CPAP Has Its Dental Downsides – But It’s Not Necessarily the Only Option for Treating Your Sleep Apnea
By office on Tuesday, March, 17th, 2020 in Airway No Comments
For some people with obstructive sleep apnea (OSA), CPAP therapy can be a lifesaver. But not everyone is a fan. Up to 83% of users don’t use it as their doctor tells them to, sometimes giving up on it completely. They find the mask uncomfortable or claustrophobic. They find it a pain to have to regularly clean the hose and mask or nasal pillows to prevent infection.
There are also side effects that can crop up from this therapy which uses a steady stream of air to keep the airway open – a stuffy nose, for instance, or abdominal bloating, or dry mouth, which which is not only uncomfortable, but also raises your risk of gum disease and tooth decay.
And as research has shown, over the long haul, CPAP can even change your face.
One study tracked 46 CPAP patients for two years to assess the impact on facial structure in long-term CPAP users. The researchers compared cephalometric x-rays of patients at the beginning of the study with images taken at the study’s end. A “ceph” x-ray is one that’s taken outside the mouth and shows the whole side of the head, letting a dentist see the relationship between the teeth, jaw, and profile.
While “none of the patients self-reported any permanent change of occlusion or facial profile,” the ceph x-rays showed changes in the dental arches, with both the upper and lower jaws shifting backwards a bit – something that could possibly worsen apnea symptoms over time.
A more recent case study reported that CPAP usage appeared to cause a patient’s front teeth to shift, creating gaps in her smile.
Follow-up questioning revealed that shifting of the teeth was first noticed in the months following the initiation of CPAP and the result of forward thrusting of the tongue during use. Following 12 months of orthodontic treatment, the malocclusion was corrected and teeth returned to their pretreatment positions.
As if a person needed another reason to avoid CPAP – avoidance led the authors of one paper on the matter to state that the “concept of CPAP as gold standard for OSA therapy is no longer valid.”
And frankly, while many have been helped by CPAP, the therapy is actually a kind of superficial one. As one apnea specialist has described it,
I think CPAP is like a band-aid for sleep apnea. It can be a good short-term answer. But it does not resolve the real issues that are causing the sleep apnea in the first place. It’s like putting a spare tire on your car when you blow it out. They always tell you not to ride on the spare tire indefinitely and to get the original tire fixed.
Fortunately, we have ways of getting to the root cause and actually enlarging the airway – even in adults – so patients can breathe freely through the night again. Applying gentle, intermittent forces to your teeth and stimulating stem cells to help your jaws reach their full growth potential, the removable Vivos DNA appliance actually widens the upper arch so your lower jaw can move forward into its natural position. The tongue and soft tissues are brought forward and the TMJs align properly.
The result is a wide open airway. All you need to achieve it is enough healthy teeth and bone – and a year to two year commitment to both the appliance and supportive therapies that lead to the best results and long-term success.
But you’re not without options even if you aren’t a candidate for Vivos. There are other appliances, called mandibular advancement devices, which help hold your jaw in a more forward position during sleep and keep your airway open. A wide variety of options are available, depending on your specific dental situation, and all are customized to your bite and needs.
If your only issue is snoring, some patients respond well to Nightlase, a laser treatment for widening the airway by renaturing and restructuring collagen so that the soft tissues around the top of the airway are tightened. No anesthesia is needed, and there’s no post-op pain. Results can last up to one year before retreatment is recommended.
But if CPAP is your only real option for treating the life-threatening condition of OSA, be sure your dentist knows so they can monitor your teeth movement to ensure your CPAP mask isn’t negatively affecting your bite or the position of your teeth.
Otherwise, breathe easy knowing there’s a range of therapies out there to suit your needs and address those serious sleep apnea issues!