Why does my sleep apnea mouth guard make my jaw hurt?

Obstructive sleep apnea (OSA) is characterized by recurrent obstructions of the upper airway, often resulting in oxygen desaturations and arousals from sleep (American Academy of Sleep Medicine, 1999)

Although sleep apnea treatment’s gold standard is a CPAP machine, sleep apnea mouth appliances (or oral appliances) are becoming more popular. The mandibular advancement device therapy is increasingly recognized as a viable treatment for OSA (Aarab, Lobbezoo, Hamburger, & Naeije, 2011; Ramar et al., 2015).

How do sleep apnea mouth guards work?

Sleep apnea mouth guards or oral appliances are custom made by dentists using a plastic-like mold to form to the specific shape of the patient’s teeth and mouth.

Without getting into much detail, most sleep apnea mouthpieces work by moving the jaw forward. This protrudes the mandible and improves upper airway patency by enlarging the upper airway and/or by reducing its collapsibility.

Of note, the mandible is the bottom bone (connected to bottom teeth) that houses the condyles that then create both temporomandibular joints (TMJ) as shown in picture.

Why does my sleep apnea mouth guard make my jaw hurt?

Due to their design, mandibular advancement device therapies exert additional forces on the teeth, oral soft tissues, and the musculoskeletal system. In particular, the mastication system of the masseter, temporalis and lateral pterygoid musculature are highly affected. Collectively, the pain and impairments associated with this area is called temporomandibular disorder (TMD).

TMD is defined as a subgroup of craniofacial pain disorders that involve the temporo-mandibular joint, the masticatory muscle system, and associated muscles and soft tissues of the head, face and neck. The oral appliance could impact both the muscles and joints, or individually.

If your jaw continues to hurt while you wear your device, speak to your dentist or other provider that prescribed the device. A referral or consultation with a manual and rehabilitative clinician, such as a physical therapist, should be considered so you can continue to use your device to get the full health benefit.

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