mouthpiece

Hi!  About 4 months ago I bought a mouthpiece to wear at night for 2 reasons-- one, to help me breathe better, and secondly because I am a jaw clencher.  I don't grind my teeth, but if I sleep in a certain position, I wake up with my lower jaw pushing outward against my upper teeth so hard that they hurt and ache for days.  If I sleep in a normal position, the jaw muscles just ache with no tooth pain.  The mouthpiece solved all that.  And also, any of the occasional bouts of TMJ I would get, stopped.  By this I mean the bouts I would have where I could hardly open my mouth without extreme pain for several consecutive days.  It did not happen a lot, but it was extremely painful when it did.  I have 'clicking' on the right side almost all the time, but it is not painful.

Here's the problem.  This mouthpiece holds my teeth in a parallel position, and I presume I clench like this all night.  When morning comes and I remove the mouthpiece, my bite is affected.  My lower jaw no longer wants to sit nicely behind my upper teeth.  When I am relaxed or concentrating, I find my lower jaw 'automatically' sitting in the position of an underbite.  For several hours after waking, I can't eat things which require the back teeth to be doing a lot of chewing, because they are not meeting correctly.  It wears off as the day goes on, but it still feels forced to put my jaw back in position.  I had not considered before, that I might have a slight natural underbite and the TMJ problems were from forcing it back into a normal bite position.  Is this what's going on?  Is it better or worse to wear the mouthpiece at night?

To add to it, I have a chipped tooth on the bottom front teeth which has been repaired with bonding.  It is always breaking off (like coming unglued)-- no other dental repairs in my mouth have this problem.  Is it related to this bite problem?  What's the solution?

Thanks so much!

[Jerome Tsang, DDS]

Any fillings or crowns done in a clencher or grinder tends to wear or break faster than normal.  When you are asleep, you can bite up to 5x harder than you would normally when you are awake.  Your brain doesn't respond to that intense biting but the mouthpiece helps to trigger your brain to wake up and stop biting so you don't clench at night

Was this mouthpiece made by a dentist?  You can ask your dentist about it and see if you may get a new one which will splint the teeth together in its proper position.  If its a mouthpiece only in the front, it can cause your bite to change.

[jaylee33]

Thanks so much for the info! The mouthpiece is a kind of generic one for sleep apnea (but one you warm and bite to mold to a specific mouth)-- moving the bottom jaw forward increases the air pipe flow.  So, it purposefully holds the teeth parallel instead of normal bite.  It covers all my teeth top and bottom, all the way to the back.  I am not sure in normal bite position, it would do much more than cushion the clench.  Ie- no breathing advantage.  In my case, the mouthpiece has wide pieces of squishy plastic between the molars, so when I clench at night it does not wake me up, but it stops the teeth from touching and absorbs the power of the biting.

I have extensive fillings and bonding (some for 20+ years), but only the one on the lower front teeth keeps breaking.  I was thinking it was because without the mouthpiece, my lower jaw is pushing outwards.

I just can't decide if having the weird bite problems is worth the relief I get at night.  I am really beginning to suspect I have always had a tendency to a natural underbite, but have always pulled my teeth back behind and thus, the TMJ, etc.

Can you help me choose yea or nay?

Thanks!  J.

[Jerome Tsang, DDS]

That's hard for me to comment on.  I would suggest you either go to a dentist and get a professional opinion from someone who can actually see what's going on and put it all together.  If not, you may want to try it both ways but if you have sleep apnea, I would recommend you not stop as you'll get that morning fatigue and exhaustion associated with sleep apnea.  You may also want to see a respiratory specialist to see if they have any recommendations for a mouthpiece which may be better for your alignment.