unintended side effect of my cpap experience

[Grace~~~]

Hello. I have been using my APAP now since May of last year. My stats in sleepyhead show that I am 100% compliant. This makes me very happy. (I still like getting 100% ! Like a happy kindergärtner ) I genuinely FEEL much better. Actually much, much, much better ... but there's all kinds of extenuating circumstances that are probably involved and not just cpap.

I decided to write today and share part of my experience. I did not like my first mask at all but within a month found the dreamwear mask and I have been happy. Is there something better? IDK? I haven't needed really to look yet.

Early on I complained that my teeth hurt. I have always had perfect teeth. No cavities. Best feature. So I was a little concerned. I decided my mouth might be dry so I took extra precautions. Began using rinses. Used mouth wetting mints at night. Decided to get more frequent cleanings. Keep up a crazy hydration program that I am on for other reasons anyway.

...but the worst happened.
(Well ... definitely not the WORST ...but ...)

...I woke up one morning and my teeth had shifted. I know in the scale of things this wasn't a big deal but I went running to dentist
in a 'this is the last straw vanity crushed' panic. The insurance said there was no way I could prove it was the cpap (or mask) so it couldn't be covered under medical and I have no dental.

Almost 50 years of beautiful dental records meant nothing.
Of course I know it is related to cpap. Or the apnea - and possibly tongue position. I never wore braces so why would this occur after experiencing sore teeth upon waking and a few months after starting cpap therapy? (In my case I really don't even know if I had apnea? So that makes an onset of tongue positioning / thrusting AFTER having started cpap therapy question more interesting.)

I don't see this issue mentioned here on cpaptalk often so I think I am in a very small minority.

I didn't fight with stupid insurance. I just paid to have the braces put on and my teeth are almost back to normal already in just 10 weeks. I think I'll have to wear them the rest of the year though. And I think I am going to have to have a permanent wire to keep it from happening again as I am not at all ready to give up my cpap!

It is still a small price to pay for the other benefits that the cpap has given to me. My pulse rate for example is astonishing with this therapy. And there is improvement in my iron, though I am still technically anemic. Just can't break 11.0 ... lol

I am really just wondering what I might have done wrong and how I might have prevented this? And also wondering if others are experiencing dental issues of shifting teeth and if it might be the same mask? I also thought it was the right thing to post and report this to you guys who keep track of all things cpap. I owe you all a huge debt of gratitude and think of you all very fondly almost every day.

[Lucyhere]

Hi Grace... it's nice to see you again! I don't have a problem with my teeth shifting, but I'm sure others who have experienced this problem will chime in.

Great that you are doing so well on this therapy!

[Pugsy]

Over 8 years on cpap using a nasal pillow mask all the time. Of course I wear it/headgear probably disgustingly loose....but no evidence of teeth movement or anything related to the teeth. No discomfort...nothing.
I even did about a year using the Tap Pap nasal pillow mask which uses a mouth guard and nothing happened.

I am not saying that movement can't happen but if it does happen related to cpap use it's very rare and I wonder how much of it is related to the tension of the straps or mask on the teeth. Push on anything long enough with enough force with something and it's likely to move.
There's also the fact that as we age stuff can happen to our teeth and gums that is related to nothing but the aging process.

[kteague]

I've seen this discussed on here before so hopefully those folks will weigh in. It makes perfect sense that even slight pressure on the mouth area for several hours a night could move the teeth over time. I use nasal pillows masks so it isn't an issue for me. I have had dental issues related more to just aging I believe or maybe the dry mouth affected my gum health and was a contributor. But my teeth were starting to loosen and moveable. That was scary. When I started using the TapPap mask for the first couple weeks my teeth hurt, but surprisingly the support stabilized my teeth and they are now as fixed in place as before the problems began. In your case, I'm just wondering if there would be any protective benefit to wearing a general night guard dental device at night, like those to prevent teeth grinding.

[SewTired]

I had perfect teeth for years. Then they started getting crooked and the dentist had no idea. Finally found out at the dental school orthodonia folks that I had developed 'tongue thrust' and was unconsciously pressing my tongue on my teeth. Couldn't afford the braces, so I just live with it.

My dentist also has a cpap and it is his belief, based on some data he has, that children's teeth are far more likely to be affected by cpap use than adults'. However, he also believed an adult's teeth placement could be affected by a mask that is too tight. He has at least one patient with TMJ caused by a cpap mask. Once he got him to switch to a different mask, the TMJ gradually went away. He does not claim to be an expert in this area - until he had his own cpap, his focus had been diabetes since so many of his patients have that.

[Grace~~~]

(Can I add a "please excuse my posting technique" right up front? I've forgotten how to quote and such. I apologize)

Hi Lucy.

