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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.



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.



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.




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.

For Dentists and Physicians

Clinical Videos


Informed Consent Form

Long Term Consent Form


Technical Notes for the
Klearway™ Appliance

For Patients

Video Demonstration

The Epworth Sleepiness

Patient Instructions for the
Klearway™ Appliance