Side Effects of Oral Appliance Therapy

Possible side effect with OAT treatment of OSA 

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

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 that are mostly short term. They 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.

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.

OAT is non invasive and alternative treatments (CPAP, implants and surgery) are available.

Full list of possible side effects are

  • Excessive salivation
  • Dry mouth
  • Tooth and jaw discomfort
  • Temporary bite changes

Some patients experience potential complications such as:

  • Jaw pain
  • Permanent changes to your bite
  • TMJ symptoms

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 and resulting forward bite position from wearing the MAD all night.


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