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Newly diagnosed. Dr. Recommending oral appliance instead of CPAP
#21
(07-26-2014, 10:56 PM)Doc J Wrote: I think any oral appliance that displaced your jaw (I am assuming that's what it does) would hurt. But what do I know I have not tried it, sounds like a cramp waiting to happen. Cpap is no picnic so it's up to you. I didn't have a choice and I am happy for Pap and that it works.

yes, it would, and may cause or exacerbate TMJD.

I had a dental appliance that was meant to *help* with TMJD by moving the jaw forward - which is what these do... The pain that caused in my jaw was a major bell ringer. The pain subsides, but I have never been able to chew properly since wearing that stupid thing! (it has been > 30 yrs since I had it!)
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
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#22
Don't waste your time and/or money with the oral appliance. I went and bought one ($2200) out of my pocket and it did NOT work. It caught all my saliva and made me drool (lol) and I could not swallow easy, much less fall asleep with the infernal thing in my mouth. Luckily the provider gave me a partial refund, but still cost me a lot. Just sayin..

Mark
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#23
Just my opinion but the oral appliance is a high risk option that should not be allowed to be offered
Speaking as one whos cardiac health was severely damaged by untreated SA its not worth the risk.
Unless your being monitored nightly for O2 and apnea you could well be suffering both nd have no idea you are.
Oral appliance seldom works anyway, and is simply milking your insurance.
Go with cpap. You will wind up there anyway.
But you wont suffer serious damage to your health on cpap where you very well may with the oral appliance.
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#24
(12-13-2015, 11:50 PM)Ghost1958 Wrote: Just my opinion but the oral appliance is a high risk option that should not be allowed to be offered
Speaking as one whos cardiac health was severely damaged by untreated SA its not worth the risk.
Unless your being monitored nightly for O2 and apnea you could well be suffering both nd have no idea you are.
Oral appliance seldom works anyway, and is simply milking your insurance.
Go with cpap. You will wind up there anyway.
But you wont suffer serious damage to your health on cpap where you very well may with the oral appliance.

Ghost,

What I previously posted on the forum:

"""This is a study from 2011 with 805 partipants comparing the effectiveness of fixed to adjustable dental appliances which were alot more effective in getting the AHI below 5 for mostly mild to moderate ranges.

https://advancedbrainmonitoring.app.box....7pjn8s11y4

Now it would be great to see an updated study but I don't think you can just throw this out the window.

I do agree that pap therapy should always be the first option tried and that is what I would have also recommended to the OP. But there are many people who have difficulties with it in spite of trying everything possible to make it work and this is a reasonable next option to try as long as there aren't any contraindications.

You're right about there not being able to measure whether you are having an apnea or not. But then again, if a person can't tolerate pap therapy, there is nothing to measure, right?

49er



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#25
(12-14-2015, 04:04 AM)49er Wrote:
(12-13-2015, 11:50 PM)Ghost1958 Wrote: Just my opinion but the oral appliance is a high risk option that should not be allowed to be offered
Speaking as one whos cardiac health was severely damaged by untreated SA its not worth the risk.
Unless your being monitored nightly for O2 and apnea you could well be suffering both nd have no idea you are.
Oral appliance seldom works anyway, and is simply milking your insurance.
Go with cpap. You will wind up there anyway.
But you wont suffer serious damage to your health on cpap where you very well may with the oral appliance.

Ghost,

What I previously posted on the forum:

"""This is a study from 2011 with 805 partipants comparing the effectiveness of fixed to adjustable dental appliances which were alot more effective in getting the AHI below 5 for mostly mild to moderate ranges.

https://advancedbrainmonitoring.app.box....7pjn8s11y4

Now it would be great to see an updated study but I don't think you can just throw this out the window.

I do agree that pap therapy should always be the first option tried and that is what I would have also recommended to the OP. But there are many people who have difficulties with it in spite of trying everything possible to make it work and this is a reasonable next option to try as long as there aren't any contraindications.

You're right about there not being able to measure whether you are having an apnea or not. But then again, if a person can't tolerate pap therapy, there is nothing to measure, right?

49er

I tend to not put much stock in studies that dont make much sense.

There are studies that say cpap is superior to auto pap which is silly. At very least one can set auto to their straight cpap pressure as min then give 2 cm hgher for max as a hedge against residual events..

Now there is the point if a person simply cant use pap for some reason where an oral appliance is better than nothing , if it works at all. Which there is no way of knowing..
A one night study really cant tell one much as we know as far as whst is actually going on night to night.
Uf a person cant use pap then try oral appliance. But jimo it should never be offered as the first option.

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#26
My $0.02 - I did try an oral device first, while I was waiting to see the sleep Dr. It did help - in fact, I saw a dramatic improvement in the first night, but I was sure it wasn't doing enough. For me, this was just a side-show while waiting to see the sleep Dr.

While my crappy Obamacare health plan doesn't cover DME at all, what it does cover is sleep studies! So along the way, I asked the sleep Dr. if I could repeat the diagnostic study with the oral device in place, just to see what it DID do - and she agreed. In the study with the oral device in place, my AHI was about 1/2 of what it was untreated (28 vs 57). That's a big improvement, but clearly not a replacement for PAP.

I already had TMJ issues, so I was keenly aware of the potential for making my TMJ worse - for me, that didn't happen, but I didn't use the device for years, either - just a few weeks. Since getting my machine I've been using the oral device for one or two-night trips away from home, and it seems it's good enough for that. If I go on a longer trip, I expect I'll be hauling a machine along with me (that backup machine that I haven't gotten yet).

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#27
I also vote for CPAP.
The dental solution is just a money pit in most cases so
take your time and $$ and put it on something that is proven to work (as long as you use it properly)

Cheers & good luck!

Wink
"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
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#28
When I only knew that I was snoring badly, my orthodontist had an oral device for me by the leading company for these. I found that it helped with the snoring a bit, but not all according to my partner.

My main concern is that they do tell you, and make you sign a waiver that it could permanently change your bite and dentition, but I didn't think it would happen so quickly to me. Over the course of approximately 8 months my jaw advanced forward to the point that none of my back molars touch each other anymore, chewing is not effective, and there is pressure on my front teeth which is the only place touching anymore.

Two dentists I know tried the oral device too, but x-rayed after a few months and when they saw the bone changes went to CPAP.

I have severe OSA, original study was 41 AHI. With a mild case it might work. But, if you do decide to try it, please follow up with dental x-rays so you and your doctor can monitor any changes in your jaw and teeth. Changes are permanent unless you do Ortho.

Good Luck!
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#29
I've tried a doctor-provided and fitted oral device. While it is certainly better than nothing on a camping trip, it is pretty uncomfortable. Takes about an hour to get jaw back in line in the morning. CPAP took about a month to get used to...9 years ago. If you're like me after I discovered the benefits, you won't go a night without the CPAP. I sleep like a baby.
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#30
There is a very big reason the people who sell these devices advertise like crazy. I have never seen or heard an ad on the radio for cpap but I hear them all the time for dental appliances. Hmmm...
Coffee
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