| PATIENT
INSTRUCTIONS FOR THE KLEARWAY™ APPLIANCE FOR THE TREATMENT
OF SNORING AND OBSTRUCTIVE SLEEP APNEA
General Information
Oral appliances have a definite role in the management of
selected patients with Obstructive Sleep Apnea and/or snoring.
The appliance will not cure the apnea and/or snoring but works
non-surgically to realign the jaw and/or tongue in relation
to the head. Its intention is to prevent the apnea and/or
snoring from occurring during sleep and it must be worn each
night to produce the desired effect. Regardless of how long
it is worn, the symptoms of obstructive sleep apnea and/or
snoring will return when the appliance is discontinued. There
are no guarantees that an appliance will be successful in
every patient due to physiologic and anatomic variations and
patient tolerance of the appliance. After wearing the appliance
over a period of time, some patients may need to undergo a
repeat overnight sleep study to determine the effect of the
appliance. Cooperation in caring for and in wearing the appliance
as instructed and in maintaining the highest standard of oral
hygiene is absolutely essential. In fact, the ultimate success
of treatment is directly related to the degree of patient
cooperation.
Insertion/Removal
The appliance is made with a temperature sensitive acrylic
material which is rigid when cool but soft and flexible when
heated under hot water. To insert the appliance, first submerge
it in a container of hot tap water, or hold the appliance
under running hot water only as hot as your fingers can tolerate
for at least one minute. Do not heat the appliance by any
other means as you may irreversibly damage it. Insert the
appliance into your mouth and press the upper rim up onto
the upper back teeth using both thumbs. Once seated on the
upper teeth, close your lower teeth forward into the lower
portion of the appliance and bite firmly. If necessary, use
the fingers of both hands to assist in seating the appliance.
Rinse with cold water to harden the appliance. To remove the
appliance, rinse the mouth twice with warm water to soften
the appliance and push up on the edges of the lower rim with
both thumbs while at the same time opening your mouth. Once
the lower rim is off your teeth, grasp the edges of the upper
back portion and pull down (not forward) which will dislodge
the appliance from your mouth. Do not remove the appliance
by simply opening your mouth and not dislodging each arch
separately since the wire work may be permanently distorted
and the appliance subsequently ruined.
Cleaning
To clean the appliance, use a stiff toothbrush and any toothpaste.
Thoroughly brush inside the tooth portion of the appliance
as well as the smooth outside surface. Use the same brush
to clean the expansion screw. Once cleaned, rinse well with
cool water and replace in the appliance case. It is not necessary
to keep the appliance soaking during the day. DO NOT SOAK
YOUR APPLIANCE IN MOUTHWASH as it will permanently soften
the appliance. Use a denture cleanser tablet, such as Polident
or Efferdent, if required, to help remove stains and keep
your appliance fresh.
Activation
After approximately two weeks of regular wear, the doctor
may give you a special key and request that you activate the
appliance two times per week until the next appointment. Each
turn or activation will move your lower jaw gradually forward
in 0.25mm increments which has a direct effect on the three
dimensional size of your airway. Insert the tip of the key
into the hole on the right side of the expansion screw. Turn
or push the key towards the left. There is an arrow marked
on the metal expansion screw to show the correct direction.
Once the key is turned once from one side to the other, remove
the key. A new hole will appear on the right side and will
be used for your next turn later in the week. If the key is
removed before the new hole appears, you will be unable to
place the key in the new hole the next time. Always remove
the key after turning. Pushing the key back to the right side
will close or retract the expansion screw rather than open
or advance it. Never advance the screw more than two turns
per week unless instructed to do so by the doctor.
Side Effects
A sense of the teeth not touching properly may be experienced
by some patients in the morning. This usually self corrects
within an hour or so. In addition, you may experience an excessive
amount of saliva for the first month or so. If significant
jaw or joint discomfort occurs, stop turning the screw until
your next visit. If the discomfort has not subsided in one
or two days, call the office immediately for further instructions.
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For Dentists and Physicians