Pugsy - I wear my straps loose too, I think? I am NOT sure if it is the mask or me just fighting so damn hard not to leak?
(LOL) I am at least 98.7% positive though that my teeth have shifted due to the cpap use. Though it appears 100% unquestionable that cpap is very helpful for me and thus welcome in my bed every night.

kteague - I asked the dentist if I should add a mouth guard too and he said "I think the braces have you covered but we'll keep eye on it". Seemed reasonable? But I have learned now that what seems reasonable from a doctors lips requires a lot of thinking on our part as the patient. I am obsessed with these braces. I have new accoutrements and rituals ~~~

SewTired- I hope you can get braces if you want them. But beware the adolescent flashbacks. What were your conclusions about 'tongue thrust'? Just why would we start doing that? How did they diagnose this? I am only giving the slightest credence to the idea that I am now 'tongue thrusting'. It was mentioned to me too. So just in case, I do tell my tongue each night as I wax up my braces and begin the rest of the ortho-cpap rituals ... that it is in jail now. Metal barred jail "so just 'lay down".
Where it thought it was 'thrusting to? ' and why?...are probably a questions for a professional.

[jim22]

Braces sounds radical, but ok. Once you get them off, maybe a retainer would keep your teeth in place. I sleep with a bite guard that i had made at the dentist which fits snuggly on my upper teeth. It fits tightly when i put it in before bed, and fits better in the morning, so my teeth do move a little over night. I need it because i am wearing my front teeth, but you could use one just to keep them in position.
Jim

[Doublev]

If your mask pushes against your teeth get a new mask asap! If your sleep position puts pressure on your teeth you need to fix it. It is very easy for teeth to move over time with constant pressure. It is what braces do (except braces try to make teeth straight).

I wore a ffm and this was a big reason for me to quickly move to nasal. The mask definitely would hit my teeth and i know this would be a big issue long term. Good warning to all that you brought up this topic..

So.. is it your mask or sleep position? Should be easy to tell

[chunkyfrog]

My first nasal cushion did that. (Mirage Micro).
Luckily, my teeth moved back in an hour or so.
I changed masks IMMEDIATELY. No further problems.
My doctor wrote a letter of medical necessity, so I did not have to wait for a different mask.

[WearyOne]

I never had actual movement of teeth, but when I tried a Liberty mask (that is almost exactly like the Hybrid that I use all the time), it caused my upper teeth to hurt within 10 minutes. Tried it several different times, same result, so I never used it.

[Grace~~~]

It does seem pretty radical. My mouth is like hamburger and I use a waterpik multiple times a day. Thank goodness for these 'dental threaders' as I couldn't see to get the floss behind the brackets with my 'old lady eyes'. It is also very unattractive.

seriously.

I just got the full metal bracket which was still really expensive. Not the jewelry-esque ceramic type.

As it happens, my current life is divided in to 2(3?) locations so I went to a very top notch dentist first and he broke the news that I wasn't a candidate for invisalign or a simple retainer. My front two teeth had separated and begun to 'splay' slightly. Though most people couldn't notice (as I really still have pretty nice teeth) he said it would probably continue to get worse.

When I went to stay at the other location I decided on a whim to check with a past dentist who had known me since my 20's. I didn't tell him he was a second opinion. He said nearly the identical thing. However, her saved me over $3k with my 'bare-bones ugly braces'. (Sweet guy. Very Kind.)

I brought in my cpap and mask to both dentists both of whom are very pro cpap.

I use the dreamware mask and I try to use it as loosely as possible. I sleep all over the place (literally-lol). I guess my favorite position is mostly on my stomach but usually with pillows under arm and leg. (Kinda that 'hawk / eagle' pose y'all talk about on here as a good thing?) One knee bent. I like the dreamwear mask a lot because I feel I can sleep however I like and it's comfortable-ish. Actually I can drop the ish. Truth-be-told ... I now almost crave the cpap. (I can't believe I can say that but it's true.) I associate it all with feeling good and sleep. I know cpap means such good breathing and deep sleep. The mask is almost forgotten. It almost feels .... natural? LOL - crazy what the mind can do.

The dentist also mentioned this permanent thin wire at the end would act as a retainer and hold the arch if I continued to use the cpap.

My guess is that I am worried about keeping my mouth shut so as to get all the benefits I can FEEL from cpap.
...and somehow in training myself to have a nice tight seal I accidentally began putting my tongue somewhere new?

However, I never had tongue awareness before there was a problem so I really am not certain.

The first dentist explained that if the pressure was pushing at the roots of my teeth just under my nose from the
mask it would cause this 'splaying'. Saying that just the slightest angle could 'open up' your bite.

As it must be apparent to all reading this ...I really don't know why this happened?

I do know though that I have a mouthful of metal now as I type.

[Cpapian]

I have TMJ. Have had for years. I did experience some tooth discomfort in the first couple of weeks, but it went away. I didn't think much of it, just that my TMJ was acting up until we git used to the new apparatus. No significant shifting, but I wear a night guard. Our teeth are probably shifting slightly all the time. After a couple of days with a new night guard, the old one doesn't fit.

[Diamondminek]

my teeth also moved, i have a wire on top as they havent moved as much, and retainer on bottom as they had moved too much for the wire, and i cant afford braces to get them back to normal. should have acted quicker, but there you go.