The Case of the Negative Effect of the Nightguard Sleep TMJ VA Therapy Apnea

In my little world of TMJ disorders I have been acutely aware of the negative effects of wearing upper (maxillary) nightguards for many years now. Years ago, my osteopath doctors explained that the upper hard acrylic devices will actually slow the pumping effect of the blood and CSF in the brain. This, of course, is potentially quite harmful to the body. Being a pragmatist, I did not believe them and asked for articles that confirmed this. Well folks, the closest we got to that was when UVA Hospital confirmed that our brains do indeed have a lymphatic system and if the beta-amyloid ‘crud’ does not drain at night, then you end up with ADD, OCD, and even auto immune disorders. This is what the osteopaths were talking about all this time- they kept telling me that upper hard guards slowed cranial motion. Go figure!

In the Journal of Dental Sleep Medicine, an article entitled ‘The Link Between Sleep Bruxism, Sleep Disordered Breathing and Temporomandibular Disorders: An Evidence Based Review’, posits that an upper nightguard/mouthguard causes an ‘aggravation of AHI and snoring’. This means that the upper biteguard makes snoring and sleep apnea worse. Also documented is a 30% increase in Respiratory Disturbance Index (RDI) when a maxillary guard is worn at night. There was also a 40% increase in snoring with the upper device. Sure, you want to protect the teeth and joints at night, but at what price?

As so many of you already know, sleep is critical to staying health. Without proper sleep our hormones and cells cannot recharge. Our brain cannot function properly unless we get enough sleep. So why would you wear something on your upper teeth that might make sleeping that much worse? Logically, you would not. However, as a dentist, this is what we were taught in school and this is what we use to treat sleep bruxism and grinding. It actually took me a long time to figure out that my upper appliances might be making things worse for my patients. It was a long time ago when I figured this out and ever since I have avoided these upper appliances. Now, even the Journal of Dental Sleep Medicine supports this position. If any of you dear readers are dentists, please heed my warning- take the time to analyze the situation of your patient. Don’t just slap an upper appliance in their mouth and call it good! There very well could be an underlying sleep or even a TMJ problem that needs to be looked at and addressed.

In recent months, as I explain to the new patients that the biteguard they just paid $500 for may not be as great as they thought, I have had their dentist call me and honestly berate me for saying such a thing. Well folks, the research is out there – we all just need to take some time and learn what this research is telling us. If any of the dentists out there want to talk to me about this, I welcome it. Let’s talk how to best treat your patient, what kind of therapy is best, and how to make them live better. Thank you for your time.