Don’t get mad at the patient; in this case he can’t bite on his back teeth. (The images are not underexposed; his teeth are really this dark). This is the result of long term snore guard appliance wear.
He has been in a snore appliance every night for five years. He noticed some changes in his bite almost immediately but was always able to get back on his back teeth. It slowly changed until he can no longer touch his back teeth.
This is a well-documented sequela of snore guard or forward-positioning appliances and should always be discussed with the patient before making the appliance. Most sleep physicians suggest a sleep study for patients whose snoring is a problem, and if therapy is indicated will prescribe CPAP before a snore guard.
If CPAP fails or the patient can’t tolerate the mask, then a forward-positioning appliance may be indicated. The consequences, of course, should always be discussed prior to beginning treatment.
Stay tuned for my next blog when we talk about treating this condition.
Tags: bite on your back teeth, Bite on Your BACK teeth - Part One, CPAP, No, sequela, snore guard
Good stuff — something we rarely talk about.
I’m looking forward to part 2. I often wonder about this. Thanks Steve
I look forward to hearing what you have to say. As an orthodontist I have seen this happen as a result of long-term wear of several different appliances- “sleep” appliances, NTI appliances, etc. The patient, in each case I’ve seen, has never been warned of this potential problem and often the dentist that prescribed the appliance has blamed this on an undetected discrepancy b/w CR/CO.
this is certainly interesting, I’ve always thought that physicians prescribed cpap because they were not aware of the different snore appliances,which might be true.
Awesome, please keep us posted!
In general I like to work with an earn,nose and throat specialist.