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Facial pain
#1
Facial pain
Hi everyone. This is my first post. I've been using a C-PAP machine for two years and generally I'm doing well with it. I'm much less sleepy during the day and I average between 4 and 6 hours a night on the machine.

I have a question. I've been having pain in the left part of my jaw which includes teeth, under my chin and back by my ear. I have TMJ syndrome and wear a mouth guard at night. I've seen the dentist and was assured that my teeth are very healthy. I wear a chin strap to keep my mouth shut at night. My dentist says I need a new mouth guard. I've had my
current one for at least 20 years. I suspect that the chin strap is causing my lower jaw to be pushed back in my head exacerbating the TMJ. Should I ask for a full face mask? What has been other peoples' experience with this?

Thanks
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#2
RE: Facial pain
I don't wear a mouth guard so I can't address that issue. However the chinstrap shouldn't be worn tight enough to cause pain! Another thing you can try besides a chin strap is a soft Cervical Collar. Both should be worn to prevent the jaw from dropping without adding pressure.
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#3
RE: Facial pain
I have worn a custom mouthguard for a few decades. I don't use it with my APAP for the simple reason that I broke my front teeth on the one I had after owning it just a month. Yes, my bruxism is that bad.

I have also had jaw surgery to advance my lower jaw. This was not an apnea treatment and took place a few decades ago.

I refused to even consider wearing a chin strap as a leak mitigator. It would have jammed my jaws together, a really, really bad plan. I could easily have smashed teeth.

I had to switch to an FFM because I couldn't use a robust enough jaw-flop device to keep from mouth breathing. To me, mouth breathing is a sign my jaw is relaxed and my teeth are not grinding. This is a positive, not a negative.

I should have switched to an FFM way sooner.....Mine is very comfortable and I'm not savaging my jaws. My mouth just does whatever it needs to do.

However, I did study pictures of FFMs (actually of every mask I looked at) to be sure I didn't have headgear that pressured my jaws. I wouldn't have anything that sat on the joint. I used the website of Supplier #1 to help out with photos.

My mask (F10) is liberally bedecked with Pad-a-cheek padding (I like the cotton flannel). This also lightens up pressure in the jaw area. Besides, my mask get-up now looks like the second coming of flower power, hippie mismatch, and twinkly stars. I feel sure this is unique, and what's not to like about making the mask your own?


Questions:

Is your mouthguard on your upper or lower teeth or both? That might make a difference if you want to try a tongue trick to keep air from flying out of your mouth. Personally, my mouth is too small for this trick: my tongue is always in that position. Your mouthguard might make this impractical too.

Have you tried a cervical collar? This didn't work for me, since my mouth flew open anyway (resulting in discomfort and leakage), but it does work for a lot of people. But it also might give you TMJ.

If not an FFM, can you find a mask where the headgear comes in at a different angle?
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#4
RE: Facial pain
If the pain has appeared just since you starting using the chin strap it will be it.
Trouble with chin straps is they do have a tendency to pull the chin and jaw back as well as shut.
The ideal way for the chin strap to go would be straight up to the top of your head, but this will not work, it would slip off and hinder the mask.
It is a difficult one to solve but I saw a video on YouTube where a sleep doctor used a hat and Velcro for a chin strap and it went more vertical than a normal chin strap.
If you do not need the mouth guard, try a night without it, just to see what happens.
 I believe you get softer boil and bite mouth guards over there that you could try at night as well.
I don't think we get them here.  I have not seen any here.
I am NOT a doctor.  I try to help, but do not take what I say as medical advice.


Every journey, however large or small starts with the first step.

Sleep-well
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#5
RE: Facial pain
A boiler mouthguard will not work at all like a custom night guard supervised by a dentist. A boiler will affect your bite. It can exacerbate TMJ. It can't be adjusted if TMJ kicks in.

I've had a custom nightguard that lasted maybe 8 years. My whole jaw would relax. It was adjusted regularly with additional or less plastic. Bargain.

ThisOne....is there anyway you could use your nightguard for a few hours during the day to get your face to relax, so you don't have constant tension? And then use an FFM at night without the guard?

Also, I don't think my TMJ is nearly as bad as it was...I use an FFM. I'm also a noob, so the jury is still out on this observation.


To your original question... If your nightguard is like mine, it has the effect of dropping the chin under, not out. This would increase obstruction in the throat.
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#6
RE: Facial pain
Thanks,Walla Walla. I'll try the cervical collar and see if that helps.

Half Asleep, I'm a grinder,too and I know that that's part of the problem. As I said above, I'm going to try the cervical collar, but will also look into the full face mask. Thanks so much for taking the trouble to tell me of your experiences. Do you have to replace the mask often?
My mouth guard is on my lower teeth.

I'm not sure what you mean by the tongue trick. I do keep my tongue in a certain position at the back of my mouth, so I won't swallow air.

I'll check out the masks. Thanks for the link. Your mask sounds festive!

Sleep to Snore, I have a friend who tried the boil and bite solution ending in tears.

Thank you all This gives me some things to consider and try.

ThisOne
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#7
RE: Facial pain
I tried a cervical collar, but I managed to tuck my chin into it, or simply open my upper jaw above it. Plus, it caused all kinds of problems in the back of my neck. It might work better if I didn't have to sleep on my back.

I have been Papping for about 2 1/2 months. I am on my second mask, the P10 for one month of upsetting mess. Next, for about a week total, I tried both versions of the F20 several nights and tried on three other masks (one of each variety).  and then an FFM, now for about 6 weeks. I don't recommend a fastening right on the jaw joint.

In other words, I've never replaced a mask. My DME let me exchange the P10 (but allowed me to keep it). I evidently get sent a new F10 cushion every month, and other parts of the getup at standard intervals. My cushion does not need replacing at this time, but I am very gentle with any kind  of equipment, so that's not surprising.

Incidentally, I potentially have trigeminal neuralgia (I've had one batch) and I definitely have metal screws at my jaw line. So, my face issues are quite a minefield, but so far, I got the whole APAP getup working!
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#8
RE: Facial pain
Hi ThisOne,
WELCOME! to the forum.!
Good luck as you continue CPAP therapy and I hope you find a solution to your facial pain.
Hang in there for more responses to your post.
trish6hundred
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#9
RE: Facial pain
Chin strap worked fine to keep my mouth shut on my mouthguard.
It made my TMJ pain horrible. I wore it only one night.
I switched to a full face mask and solved the mouth breathing issue.
I don't see the big deal with a full face, it's much better than a horrible chin strap.
I wear my mouth guard with the full face, no problem.
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#10
RE: Facial pain
Thank you for your kind responses. I think I'll probably end up with a full face mask, but for now, I saw the dentist last week and he took impressions for a new mouth guard. I'll see how that goes. If it doesn't help with the pain, I'll see my primary care doctor and ask for a ffm.
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