

Oral Appliances are placed in the mouth and are worn much like an orthodontic appliance or sports mouth protector. They are worn during sleep to prevent the collapse of the tongue and soft tissues in the back of the throat so that the airway stays open during sleep. The appliances promote adequate air intake and help to provide normal sleep in people who snore and have a medical condition known as sleep apnea. Oral appliances can be used alone or in conjunction with other means of therapy such as continuous positive air pressure (CPAP). Determination of proper therapy can only be made by joint consultation of your dentist and sleep physician.
Currently, over 40 different types of oral appliance are available to specially trained dentists to treat sleep disordered breathing. At first glance, this number appears overwhelming but on close examination each of the appliances falls basically into one of two categories and the diverse variety is simply a variation of a few major themes. Oral appliances can be classified by mode of action or design variation.
Mandibular repositioning appliances are by far the most researched appliances available. They all function to reposition and maintain the lower jaw (mandible) in a protruded position during sleep. It is felt that this serves to open the airway by indirectly pulling the tongue forward since the tongue is attached to the lower jaw, by stimulating activity of the muscles in the tongue and making it more rigid, and by holding the lower jaw and other structures in a stable position to prevent opening of the mouth.
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The Adjustable PM Positioner™ utilizes materials and a design that minimize office chair-time and provide the patient control of adjusting the jaw position under the dentist’s supervision. Research studies have shown that this appliance is successful in treating 77% of patients with moderate obstructive sleep apnea. The appliance fits over all maxillary and mandibular teeth and is made of a special acrylic material (Bruxeze™) that softens in hot water to provide a combination of comfort, strength, and retention. This material has proven to be very durable. Expansion screws are located on the right and left buccal areas to allow maximum space for the tongue and easy anterior-posterior positioning of the mandible to achieve optimal effectiveness. This design permits ample lateral and protrusive movement to maintain jaw comfort. The device uses a unique method of retention consisting of small projections of acrylic within the device that comfortably grip the undercut areas of two posterior teeth in each quadrant. Therefore, no metal clasps are necessary. Clinical Research Associates gave the Adjustable PM Positioner™ its highest rating for appliances tested. FDA Approval: Approved for both snoring and OSA |
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The SomnoMed MAS is a custom-made device, consisting of upper and lower dental plates with a unique patented fin-coupling component, which allows normal mouth opening and closing. If required, a part can be added to make the device adjustable. This feature provides incremental and adjustable levels of lower jaw advancement, which improves the effectiveness and comfort-level of treatment as the jaw is moved only as far as is required to alleviate snoring and reduce OSA. Key features and benefits of the device include: Permits normal mouth opening Allows speech and drinking Provides full lip-seal Easily adjustable Safe and effective Clinically proven Custom-fitted Additionally, the SomnoMed MAS is made from durable fade-proof acrylic that retains its shape and color for at least four-five years and is covered by a two year manufacturer's warranty. FDA Approval received July 2005 |
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The Thornton Adjustable Positioner (TAP®) is a custom-made two piece adjustable appliance that is worn while sleeping. The trays of the appliance snap over the upper and lower teeth and hook together. The design is based on the same principle as cardiopulmonary resuscitation, CPR. The airway must be opened to allow air to pass through the throat. The TAP® holds the lower jaw in a forward position so that it does not shift nor fall open during the night. This prevents the airway from collapsing. The more you pull your jaw forward, the more your airway will open. The TAP® is the only mandibular advancement device that can be adjusted easily by the patient or practitioner while in the mouth. This feature allows the patient to always be in control of their treatment. The unique design also allows the patient to fine-tune their treatment position at home to achieve maximum results. Most patients experience relief the very first night they wear their TAP®. Although it may take up to a week to get used to wearing a TAP® appliance, this is a small hurdle for patients. Nine in ten patients wear the device all night, every night – making the TAP® a highly effective solution for both snoring and sleep apnea. FDA Approval: Approved for both snoring and OSA |
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The EMA® - Custom appliance is a simple, patient-friendly oral appliance created for noninvasive treatment of snoring and OSA. The primary treatment mechanism of opening the bite and gently moving the mandible forward is achieved with the use of interchangeable elastic straps that offer varying degrees of mandibular advancement. The flexibility of these elastic straps provides unsurpassed lateral movement and overall TMJ comfort. The 2 mm thick pressure formed bases offer orthodontic retention (resulting in no tooth movement) and maximum anterior tongue space because there are no projections in the palate. The Elastic Mandibular Advancement (EMA®) appliance uses elastic force to advance the mandible. Hand plastic trays are pressure formed to the patient's models and utilize the undercut areas of the teeth for retention. This insures that there will be no movement of the patient's teeth. Bite planes are used to open the bite. Mandibular advancement is achieved with different length straps. The elastic pull can also be adjusted to suit the patient's musculature. The straps provide complete lateral movement. The EMA® - Custom is available only to dental professionals |

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