Patient Instructions
Insertion and Removal
To insert your oral appliance, first connect the upper and lower portions so they are joined together as one piece. Place the appliance in your mouth by positioning the upper portion over your top teeth and seat it fully by pressing upward on the lower arch or back portions of the appliance. Then gently move your lower jaw forward to align your lower front teeth with the appliance, and slowly close your mouth while pressing down on the lower portion to ensure the appliance is fully seated.
To remove your oral appliance, place your thumbs on both sides of the lower portion of the appliance near the eye teeth area or slightly farther back and firmly push upward. Next, place your fingers along the upper edges of the upper portion and pull downward until the appliance releases from the teeth. If the appliance is not connected or the lower portion has already been removed, you may use the “lobster technique” by pinching the appliance at the back molar on either the right or left side and gently pulling downward, then slowly working your way down and around the arch until the appliance is fully removed.
01
The First Week
- No adjustment of the screw mechanism should be made during the first week after your receive your appliance. It is important to allow your jaw and teeth to become comfortable with the appliance in place at night.
- Monitor your symptoms (see the included adjustment journal), including snoring, daytime sleepiness, and sleep quality.
- You may experience increased salivation, drooling, and mild tenderness in your teeth and jaw as you acclimate. If you have concerns, contact our Clinical Treatment Department at 815-599-3082.
02
After the First Week
Adjust the appliance at your own rate (we recommend starting with 1-2 turns every other day). Make turns to the appliance when it is outside your mouth. Insert the key in the front assembly (see above picture) and turn the key in the counterclockwise direction (left). One turn is described as either 180 degrees, TAP to TAP on the key, or a half turn.
The goal is to make the amount of turns advised by the doctor. (____________)
Turns: Every 180 degrees is 1 turn and equal to 0.25mm. Every four (4) 180 degree turns is equal to approximately 1mm. When turning the appliance, turn counterclockwise (left) while looking at the hook. You should see movement from one line to the other on the metal portion of the appliance.
Some patients are able to make these movements faster than others. If you start to feel a lot of tenderness, stop making turns or even turn back if needed. Once you begin making turns again, move a little slower by decreasing the number of turns or increasing the number of days between turns. Be sure to monitor your symptoms as you progress with turns.
KEEP TRACK OF YOUR TURNS AND RECORD THEM ON YOUR ADJUSTMENT JOURNAL
IMPORTANT
WARNING
Keep the appliance away from all animals. It tends to attract them, and the lab does not cover damages from animal interference.
Avoid extreme temperatures: Do not use water that is too hot or too cold when cleaning.
Do not store the appliance in extremely hot or cold environments.
Avoid abrasive or chemical cleaners that are not specifically suggested by our office.
WARRANTY
For 12 months from the shipping date, the lab will repair or replace any device free of charge in case of in-mouth material breakage that is not the result of any modifications that could alter the normal use of the appliance. If new models or impressions are required due to dental work, the warranty is void.
Patients Using CPAP
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If you tolerate CPAP, always start by using it simultaneously with the oral appliance.
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You have been advised to wear the oral appliance alone only during observed naps.
Problems
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Retention Problems: Contact us if you experience retention issues. This may require adjustments or sending the appliance back to the lab. There’s a fine line between too tight and too loose. If the appliance is overly rigid or retentive, adjustments may be needed at your next visit. The appliance may loosen with wear during the first month.
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Jaw Joint Pain: Mild tenderness in the jaw joint, similar to overworked muscles, is normal initially but should not last more than 1-2 hours in the morning. If pain persists into the afternoon, causing headaches or earaches, consult the jaw tenderness handout and contact our office if necessary.
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Tooth Tenderness: Initial tooth tenderness is normal and should not last more than 1-2 hours in the morning. If it extends into the afternoon or lasts all day, contact our office for possible adjustments.
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Increased Saliva Flow: A bit of extra saliva flow is typical at first and will diminish after a few days.
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Dry Mouth: Using rubber bands may help. If dryness persists, consider OraCoat XyliMelts, OraCoat XyliGel, or Biotène Oralbalance Moisturizing Gel. Please call us if the problem continues.
Cleaning Instructions & Infection Control
clHand Hygiene: Hand washing is crucial for reducing infection risk. Follow these steps:
- Wet hands with warm running water.
- Apply soap and distribute it thoroughly.
- Rub hands together for 10-15 seconds, covering all surfaces.
- Rinse thoroughly to remove soap and dry with a clean towel.
Daily Cleaning: Clean your appliance daily for optimal benefit and longevity:
- Clean your appliance immediately after removing it.
- Use a soft toothbrush and recommended soap cleaner (not toothpaste) to brush the appliance, then rinse.
- Dry all parts and the storage case with a clean towel, leaving the lid off to air dry.
- Store the appliance in its case, away from children and pets, and out of direct sunlight.
Weekly Deep Cleaning: Recommended 1-2 times weekly:
- Rinse and lightly brush the appliance.
- Fill your sonic cleaner halfway with lukewarm water.
- Add the cleaning solution and place the appliance in the container. Follow the specific cleaning instructions for your solution.
- After cleaning, rinse the appliance again with cool to lukewarm water, dry it, and store it in the container.
Allergen Note: Some cleaners may contain allergens. Follow the instructions and warnings for the cleaner used. DentaSoak cleaning solution may be preferable if you suspect an allergy.
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Morning Repositioner
30 minutes after removing the appliance, complete the morning repositioner exercises for a total of 3-5 minutes.
Instructions:
- Insert the repositioner onto the upper teeth.
- Bite into the grooves on the lower portion, squeezing your back molars together and holding for 5-10 seconds, then release.
- Repeat this squeezing and releasing for approximately 3-5 minutes, or until the original bite position is achieved.
Cleaning: Always use cool water for cleaning the repositioner, as it is thermally sensitive and will deform in hot water. You can follow the same cleaning instructions as for the oral appliance.
Important Reminders
Your 90 days of included visits and adjustments begin on the date you receive your appliance. Visits outside this period will be billed to your medical insurance.
Return Visit
Your first follow-up will be scheduled 6 weeks from your delivery to check settings and order your follow-up sleep study.
Sleep Study
An order will be sent to the sleep center for an overnight study with the oral appliance. The order will include the settings to be tested during the study. If adjustments are made to the appliance before the study, please inform our office. The order is valid for 90 days; if the study isn’t completed, an office visit may be required for a new order and to verify appliance settings.
Results
Please ensure that Midwest Dental Sleep Center is included on any release of information from the sleep center to guarantee we receive the results. Our office will contact you to review them. If you have not heard from us within 3 weeksafter the sleep study, please call our office. Remember, we cannot assess the appliance's effectiveness until we receive the results; caution is advised when operating vehicles or machinery until then.