0857 How To Fix Mask Leak For Those With No Teeth

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Abstract Introduction Mask fit is a crucial factor for patient adherence and effective use of PAP therapy. However, patients using dentures may face significant challenges to achieving a good mask seal, resulting in mask leak and inefficacy of therapy. Report of Cases A 67-year-old male with Obstructive Sleep Apnea (OSA) previously adherent to Bi-level Positive Airway Pressure (BPAP) therapy presented to clinic for complaints of mask leak. Due to a suspected dental infection, he had had all his teeth removed three years prior to this visit and had been instructed by his dentist to remove the dentures each night when he slept. However, removal of the dentures affected the fit of his full-face mask, and he experienced significant mask leak with return of pre-PAP symptoms. He was a habitual mouth-venter and preferred full-face masks. Despite trialing different masks, he was no longer able to tolerate his BPAP secondary to the leak and discontinued PAP therapy altogether. During his visit to the sleep center, a mask refit was performed with and without his dentures in place. While no masks sealed effectively with his dentures out, a satisfactory alternative was found if he wore his dentures. He was counseled to wear his dentures while using PAP, remove his dentures for the recommended minimum amount of time during the day instead of removing them for sleep, and to follow up with his denturist/prosthodontist for further instructions. Conclusion Edentulous patients may pose difficulties with mask fit, and a multi-modal approach may be necessary to effectively treat their sleep apnea. Luckily, our patient was able to find a mask that he found comfortable while wearing his dentures and had minimal leak. Alternatives may include consideration of positional therapy with lower pressures for a potential nasal mask, weight loss, hypoglossal nerve stimulator, or referral to an oral surgeon, denturist, or prosthodontist for guidelines on sleeping with dentures. Close monitoring of symptoms and download data is recommended following oral surgery and switch of mask interface. Support (If Any)