Dental Health Decline Under CPAP Use

[Phil7]

I'm curious where I stand, like if I'm a worst case example.    

I've been on CPAP for 11 (maybe 12) years now (starting around 40).    My original CPAP prescription was for a static pressure of 13.    My auto CPAP pressure range is normally around 14 now with spikes up into 17 at occasionally (highest peaks are 19 on bad nights)

Up until around 40, when I started CPAP, I had maybe 10 cavities fixed and two teeth replaced with implants (after failed root canals).  I don't think that was doing too bad dental health wise, for a guy with untreated sleep Apnea at ~40.

My dental health took a rapid nose dive, under CPAP use for the last ~11 years.   I recently had all remaining teeth removed, for a lower bridge and full upper denture (for the sucker punch price of $49k total).   I never understood why my teeth were falling so fast.  
Also, I still have a temporary upper denture in, while waiting on the lower bridge to be finished first (3 implants for the bridge).   The All-On-Four temporary upper denture looks like nice teeth in the front, but has a thick ridge in the back where my tongue can't lay flat against the roof of my mouth.  I'm pretty sure this has been making my sleep apena worse, and maybe leading to more mouth breathing issues at night.

$49k for the upper All-On-Four upper denture and lower bridge.  I'd guess all the root canal and implat work before this was easily another $50k out of pocket over the last 11 years.  So, in 11 years of CPAP use, I've lost around $100k on dental work.    Don't be me, save yourself.

[2SleepBetta]

A dumb question, here, with no intent to imply anything. Before CPAP I'd awaken with a hated bone dry "lizard" in my mouth-breathing mouth. Early experience with FFM years back, less so, if at all.

Now a longtime user of  nasal pillows with mouth sealed by Silipos Gel-E-Roll, dry mouth is never a problem. 

So the question arising from all this, are you or have you been a mouth breather or is dry mouth a different matter for you as I understand it is for many?

[CorruptAlligator]

Perhaps issues with bruxism? Teeth clinching developed over time? Teeth clinching can put lots of pressure on teeth and cause teeth to loosen (Gum health contributes as well).

[Phil7]

I've been using nasal pillows for years myself.    I was also not mouth taping for years.   I remember trying a small full mask once, and was violently awaken when my lower jaw fully opened out of the full mask, like I was gasping for air in my sleep oddly.

Also, I oddly still wake up with dry mouth, even when taping now.   I've been taping with BSN Medical Cover Roll Stretch, 4" x 10 yds tape for several nights now, but still having dry mouth issues.  I poke as small hole in that tape, as I've still been to nervous to try mouth taping w/o at least poking a small hole in it.

I tried SomniFix pads, but the adhesive is way too weak on that for me.  The BSN tape sticks really well, but is also very stretchy (so a created small hole can easily expand into a larger hole).   I also never had any advice or help with this stuff.   I had 1 sleep lab study, then was dumped into a medical supplier that just wanted to pass the masks and machines w/o helping me at all.   I got a CPAP perscription from my MD years ago, and have been on my own ever since (which is the way I felt before with the medical supplier and sleep lab anyway).

[staceyburke]

I have used Cpap for 25 years with no dental problems. I’m not sure why the use of pap therapy would have any effect on teeth

[Phil7]

From what I've read, having dry mouth from CPAP use can very easily lead to rapid tooth decay.   I don't recall ever having a dry mouth issue before using CPAP.   For years, I would wake up after using CPAP with an extremely dry mouth.   30+% of all cavities are suppose to be caused by dry mouth issues in general.   There's also suppose to also be something about dry mouth that also increases mouth acidity, which also accelerates tooth decay.

What I know for sure is over 11 years of CPAP use, I had very mediocre dental work over the first ~40 years of my life, followed by a very rapid decline over the last ~11 years of CPAP use into having all natural teeth now gone.

Another note is that by age 55, 51% of people are in a full or partial denture (and ancient humans had bigger jaws that stuck out further and had perfect teeth w/ no dental issues at death).   I remember another study where one Native American tribe had perfect teeth for decades, then corn was introduced into their diets and they started having modern dental issues (burial ground fossil record study).    We're all just pawns of corporate American now, with high fructose corn syrup in almost everything.  Ha.

[Makai1959]

I don’t think I’ve had a increase in cavities, but it did destroy the orthodontics that my parents paid for. My lower teeth are very crooked now.

[Nightynite]

I was always a mouth breather, when I was diagnosed with sleep apnea and spent time researching, I read about the importance of breathing through your nose. I eventually trained myself to breath through my nose and it wasn’t easy. But now I only use a nasal mask and pretty proud of being able to accomplish this challenge.

[SarcasticDave94]

I'm just wondering if mouth breathing was present before PAP and you're just not aware of it until getting on PAP. PAP therapy itself tends to make us highly aware of lots of things we didn't notice before, just due to the addition of PAP and a mask.

Supposing I'm partially correct that you had some dry mouth complications with teeth before PAP and with, maybe your teeth issues are just playing catch up.

You said yourself you do mouth breathe to a certain degree. You tape now, you had a full face mask that moved and you're feeling like you're struggling to breathe, 2 examples of your info that indicated at least sometimes mouth breathing, so I can see dry mouth as a possibly bigger issue than you're aware. It's just easier to blame CPAP. That's my take.

[Phil7]

When I first started thinking about mouth breathing, I didn't catch myself mouth breathing normally during the day.  I've been doing nasal breathing exercises lately, to help with that in case. Youtube wise, I've been liking sarah hornsby's channel (early videos going back years) and anything where Patrick McKeown is talking.

Otherwise, with Nasal Pillows, I'm starting to think maybe I don't have so much of a mouth breathing issue as a 'gasping for air in my sleep' issue.  I first started noticing this, before I tried mouth taping and when test driving a Dreamware full face mask (I did not like that mask at all).  I woke up violently when trying that mask, and discovered my mouth fully open and where my jaw was completely out of the mask. I think that was me gasping and not mouth breathing, but I'm not sure and am taping my mouth every night now.

Since I started mouth taping (back to a Nasal Pillow mask), I haven't noticed an event where I've woken up feeling like I'm trying to fully open my mouth or gasp.