Other Factors to consider
The mass majority of orthodontic cases will require long-term retention (using either fixed or removable retainers) to maintain the teeth in their desired (orthodontically corrected) position.
If you are considering orthodontics in the short-term then you may wish to consider completing this prior to getting your Breathe Medical® Device made because once this device has been fabricated, its precise and strong fit should not be adjusted. Furthermore, it will simply retain the teeth in their (ideal) position.
General speaking, well planned orthodontic treatment should improve OSA through a reduction in tooth crowding however excessive tooth extractions can aggravate issues, by encroaching on mouth and tongue space.
Breathe Medical® Devices can provide orthodontic retention because they stabilise the teeth in much the same way as a standard removable orthodontic retainer. The materials used and retention mechanisms are strong and provided they are worn for the recommended amount of time (your orthodontist can advise) then they should function as well as removable retainers.
It is recommended that retainers are worn during waking hours is tooth movement (relapse) is noted. Please discuss matters with treating orthodontist if in any doubt.
Jaws change shape and teeth move throughout our lifespan. The mass majority of this movement finalises by approximately 18 years old. For this reason, Breathe Medical® Device are not usually recommended for patients under the age of 18 years old although there have been some interesting developments in Europe with a new device that is believed to be suitable for those under 18 years old.
Restorative Procedures (fillings, crowns, bridgework etc.)
The Breathe Medical® Devices are precision made and fits very accurately around the teeth. Whilst minor adjustments can be made later, as a rule it is recommended to get all required restorative procedures/ treatment completed prior to it being made. Otherwise there is a risk of reduced retention of the MRD.
Partial Dentures (Prosthesis)
It is usually beneficial to remove dentures at night to allow the soft tissues to rest.
Mandibular repositioning devices can be made to fit around teeth (there can be spaces, due to missing teeth). As a rule, if you have enough teeth to successfully support a partial denture, then the teeth should also provide adequate support and retention for a mandibular repositioning device (MRD).
Full/ Complete Dentures
Whilst conceptually it is possible to construct a mandibular repositioning device in a mouth with no teeth. In general the forces required to move and maintain the lower jaw in the correct position will lead to the lower part dislodging.
A solution that could be considered is the combination therapy of a device to maintain the jaws forward position (maintaining an open airway). Together with a chin strap/ support to ensure that the jaws remain closed and lips together and hence prevent the lower part of the mandibular repositioning device simply lifting up.
These should not present problems; in some circumstances, they may actually aid treatment planning and the overall retention of the actual mandibular repositioning device.
Crowns should not create problems for you unless they are too conical (which can reduce the retention of the mandibular repositioning device). With forethought and planning, crowns can be designed to provide optimal service but also ensure good retention of a mandibular repositioning device (if required). In much the same way that they can be used to help retain partial dentures.
With appropriate planning, there should not be any issues. In fact, the use of a mandibular repositioning device can help to protect veneers form damage by reducing the chance of them being over-loaded at night time. Protective coverings are often recommended for veneer patients to wear at night to reduce the chance of damage.
Please Note: Veneers must be very well constructed and bonded into position to be successful. Veneers that have been poorly designed/ planned will be expected to be de-bonded by an MRD.