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Overview of oral appliances

Oral Appliances are plastic devices worn over the upper and lower teeth, similar to an orthodontic retainer or mouth guard. Worn during sleep, oral appliances prevent the soft tissues of the throat from collapsing and obstructing the airway. The appliances move the lower jaw slightly forward, bringing the base of the tongue with it, opening the airway to allow improved breathing, reduced snoring and fewer apneas during sleep.

Oral appliances can be used alone or in conjunction with other means of sleep apnea 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 there are at least 40 different designs of oral appliances available to specially trained dentists to treat snoring and sleep apnea.

At The Orofacial Pain Center we use four different mandibular repositioning appliances as primary treatment.

The Herbst appliance
The Herbst Appliance is a mandibular repositioner that has been in use for many years in orthodontic and TMJ therapy prior to its modification for treatment of sleep disordered breathing. Using a telescopic sliding tube connection between the upper and lower retainer portions, the Herbst permits lateral and vertical movement while maintaining the desired mandible-forward position. It is sturdy and fully adjustable to find the most effective and comfortable position. Adjustment of position is quick, easy and very accurate. Base materials available include thermoactive and soft materials as well as hard acrylic, with retention by friction grip and optional clasps.

   

PM Positioner
The Adjustable PM Positioner is a mandibular repositioning appliance designed for use treating snoring and sleep apnea. With bases of a thermo-active material fitting over the upper and lower teeth, expansion screws on the left and right cheek areas control the anterior-posterior positioning of the lower jaw to achieve optimal effectiveness with comfort. Some lateral movement is possible and the tongue space is unobstructed.

   

Thornton Adjustable Positioner
The TAP Appliance uses thermoplastic bases and a unique adjustable bar and hook arrangement in the front of the appliance to achieve effective positioning and comfort. The custom designed bases are well retained through frictional grip on the teeth, the hook from the upper engages the bar on the lower and the projecting handle is rotated to attain the desired forward position. Some lateral as well as a little vertical movement is possible, and all of the adjusting mechanism is located at the front of the appliance.

   

Klearway appliance
Klearway™ is a fully-adjustable oral appliance used for the treatment of snoring and mild to moderate Obstructive Sleep Apnea. Fabricated of thermoactive acrylic resin, Klearway becomes pliable for easy insertion and conforms securely to the dentition for an excellent fit while significantly decreasing soft tissue and tooth discomfort. Small increments (0.25mm) of forward lower jaw advancement are initiated by the patient under the direction of a dentist and this helps avoid rapid jaw movements that can cause significant patient discomfort. The appliance does not encroach on tongue space.

Once warmed under hot water and inserted, the acrylic resin hardens as it cools to body temperature and firmly affixes itself to both arches. Lateral and vertical jaw movement is permitted which enables the patient to yawn, swallow, and drink water without dislodging the appliance.



# FAQ's About Oral Appliances # Possible Side Effects# Effectiveness, Rationale and Indications

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