I have noticed two things.  One - some mornings my upper teeth are very sore and tender.  The soreness is from inside the gums and down.   I feel the tenderness when I bite down on food.  The other thing I have noticed is the space between my upper teeth is ever so slightly greater.

They may or may not be related.

Does  anyone have thoughts or insight on this.  My next dentist appointment is not till January.

[srlevine1]

Does  anyone have thoughts or insight on this.  My next dentist appointment is not till January.

I would suggest that you bump up your dentist appointment as pain is not a normal condition and can be caused by a number of things -- some not so pleasant and better treated early rather than later. A few bite-wing x-rays may be appropriate.

As for gapping, etc., my dentist noticed a small realignment of my teeth over time and he attributes it to tight mask straps. I use a four-point headgear with the ResMed Mirage Activa LT mask and I keep it tight to minimize leaks over my beard.

Best of luck with the dentist and a good night's sleep.

[Kryogen]

See your dentist and have your mouth guard and occlusion checked and readjusted if needed.

Opening of spaces at the front could be a sign of an improper occlusion, missing posterior teeth or periodontal disease.

Make sure that your mouth guard is adjusted in centric relation with posterior contacts 20 microns less than front contacts.(barely touching).

Just opinion, see your dntist for real advice.

[Cpapian]

I'll call her today.

No dental disease or missing teeth, possibly a change in my bruxism.  Maybe a new night guard is in my destiny

[Kryogen]

Great, let me know what the outcome is. If you need a second opinion just pm me.

[TBMx]

I am a motuhbreather and grind my teeth as well. (I am using a FFM)
My grinding got better during therapy - not to the point I would say it is gone - but noticeably better.

Regarding the "sore teeth" where there is no mouth-guard: are you absolutely sure, that you are not mouth-leaking (not even a little bit)? (that can cause that - and that plus a not so well sitting nasal-mask / pillow over time can reposition the teeth - for sure not a common thing but it CAN happen)

[Cpapian]

I am a motuhbreather and grind my teeth as well. (I am using a FFM)
My grinding got better during therapy - not to the point I would say it is gone - but noticeably better.

Regarding the "sore teeth" where there is no mouth-guard: are you absolutely sure, that you are not mouth-leaking (not even a little bit)? (that can cause that - and that plus a not so well sitting nasal-mask / pillow over time can reposition the teeth - for sure not a common thing but it CAN happen)

Hi TBMx,

I have figured out a few things (I think).  I generally spend the first part of the night sleeping on my stomach.  When I sleep on my stomach my lower jaw slides forward, just a little bit, so the lower teeth rest against the bottom of my upper teeth.  From that position my lower teeth are pushing my front teeth out.  (Why, I don't know)  If I don't resolve this soon, I guess I would end up with Buck Teeth and/or a big space between my two front teeth.

You mentioned the position of the nasal mask.  I agree.  I tried to position it differently last night to make it higher and closer to my nose.  I think it might have helped in a small way.

I placed a call to my dentist and am waiting to hear back from her, but the receptionist also mentioned mouth breathing as a possible culprit.  To my knowledge, I am not a mouth breather and have been playing with taping my lips to prevent those little air puffs escaping through my lips.  As well SleepyHead isn't noting any remarkable leaks.  Although it seems some time during the night I will have a bunch of large leaks for 15 or 20 minutes, which I assume to be positional.  Maybe when I switch from front sleeping to side sleeping.

I am considering maybe switching my mouth guard to the top teeth.  That might prevent the upper teeth from shifting.

The other thing I thought about was maybe trying nasal pillows/cushions.  They might be lighter.  Just wondering if the weight of the mask is making my lower jaw attempt to push it away.  I tried two different ones to see if I liked them.  But the head straps wouldn't stay in place.  However, I may possibly revisit that as well.

I'll wait till I hear back from the dentist before I make any radical changes.

[Kryogen]

upper arch mouthguard will help prevent upper teeth movement but won't prevent lower teeth movement... so you kind of have to find/fix the issue with your dentist anyway.

[TBMx]

upper arch mouthguard will help prevent upper teeth movement but won't prevent lower teeth movement... [..]

That would be my concern as well.

But as you said your lower jaw is moving forward: I have a really hard time believing that this does not result in some sort of mouth-leak. You mentioned the need for taping as well.

To dry your mouth you don't need to have a large leak - a (somewhat) constant small leak is equally bad for that. (ususally teeth grinding is accompanied by more saliva production (during the time of grinding) - so you might not notice that effect that much)
Your gums do hold your teeth as well - no gums no teeth.
Dry gums means: it can't function as it should.

Maybe you want to rescale your leakchart (to something useful like 0 to 20 liters per minute max) and look really closely for leaks! (not just a quick glance for really large leaks)

[Kryogen]

Not exactly. Bone holds teeth and gums grow on bone... mouth breathing will not result in bone or gums loss.

Excessive or constant jaw pressure could result in some degree of teeth damage, or bone loss, which will result in some degree of gums loss also.