Fitting preparation: If you are 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® includes:
- soft thermoplastic mouthpiece
- filler material (modeling strip)
- wooden spatula
- storage case
- a video CD-ROM "SomnoGuard - Fitted by an Expert" to help to visualize the major steps of the fitting process.
1. Push the spatula through the rectangular hole in the mouthpiece so that its tip protrudes out the back by a few millimeters. The spatula helps you hold the mouthpiece with your fingers while fitting. The wooden spatula through the rectangular hole in the mouthpiece(Picture).
2. First put the unfitted mouthpiece into the mouth with the spatula pointing away from the face. The upper part of the mouthpiece has a notch in it. The upper part of the mouthpiece forms the biting channel for the upper teeth, the lower part the biting channel for the lower teeth.
3. Before doing the real fitting, practice the process with cold water. If you fit the device yourself practice in front of a mirror. Put the mouthpiece in the unheated water for exactly, as you will have to do later with hot water for the actual fitting.
Please read and follow instruction carefully and use a watch to check very imported time fitting.Custom-Fitting your SomnoGuard® Mouthpiece:
1. Boil about 1/2 L (liter) of water in a bowl. The water must be deep enough to cover the mouthpiece completely.
2. Take the bowl off the hob and immerse the SomnoGuard® with the wooden spatula in a sloping but not vertical position while heating the plastic material. People with considerable fitting experience should immerse the oral appliance for 25 to 35 sec. (seconds) to achieve an optimal teeth and jaw impression into the plastic. However, those who have limited or no fitting experience should immerse the SomnoGuard® into the hot water for no longer than 20 to 25 sec. (seconds) as this reduces the risk of the inner and outer walls of the appliance sticking together. After heating, the mouthpiece will appear transparent. Gently feel the biting channel to check that the plastic is moldable. Be careful that in the heating process the inner and outer sides of the appliance do not stick together. If necessary, using the spatula, briefly out of the hot water and push the sides back in their original position with the fingers.
3. With the spatula, take the mouthpiece out of the hot water. Gently shake it to get rid of the last water drops. Wait until the temperature has cooled down a little (approximately for 12 seconds with an immersion of 20 to 25 seconds and approximately 15 seconds with the mouthpiece heated for 25 to 35 seconds), and test on the back of your hand whether the plastic's temperature is acceptable for fitting. Make sure that you can still mould the mouthpiece. If you fit the device yourself look in a mirror and open your mouth wide. Insert SomnoGuard® in to the mouth, holding the spatula. The notch has to be at the top. First position the lower jaw in the lower channel of the mouthpiece, then the upper teeth in the upper channel. Make sure that the tongue can be moved in the middle inner part of the mouthpiece. The thermo flexible mouthpiece is automatically adjusted to any dental arch width if fitting is performed correctly.
4. Check that the spatula is well fixed in the opening of the mouthpiece and protrudes a few mm. through it, otherwise the opening may close permanently during the fitting process. Move the lower jaw forward approximately to half the maximum extension possible (see figure 3 which shows the desired position).
|Figure 1: Normal jaw position||Figure 2: Maximum jaw extension||Figure 3: The desired position is half maximum extension|
Bite the plastic hard. Be careful not to bite the borders of the mouthpiece, otherwise you might ruin it. Suck in while closing your mouth and press your tongue against the lower inner surface of the front teeth under the spatula. While doing that, press on the outer walls of the mouthpiece with your fingers to make sure that it is moulded properly.
5. One the mouthpiece cooled (approximately 1/2 min. minute), take it out of your mouth, still using the spatula and insert it in cold water for approximately 10 sec. (seconds) to fix the individual fit. If you have followed all the steps carefully and have done everything correctly, the appliance will show a distinct impression of you teeth throughout the whole mouthpiece, and the border walls of the mouthpiece will not be damaged (see figure 4).
Only then can you be certain that the mouthpiece will lightly grip you teeth and stay in the required position during sleep.
6. Take the spatula out of the opening. Put the mouthpiece back into your mouth to check that it fits properly. Having the lower jaw extended forward should still be comfortable. If it is not, repeat the steps 1 to 5. Most users get a more comfortable fit by moulding a second time. You can, if necessary, repeat the fitting process up to three times. Note: that if you refit the mouthpiece, you cannot leave it in boiling water for more than 25 sec. (seconds). If refitting is required, heat the upper and lower parts of the mouthpiece separately.
7. If you do not stop snoring completely, re-mould with your lower jaw extended a little farther but not at maximum extension.
The first weeks with SomnoGuard®: Generally expect to have a two to three-week adaptation period to achieve maximum comfort. 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. It is normal.
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 appliance. This way, the retention on the teeth is improved. With time you'll get used to initially. The uncomfortable feeling disappears within the first few minutes after taking. 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.
Specific Notes: Consult your dentist before using SomnoGuard® if you suffer from gum disease or other dental problems. If you have a "deep bite", you dentist can raise the molar area, i.e. the position of the molar teeth, with the filler material that is in the pack which is made out of the same copolymer as the oral appliance itself. For modifications such as these the mouthpiece should always be fitted by your dentist. If you have a receding chin (retrognathia), full dentures or have missing teeth, consult your dentist before using.
A deep bite is apparent when no distinct impression of the teeth can be seen in both channels of the appliance after the first fitting. When raising the molar area it is necessary for both the part of the appliance that needs correction, and the filler material to be immersed separately in hot water for approximately 15 sec. (seconds). The soft and warm filler material can then be pressed in the biting channel at the appropriate place. Only use as much of the filler material as is necessary. The remaining material can be used, if it is necessary, to raise other biting zones of your mouthpiece. Usually, it is only necessary to remodel one biting channel to achieve a good and equal jaw impression in both channels. After fixing the filler material in the biting channel, immerge the corrected part of the mouthpiece in hot water for approximately 20 sec. (seconds). Bite into the appliance carefully without moving your lower jaw forward, and insert it in cold water to fix it. The oral device is ready to use.
Malformation and damages, for example bitten side walls, can often be corrected and remodeled as described previously. The mouthpiece can be refitted two or even more times. You may have to refit the mouthpiece to reduce the current advancement of the lower jaw ( for example if muscular pain appears in the joint), or to increase the extension if you still snore. With the filler material, the opening (rectangular hole) on the front part can also be closed if necessary.
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