Appliances Used in Our Office

We use several oral appliances in our office depending on the size and shape of your mouth and tongue. Dr. Simmons will discuss the advantages and disadvantages of each with you before making a final choice.

• CPAP Pro
  

  CPAP/PRO is a nasal pillow device that is held in place by custom or boil and bite appliance. It may also attach to a mandibular repositioning appliance.

  FDA Approval: Approved for both snoring and OSA
  Date of FDA Approval: Dec. 1, 1999
  FDA Registration Number: K992384

• Elastic Mandibular Advancement Appliance (EMA)
  

  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
  FDA Approval: Approved for both Snoring and OSA
  Date of FDA Approval: Sept. 29, 1997
  FDA Registration Number: K971794

• Herbst Telescopic Appliance
  

  The Herbst Appliance has been proven to be effective on chronic snoring and mild to moderate obstructive sleep apnea sufferers. This appliance allows patients to move laterally and vertically without disengaging the appliance. Also, if it is determined that the initial position does not provide the anticipated relief of the condition, the mandible can easily be moved forward by two options of adjustability. The first option is traditional hardware with sets of 1,2 and 3 mm shims for advancing those increments only. The second being the Telescopic version allowing the clinician to advance in ¼ mm increments by making one full turn of the protrusion collar up to 6-8mm from the start position. The appliance can be fabricated from hard acrylic, thermoactive and soft materials and is tooth retained via friction grip or clasps.

  The Herbst Appliance is a mandibular repositioner that has been in use many years for orthodontic and TMJ therapy prior to its modification for treatment of sleep disordered breathing.

  The greatest advantage of the Herbst appliance is that it allows for very quick, easy and accurate mandibular protrusive adjustability. This is accomplished through simple manipulation of the rod/sleeve plunger mechanism. Vertical opening varies is 5 mm and there is limited freedom of movement for the mandible in a lateral direction. Bilateral interarch elastics are recommended to keep the jaw closed during sleep.

  NOTE: Some clinicians feel that limited lateral movement of the lower jaw during appliance use is beneficial for TMJ comfort while others believe it is of no benefit. Also, some clinicians find compromised effectiveness if the mandible is allowed to drop down even as much as a millimeter during appliance use while others find no difference. These are both areas that require more scientific study. We are presently unaware of the precise effect of these parameters on appliance effectiveness.

  FDA Approval: Approved for treatment of snoring
  Date of FDA Approval: March 20, 1996
  FDA Registration Number: K955822

• OASYS
  

  The OASYS Oral/Nasal Airway SystemT is the first dental device to be reviewed by both the dental and ENT divisions of the FDA and to be approved as a dental device for treatment of snoring and sleep apnea through mandibular repositioning and also as a nasal dilator for reduction of nasal resistance and improved nasal breathing.

  The OASYS Oral/Nasal Airway SystemT functions to:

  • Act as a mandibular repositioner
  • Act as a nasal dilator
  • Allow mouth breathing to occur, if required.

  The OASYS Oral/Nasal Airway SystemT is designed to achieve these functions with the following goals:

  • Maintain maximize the intraoral volume.
  • Minimize the force on the teeth.
  • Have no components that extend extra orally through the lips.
  • To reduce upper airway resistance.

  THE OASYS ORAL/NASAL AIRWAY SYSTEM REDUCES THE FORCES ON THE TEETH BY DESIGN.

  The OASYS Oral/Nasal Airway SystemT fits securely onto the lower arch only. The upper flange extends in front of the upper arch and under the upper lip. This maintains a slippage during mandibular movements during usage. There is a nature give to the wires that creates a yielding give when the mandible pulls back on the device. Provided is an upper splint that distributes the forces through the entire arch. Together these act to reduce the forces on the teeth.

  MAXIMAL INTRAORAL VOLUME

  The OASYS Oral/Nasal Airway SystemT maintains maximal tongue space by positioning the connectors and adjustment components outside of the dental arch leaving the palate and anterior oral space completely free for the tongue to position itself up and forward. There is usually even an open space for the tip of the tongue to go between the incisor teeth.

  SYNERGISTIC FUNCTION FOR MAXIMAL RESULTS The OASYS

  Oral/Nasal Airway SystemT maintains the patentcy of the oropharyngeal airway by functioning as a mandibular repositioner and as a nasal dilator by maintaining a stretch in the nasal labial tissue to dilate the internal nares.

  For more information http://www.oasyssleep.com

  FDA Approval:
  Date of FDA Approval:
  FDA Registration Number:K030440

• SomnoDent(r) MAS
  

  The SomnoDent(r) 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 SomnoDent(r) 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

• SUAD
  

  The SUAD is also a custom-made appliance that is made of a heat-sensitive acrylic and is reinforced by a metal framework. The SUADadjustment mechanism (Herbst) is positioned on the sides of the device and consists of a piston that slides within a tube. The appliance is comfortable on the teeth and the mechanism allows good freedom of movement of the jaw. Therefore it is used frequently in patients who tend to grind their teeth heavily. The position of the jaw can be adjusted by using small rings that slide over the piston and when the tube is positioned over the piston it will advance the jaw the width of the ring. Small elastics (rubber bands) are used to keep the jaw from falling open during the night although the patient is able to partially open the mouth, which can improve comfort when using the appliance.
• TAP
  

  The Thornton Adjustable Positioner (TAP(r)) 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(r) 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(r) 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(r). Although it may take up to a week to get used to wearing a TAP(r) appliance, this is a small hurdle for patients. Nine in ten patients wear the device all night, every night  making the TAP(r) a highly effective solution for both snoring and sleep apnea.

  Features

  • Patient-friendly
  • Superior results
  • Easy to fit
  • Infinitely adjustable
  • Precise control of advancement
  • Interchangeable hooks
  • Freedom for lateral movement
  • More room for tongue
  • Allows lips to close

  The TAP® can help prevent conditions linked to sleep apnea:

  • Chronic daytime sleepiness
  • High blood pressure
  • Heart attack
  • Stroke
  • Heartburn, reflux
  • Morning headaches
  • Depression

  FDA Approval: Approved for both snoring and OSA
  Date of FDA Approval: August 21, 1997
  FDA Registration Number: K972061

• TAP
• TAP
• Tongue Retaining Device (TRD)
  

  The TRD is lab constructed of a flexible polyvinyl material adapted to the general contours of the teeth and dental arches. It does not depend on teeth for retention. Rather, the tongue is held forward by the negative pressure created in the vacuum bulb on the front of the appliance.

  The appliance is available in four tongue extensions and with or without air way tubes for patients with compromised airway patency. It is constructed in conjunction with the Kel Gauge (described in another section of this program.)

  Since the mandible is not rigidly or firmly held by the appliance, freedom of movement is possible during use. This would seem to make the TRD a good choice for the edentulous patient, the patient with periodontal disease and the patient with temporomandibular joint dysfunction.

  There is ample research available documenting the effectiveness for treatment of snoring and OSA in certain patients.

  NOTE: Mandibular repositioners have been successfully used in edentulous patients over dentures in certain cases where the dentures have had adequate retention. Mandibular repositioners have also been successfully used in patients with compromised periodontal status or TMJ function. In these cases, however, the clinician needs to be especially careful in design and follow up.

  FDA Approval: Approved for both snoring and OSA
  Date of FDA Approval:
  FDA Registration Number: