Teeth and jaw alignments problems

[DPcarer]

Hi, my friend has bulbar onset and now at the stage of total head drop. More often than not his lower jaw will go forward meaning his lower teeth are resting in front of the upper ones. It's very unpleasant for him. Over the weeks he can feel his front upper teeth loosening because of the pressure that is now always on them. Has anyone else got experience with this perhaps?

At night time it's very difficult for him to find a position in bed that's comfortable. Having to ensure that the lower teeth and jaw are placed back behind the top teeth. But with gravity it's very easy for that to slip. His tongue is paralysed too of course so biting that is a constant risk too.

Has anyone ever worn a strap perhaps that holds the lower jaw back? Or are there any ideas that we might not have tried?

Thanks for your insight...

[Ellie]

What about a mouthguard for his upper teeth? I wear one in bed, made by my dentist, so it's a perfect fit.

A chin strap can help but it usually has to be quite tight to hold the jaw aligned, can be almost scary to wear if one had respiratory insuffiency and, if the wearer cannot take it off, is a choking risk should they vomit.

[Mary C]

DPcarer
I can’t begin to even imagine how awful that feels.What a cruel disease.
Can the palliative care team offer any ideas?or dentist?( Could palliative/ hospice team discuss with a dentist how to resolve this issue asap?
At night in bed it must be so scary…surely somebody will have been experiencing similar and can offer advise.
If in that situation I would be asking neurologist, respiratory team dentist, hospice and everyone involved in your friends care to try and get some comfort .
So sorry and hope you get some answer for your friend soon.
Best wishes
Mary

[Mary C]

@DPcarer
Another thought?..on google there are a few articles about dental problems with MND ..Is there a local dental hospital that has met these problems before…maybe dentist can advise about where and if a referral could be made?
look at article”Dental treatment for a patient with motor neurone disease completed under total intravenous anaesthesia”…who presented at birmingham dental hospital.

Not suggesting it’s same problem but could it be a place to get a referral to or similar facility near to your friends area.
Leave you in peace but have to say It disturbed. Me to think of your friends situation.
best wishes
Mary

[matthew55]

I wear a lower gum shield all the time to save my teeth clashing and grinding. 👀🛡️😀🤗xx

[DPcarer]

Thank you all for your suggestions. Sound like a mouthguard is the way to go. We had tried a rugby style one months ago for when we were out in the wheelchair, but it wasn't suitable at all - difficult to breathe. We'll look into a proper fitted one

[Ellie]

DPcarer There's a notable difference to the wearer between a sport mouthguard and a slim, made to measure mouthguard.

Hope D gets sorted and gets some much needed relief. xx

[John D]

I have an upper mouthguard made by my dentist. £300 which seems to be the going rate round here. Has taken a while to get used to it and don’t sleep with it in.