Avoid Permanent Side Effects of OSA

Richard Sellman — Thu, 17 Aug 2017 07:43:46 +0000

The Two Main Side Effects of Oral Appliance Therapy:

1. The teeth moving apart, resulting in spaces between the teeth

2. The lower jaw moving in to a different position that results in teeth not lining up anymore

Every night before bed you should tap your teeth together to make sure that your bite ALWAYS FEELS THE SAME BEFORE BED. If you feel that your teeth are not coming together the way they used to (usually meaning that your back teeth don’t touch as well), and this occurs for a day or two, GIVE US A CALL.

Before Bed Alignment Check

The Floss Check

Every night before bed you should FLOSS YOUR TEETH. The feeling of passing the floss between your teeth should ALWAYS FEEL THE SAME BEFORE BED, or at least it shouldn’t go from “difficult” (as in the spaces between the teeth are tight) to “easy” (as in the spaces are getting bigger). If you feel that a couple of nights in a row that the spaces between your teeth might be changing, GIVE US A CALL.

The Bite Check

Second, every night before bed you should CHECK YOUR BITE. You’ve probably never given it much thought, but your teeth fit together in a very specific way. You’ll immediately notice that in the morning after wearing your oral appliance that your bite will feel “weird” or “off.” This is to be expected, as your lower jaw is held in a different position all night long, and it takes a bit for your jaw position to return to normal. For most of our patients their jaw will go back to normal on it’s on within an hour or two.

*You can speed up the process of aligning your bite each morning with simple stretching exercises or using the “AM Aligner” that you were given.

*If you ignore these simple steps you could have permanent changes to your teeth or bite that may require correction at additional costs, or could result in damage to and/or pain in your teeth or jaws.

Should you have any questions at all, please call us.

(707) 292-6462 RICHARD SELLMAN, DDS

Side Effects of Oral Appliance Therapy

Richard Sellman — Thu, 17 Aug 2017 07:36:32 +0000

OAT therapy moves the lower jaw and the condyles of the jaw joint downward and forward, holding it that position while you sleep. This stretches open the airway and to keeps your tongue from falling back and blocking your airway.

Initial Side Effects

Initial side effects include jaw muscle, teeth and TMJ joint soreness. As your body adjusts to this nightly thrust the symptoms usually subside. The appliance is initially set at a tolerable 50% of your maximum protrusion in order to minimize this soreness. If needed, the appliance is slowly adjusted forward in order to open the airway and alleviate the symptoms of OSA.

Other Short Term Symptoms Include:
Excessive salivation
Dry mouth
Tooth and jaw discomfort
Temporary bite changes

Long Term Side Effects

Long term side effects can be a slight opening of the posterior teeth contacts caused by the force of protruding and holding the lower jaw forward at night and by a downward and forward movement of the rest position the lower jaw.

You may feel more contact on your front teeth and less on your back teeth. It is however usually less that a 1-2 millimeters after wearing your MAD for several years.

Most longtime users are OK with this as their health issues and symptoms of OSA have drastically improved.

Can Long Term Oral Appliance Use Cause TMJ?

Wearing a custom MAD does not cause TMJ. However, if you have symptoms of TMJ they should be evaluated and treated if severe, before wearing a custom oral appliance. Often people with OSA clench and grind their teeth while asleep and can cause jaw TMJ muscle soreness and premature wear of their teeth. This can be related to involuntary jaw thrusting during apnea events

What is an AM Bite Splint?

It is a thermoplastic material that is softened by heating, and fits over the lower front teeth. When the patient bites down normally on the back teeth, this imprints an impression of how their front teeth come together in a normal bite. It hardens up as it cools. Each morning Dr. Sellman’s patient’s will place the AM bite splint over their teeth after they take their appliance out. It will then exercise their jaw by biting into the AM splint for a few minutes, thus re positioning the jaw in the normal bite. This corrects the stretch in the muscles, moving the bite position forward after wearing the MAD all night.

Long Term Complications

Some patients experience potential complications such as:

Jaw pain
Permanent changes to your bite
TMJ symptoms