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Oral Dental Appliance
#11
RE: Oral Dental Appliance
I haven't been able to tolerate a CPAP mask of any kind so I had a custom made mouth splint made by a dental technician AU$750 about three weeks ago. I'm surprised that most of the time I can hardly feel it in my mouth. I haven't had aching jaw muscles or anything but it is pressing slightly on my gum on one side which is noticeable by morning so will get it adjusted. I would expect you will have better fit with a custom made splint than a commercial one.
One thing I was worried about was lack of data - I have severe OSA - my partner bought me a fitbit Charge 2 which measures sleep stages so this is giving me some indication. I'm going to have another sleep study with the oral splint in just before Christmas.
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#12
RE: Oral Dental Appliance
(09-11-2017, 10:34 PM)Romster Wrote: I haven't been able to tolerate a CPAP mask of any kind so I had a custom made mouth splint made by a dental technician AU$750 about three weeks ago.  I'm surprised that most of the time I can hardly feel it in my mouth.  I haven't had aching jaw muscles or anything but it is pressing slightly on my gum on one side which is noticeable by morning so will get it adjusted.  I would expect you will have better fit with a custom made splint than a commercial one.  
One thing I was worried about was lack of data - I have severe OSA - my partner bought me a fitbit Charge 2 which measures sleep stages so this is giving me some indication.  I'm going to have another sleep study with the oral splint in just before Christmas.

Yes, get it adjusted, you should not feel any discomfort on your gums. Will take 5 minutes to fix that.

A properly made and adjusted dental appliance is not uncomftable.
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#13
RE: Oral Dental Appliance
I tried the TAP3 oral appliance because I was sick of waiting for CPAP re diagnosis.  It's been somewhat helpful bit all-in-all, I'd give it a C+.    

It's helped with snoring and has been a bit helpful with apnea.   Easy to get used too but also, over $1000 out of pocket

Have you thought of a nasal pillow mask with a mouth piece stabilizer?
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#14
RE: Oral Dental Appliance
I tried all kinds of nasal pillows and nasal masks. All intolerable.
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#15
RE: Oral Dental Appliance
Kryogen gives good advice re: MAD devices. I had one made a month back and am just now starting to use it. My CPAP pressure isn't enough to completely fix my apnea, and if I go further up with the pressure, I start getting more events (perhaps more central events, this happens to some people).

Read a lot on the research around oral appliances, and they DO work, if they're custom fitted and if you set them at the right level of protrusion.

Reason I had one made in the first place though, is I had a sleep endoscopy done. They found that where my airways collapse (pharyngeal area) is where an oral appliance would most likely help.
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#16
RE: Oral Dental Appliance
My dentist warned me away from the custom made dental appliances early on in my Apnea diagnosis. He told me that the chances of jaw displacement and chronic issues resulting from bite changes after long term use were not worth it and advised me to go the machine route instead. This even though he admitted he could stand to make a LOT of money from making me one.
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#17
RE: Oral Dental Appliance
(09-13-2017, 04:37 AM)dcg494 Wrote: Kryogen gives good advice re: MAD devices. I had one made a month back and am just now starting to use it. My CPAP pressure isn't enough to completely fix my apnea, and if I go further up with the pressure, I start getting more events (perhaps more central events, this happens to some people).

Read a lot on the research around oral appliances, and they DO work, if they're custom fitted and if you set them at the right level of protrusion.

Reason I had one made in the first place though, is I had a sleep endoscopy done. They found that where my airways collapse (pharyngeal area) is where an oral appliance would most likely help.

If your CPAP isn't fixing your Apnea then it is because the machine settings are not set up properly for you.  If you post your sleepyhead data on this forum in a separate thread (see my signature lines on how to do that) we could give you advice and I am willing to bet it would result in your Apnea being very well controlled without the need of any MAD device and the resultant risks of using them.
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#18
RE: Oral Dental Appliance
(09-13-2017, 01:36 PM)Marillion Wrote: My dentist warned me away from the custom made dental appliances early on in my Apnea diagnosis.  He told me that the chances of jaw displacement and chronic issues resulting from bite changes after long term use were not worth it and advised me to go the machine route instead.  This even though he admitted he could stand to make a LOT of money from making me one.

(just my opinion)

(seriously, for all the talk that it requires, and the cost of the appliance itself, all the adjustments, and the recall visits, it's not a lot of money in a dental office. So your dentist probably does not know what he's talking about)

Most dentists are not seriously trained in orthodontics or apnea and so their opinion isn't worth much.
For a serious opinion you need to see a dentist that has good training in orthodontics and apnea, and there are not many.

It might on might not be a good treatment for you, it depends.

Let's say you are slightly class 2 with obstructed airway. A MAD side effect would be to slightly advance your mandible. The side effect would be a benefit. That would make you a good candidate, because it would improve your apnea, and it would improve your jaw relationship.

Just my opinion, but I'm out of this thread now, thanks. It's a cpap forum anyway.
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#19
RE: Oral Dental Appliance
My dentist specializes in orthodontics. Smile But I guess we will just have to agree to disagree.
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#20
RE: Oral Dental Appliance
(09-13-2017, 01:36 PM)Marillion Wrote: My dentist warned me away from the custom made dental appliances early on in my Apnea diagnosis.  He told me that the chances of jaw displacement and chronic issues resulting from bite changes after long term use were not worth it and advised me to go the machine route instead.  This even though he admitted he could stand to make a LOT of money from making me one.

My jaw surgeon who has done over 4,000 jaw surgeries told me the same thing. Long term, a MAD will destroy your joints & bite. My advice to someone young/fit with sleep apnea & wants to use a MAD indefinitely is to just bite the bullet and look into getting corrective jaw surgery, especially if you have other bite issues. It is a touchy subject though because dentists in my experience seem to be very passionate about MAD's, so I would also agree to disagree with someone who like MAD's.
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