Dental Sleep Medicine Insider September 2015 | Page 15

SIDE-EFFECTS

HAPPEN!

In the last issue of the DSM Insider, I provided you with
some tips about how I handle some of the most common
OAT side-effects including loose restorations, excess
salivation, and joint/muscle pain. Well, now I’m back as
promised. Here’s my encore, Part Deux. Do side-effects
occur? Yup. What are you gonna do about it? Address
them with the tips below and then….GET OVER IT!
Dry Mouth: This is common, especially in our older population due to medications, but usually does not cause a
patient to abandon treatment. Ensure there is a mouth
seal. That should really be a consideration when determining which device to use. If there is no seal, you can reduce
vertical or minimize bulk in the anterior to achieve one. All
of the appliances I fabricate use elastics or have some way
to achieve and promote mouth closure so the jaw will not
open and rotate, potentially compromising the airway.
Also, keep a stock of GC Dry Mouth Gel on hand for the
patients to take home right then and there.
Bite Change: Although bite changes are more common
than I’d like them to be, this almost NEVER causes a patient
to discontinue treatment. I always let the patient know
they can go back to C-PAP, and all of a sudden the bite
change isn’t an issue anymore. When I tell them a bite
change can occur, I say, “A small percentage of patients
even notice and not one of my patients has ever missed a
meal.” Almost 100% of the time the patient responds, “Well
I could use that” as they pat their gut.
Although the jury is still out on morning repositioners
preventing bite change, I ask my patients if they are using
their “chew toy” (as we call them around my office). More
often than not, I get a sheepish look and a quiet “No” from
the patient. Do you know who does notice bite