What CPAP Mask Should I Use if I Wear Dentures?
By Lily - Registered Respiratory Therapist
If you use CPAP and also wear dentures…
If you are one of the many CPAP users who also wears dentures, I’m sure you’ve had your fair share of struggles trying to find a mask that is comfortable and actually seals.
You try on the mask at your sleep doctor’s or at a local provider, and it fits wonderfully. They may even test the mask by turning on the CPAP machine to see if there are any leaks. They help you adjust the mask and it seals perfectly.
The only sound you hear is the soft hum of the CPAP machine. You are surprised at how quiet it is, and you can’t wait to try out your machine that night. Come bedtime, you prepare for bed, take out your dentures and put the mask on as you were shown.
Then you turn on the machine, and it is loud! Your mask is leaking, and it sounds like you have a hair dryer next to your head. You adjust the headgear straps, tightening them like you were shown and reposition your cushion.
The noise diminishes somewhat but you know you can’t sleep like this. Finally you give up and decide to just go to bed. “What went wrong?” - you ask yourself as you drift off.
Dentures give your face structure
When dentures are removed, your lips and cheek lose support, which may cause your face to “shrink up,” changing your face shape. Since most people do not remove their dentures during their mask fitting appointment at their local supplier, it can be very hard to find a good CPAP mask for denture wearers.
In this article, I’ll give some mask recommendations for CPAP users with different types of dentures (full/partial) and outline the pros and cons of each mask.
Can I wear my dentures with my mask?
Your dentist will recommend you not to go to bed with your dentures. Wearing dentures in your sleep may lead to sore gums and inflammation and can shorten the lifespan of your dentures.
Your gums need to breathe, and leaving dentures in at night puts pressure on the gums, which can lead to the formation of painful mouth sores. Sleeping with dentures also makes it more difficult to swallow your saliva, and you risk developing aspiration pneumonia (pneumonia caused by accidental breathing in of fluid/objects).
Dentures also prevent saliva from coating your natural teeth, causing plaque buildup. The combination of the acidic saliva and oral bacteria (plaque) will shorten the lifespan of your dentures, as well.
Many CPAP users choose to sleep with their dentures because dentures give structure to their faces and improve the seal of their masks. Although dentists don’t recommend keeping your dentures in when you sleep, ultimately it is up to the patient to decide.
They may take the dentures out and render therapy less effective due to mask leak or keep the dentures in and have a better seal but possibly risk gum soreness and oral bacteria buildup.
Hopefully, the mask recommendations in this article will help you find a mask that seals well even without dentures.
I wear (partial) upper dentures
Nasal cushion masks can be a problem because they rest on the area between the upper lip and nose. The nasal cushion can put pressure on the exposed gums after removal of the upper dentures, and this may be painful for some.
The pain can be worse if your new dentures have been rubbing on your gums, leaving them sore and sensitive. Any additional pressure, however slight, on sensitive gums can be very painful.
CPAP users who do not struggle with gum pain can have problems with mask leak once upper dentures are removed. Upper dentures provide support for nasal cushions, giving them a base to rest on so they form a tight seal under the nose.
Nasal masks pose a similar problem as nasal cushion masks. Nasal masks need support from the cheeks and upper lip area, both of which lose firmness when upper dentures are removed.
CPAP users who do not breathe through their mouth or prefer not to use a full face mask should consider nasal pillows instead of nasal cushion or nasal masks.
Although nasal pillows look similar to nasal cushions, they gently push up against the nose and do not sit on the same area of the face as nasal cushions. A popular nasal pillows mask is the ResMed AirFit P10 due to its light weight and minimalistic design.
If mouth breathing is an issue, please wear a chinstrap underneath your nasal pillows mask to prevent mouth opening.
What if I don’t like nasal pillows?
If you find that nasal pillows irritate the insides of your nose or you simply just don’t want anything sitting in your nose, the other option is a full face mask.
If you tend to open your mouth at night and find chinstraps intolerable, then a full face mask is your best option. There are two styles of full face masks: traditional and minimalistic.
Traditional masks have cushions that cover the mouth and extend over the nasal bridge. They do not put any pressure on the area above the upper lips, in contrast to minimalistic full face masks.
Minimalistic full face mask cushions also cover the mouth, but the top of the cushion sits underneath the nose rather than over it. There are holes in the top of the cushion which allow air to flow into your nose.The cushion presses on the same area above the upper lip that nasal cushions rest on and may put pressure on sore gums.
I have full dentures
Finding a mask that doesn’t leak is a challenge for users with full dentures, and clinicians hold differing opinions on what type of mask works best.
Some argue that nasal pillows with a chinstrap provides the best seal while others stand behind full face masks. When full dentures are removed, the face loses the structural support needed to keep the mouth closed and can shrink in on itself.
Air will escape from the partially opened mouth, and this can lead to dryness and even a sore throat in the morning. This is why a full face mask or a nasal pillow and chinstrap combo are recommended.
Both setups have their pros and cons. and it will take some time to find the best sealing mask for you.
A nasal pillows mask with a chinstrap can provide a good seal if the user is able to tolerate a chinstrap. Many people find chinstraps confining and hot, and I recommend starting off with a minimalistic chinstrap like the ResMed chinstrap.
For those who cannot tolerate a chinstrap, a full face mask like the AirFit F20 is a good choice due to the universal fit cushion design and magnetic clips which make it easy to put on and take off.
If you are having trouble getting the mask to seal around the bottom of the mouth, you may want to try smaller full face masks, such as the AirFit F30.
If the full face mask just seems to leak everywhere, I recommend giving the ResMed Mirage Quattro full face mask a try. The Mirage Quattro is an older mask, and you see it in the design. It is bulky and very different from the sleeker, lighter full face masks that are common nowadays.
However, it has a MicroFit dial on the forehead with 24 incremental adjustment settings which ensures the mask contours to your face. The MicroFit dial is unique to the Mirage Quattro and makes up for the bulkiness that is the rest of the mask.
You may want to have more than one mask
It is a good idea to have more than one type of mask at home. You can switch between a full face mask and a nasal pillow mask to prevent the mask from applying pressure to the same spots on your gums.
This can make all the difference if you’re suffering from sore gums. By switching masks, you’re giving your gums a chance to heal and still be able to use your machine at night.
There are many different nasal pillow masks and full face masks available and I encourage you to be open to trying different masks. It will be a process of trial and error, but we at RespShop are here to help you find your best fitting mask.