SomnoGuard® AP Fitting
If your from Vancouver, B.C. area and you require dentist fitting, please contact us. Patients with sleep apnea should be able to extend the lower jaw at least for 7mm (millimeters). The pack of SomnoGuard® AP includes:
- two soft separate thermoplastic copolymer pieces (the upper and the lower trays are each made of two components)
- storage case
Mouthpiece before fitting:
Mouthpiece after fitting:
SomnoGuard® AP has been developed to reposition the lower jaw forward from 0 to approximate 10mm (millimeters) depending on the length of the adjusting screw used. At the same time a restricted sideward movement is possible. Due to the advanced lower jaw position the upper is wider and can breathe more easily without snoring. In addition nocturnal breathing arrests are reduced. SomnoGuard® AP allows you to breathe through your mouth when you have difficulties breathing through your nose - useful if you have a cold.
- The part with the guide bar ("C-bar") for the bolt head and the engraved line into the thermoplastic material characterizes the upper tray designed for the part for the upper jaw ("upper part-tray").
- Immerse the upper part for 3 to 3½ minutes into a saucepan of about 1 liter of boiling water around 7 cm deep. As the device heats up the thermoplastic filling becomes clear and the device rises to the surface.
- Take the upper part out with a tablespoon and allow cooling for 15 seconds. Make sure that the temperature of the device is acceptable for fitting whilst being hot enough to allow the mouthpiece to be molded.
- Fit the upper part to the upper jaw and make sure that the front teeth are pushed firmly to the front. Bite the plastic through to the base of the device within the 15 seconds of removing the device from the water bath and maintain this position for about 10 seconds. Remove from the mouth and insert into cold water.
- Heat the lower part with the smallest screw fully tightened (10mm millimeters) in the same manner as the upper part. The position of the screw corresponds approximately with the normal jaw position.
- When the lower part has cooled down for 15 seconds connect both parts, put them into your mouth and bite the plastic of the lower part through to the base of the device. After a few seconds take the whole appliance out of your mouth and insert it into cold water. Put the device into your mouth again in order to confirm the correct fitting.
- By turning the screw you can adjust the protrusion. The notches on each side of the screw are at 4mm intervals and staggered so that the distance between a notch on one side and the next notch on the other side is 2mm. Move the lower jaw forward approximately to half the maximum extension possible (see figure 3 which shows the desired position).
- The stainless steel adjusting screws are 12 and 16 mm long. For safety reasons the screws should be tightened as far as possible, but so that the thread is always a minimum of 7 mm into the 9 mm long device, but never extending out of the front.
- If necessary you can repeat the fitting. Heat the parts again so that the mouthpiece becomes soft. Push the material into the channels with your fingers and repeat the fitting.
- To improve the fit place the molded top and bottom trays separately into hot water for 10 to 15 seconds. Put the trays together. Position the device in your mouth using the impressions created by the former fitting. Then suck in any saliva and your cheeks against the device. Massage your cheeks so that the device moulds to the shape of your gums and arches. After about 45 seconds remove the appliance. You can repeat this procedure at any time to increase the retention of the device. Make sure that the appliance allows for side to side movement of the jaw and it feels comfortable. If it does not feel comfortable start the fitting again.
- While fitting the bottom tray material from one tray may become stuck to the other, limiting side-to-side movement. You may need to trim off any excess material on any part of the appliance with a pair of sharp scissors. Place either the top or bottom tray back into the hot water for 10 seconds to soften the material for ease of cutting. Any rough edges may be smoothed with a wet finger while the material is still warm. It is recommended that you keep the off-cuts of any excess co polymeric material; you may need them to fill up the trays of the appliance if a future refitting is necessary.
SCALE ON THE LOWER TRAY --->>>
The c-bar is the track part for the screw thread of the part for the lower tray and allows to adjust the advancement of the lower jaw forward a range of 0 to 10mm (millimeters) ("lower part-tray"). With the locknut included in the pack a specific protrusion can be ﬁxed. The locknut should then be put on the adjustment screw and ﬁxed lightly against the housing using the spanner.
The first weeks with your mandibular advancement device:
Maximum comfort may not be immediate. Allow a two to three week adaptation period. During the first few days you may not be able to keep SomnoGuard® in your mouth the whole night, or the mouthpiece may fall out during the night. This is normal so don’t give up straight away! It is important to suck on the mouthpiece while putting it on to get rid of the accumulated saliva in the channels of the appliance. This way the retention on the teeth is improved. With time you'll get used to SomnoGuard®, it will become more comfortable every night. However you should normally expect initial discomfort from the mouthpiece around the teeth and the joint areas. The uncomfortable feeling disappears within the first few minutes of taking SomnoGuard® out of your mouth. If you use SomnoGuard® regularly, the feeling of a foreign body in your mouth will completely disappear within a few weeks. In most patients there are no significant side-effects during the adaptation period, so do not give up! In a few weeks you and your partner will be very satisfied with the result.
If you have a receding chin (retrognathia), full dentures or have missing teeth, consult your dentist before using SomnoGuard®. In the minority of patients, use of the mouthpiece can cause joint pain. This is temporary. If you feel acute pain in the joint area with a SomnoGuard® appliance, or if the pain persists, stop using the oral appliance immediately and consult your dentist or doctor. Do not use your SomnoGuard® device if you already have jaw joint problems. If you have difﬁculties breathing through the nose (e.g. when you have a cold) make sure that you can get enough air through the mouthpiece. If you feel that you won’t get enough air, you should not use your SomnoGuard® until you have fully recovered and can breathe normally again. If you have a blocked nose, do not use this appliance before consulting your doctor.
If you grind your teeth during sleep (bruxism), the life span of all SomnoGuard® appliances may be reduced considerably. Users of the two-part SomnoGuard® AP are advised for safety reasons to thoroughly check the appliance every morning for uncommon changes (e.g. cracks, bending of the adjusting screw, etc.). You must not use the appliance if it is damaged in any way, but should consult your dentist about therapeutic alternatives especially designed for bruxists.
Users of medical gases (e.g., oxygen) should consult their doctor before using the SomnoGuard® oral appliances. Remove the SomnoGuard® appliance from your mouth before eating or taking medicines. On special request screws and locknut made from biocompatible titanium are available for those who suffer from allergic reactions to stainless steel.
Consult your dentist before using SomnoGuard® if you suffer from gum disease or other dental problems.
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