SomnoGuard mandibular advancement mouthpiece reduces night snoring and pauses in breathing in case of sleep obstructive apnea. Its working principle is based on lower jaw advancement, which leads to tongue advancement. Once in this position breathing tracts are wide open and you can breathe freely without snoring. Necessary conditions of using SomnoGuard 2.0 are a perfect nasal breathing and a complete dentition. A ventilation hole in the inner wall of both mouthpiece types allows for a short emergency breathing through the mouth. The bibloc SomnoGuard AP mouthpiece allows easily and at any time a mouth breathing.
Modified SomnoGuard 2.0, according to Dr. Juergen Abrams, ENT specialist and dentist at Hamm (Westp.), differs from SomnoGuard 1.0 by a thickening of 1,5 mm at the bitestrip, molar level, as well as by a raising of lateral faces of 1 mm at the same level. In most cases, this costly enhancement on SomnoGuard 1.0 is not necessary if SomnoGuard 2.0 is used.
SomnoGuard 2.0 : 1 mouthpiece, 1 wood spatula, 1 conservation box, 1 filling strip and 1 instructions for use.
- There is a wood spatula in the package. Insert this spatula in the breathing hole which is located at the mouthpiece front, so as to let the tip juts out a few millimeters on the other side. It is then easy to handle the mouthpiece by means of the spatula during its adjustments inside the mouth.
- First of all, put the mouthpiece inside your mouth so as to let the spatula juts out from the oral cavity. The upper part of the mouthpiece is recognizable by its groove wrapping the labial string. The upper part of the mouthpiece forms a flute for the upper dental arch and the lower one forms a flute for the lower dental arch.
- It is advisable to practise the shape forming with running water at the beginning. If you proceed by yourself to the shape forming , follow the supplied instructions with the help of a mirror. It is recommended to have an easy to read watch with a second hand for time measurement.
If the person is well trained, an immersion period of 25 to 35 seconds is recommended, in this case the jaws impression would be optimum. For less or not trained persons, it is advisable to let SomnoGuard 2.0 not more than 20 to 25 seconds in water. Once heated, the mouthpiece becomes transparent, you have then to test with your finger that the side faces are quite flabby.
Important: regardless of the heating period, it is necessary to avoid that the internal and external side faces of the mouthpiece stick together. If necessary, immerse briefly the mouthpiece in hot water and unstick the faces with your fingertips.
- Bring 1 liter water to boil in a container. This latter must be high enough so that the mouthpiece handled by the spatula could be totally immerged in water.
- After taking off the container from the heat source, plunge very carefully SomnoGuard 2.0 on the bias (not vertically) in the hot water using the spatula and wave gently to soften the plastic material.
- Take off the mouthpiece from hot water holding it with the spatula and drip it with caution. After 12 to 15 seconds, check whether its temperature is bearable by applying it on the inner side of your wrist and check also if it is still able to be formed. Insert then the mouthpiece in your mouth with care, and be sure that the groove for the labial string is located at the top, and fitting at first the dental flute of the lower part on the lower jaw teeth, then the dental flute of the upper part on upper jaw teeth. The thermoformed mouthpiece, being still soft, fits by itself on the dental arches.
- Make sure that the spatula is firmly fixed in the mouthpiece breathing hole and juts out on the other side by a few millimeters, to avoid its clogging during the adjustments. Then protrude the lower jaw, with half the maximum possible advancement. Usually, for a normal anatomy, such a protrusion corresponds to a face to face setting of incisors (see figure 3). Now, clench your teeth firmly. Avoid biting the lateral sides of your mouthpiece otherwise you could damage or even destroy it. The fact of biting leads simultaneously to expel air from the oral cavity, and to press the tongue against the lower back side of incisors , under the spatula. Then press with your fingers the lateral sides of your mouthpiece upon your teeth to adjust securely the mouthpiece to the dental arches.
- After approximately 30 seconds, take the mouthpiece out of your mouth, holding it with the spatula, and then plunge it for 10 seconds in fresh water to stabilize its shape. A correct shape is recognizable by a regular impression of both teeth rows on the whole mouthpiece length with no damages found on lateral sides. Only such a correct shape allows a soft sticking of the mouthpiece on teeth while its utilisation.
- Now, you can take out the wooden spatula from the mouthpiece. Then, place again the mouthpiece in your mouth to check whether its form is adequate. The lower jaw advancement should give a feeling of comfort. If not, start again steps 1 to 5. Most users notice a better sense of well-being after a second form operation. You can carry out up to 3 forming procedures. However, when you proceed to an additional forming procedure, do not exceed 25 seconds immersing the mouthpiece. It could be necessary to warm up separately the lower and the upper part of the mouthpiece.
- If you can’t help stopping snoring completely, reform your mouthpiece as described before. In this new attempt, the upper jaw should be advanced a little more forward, but not to its maximum extent.
||Fig. 1: normal position of jaw
||Fig 2: lower jaw excessively advanced
||Fig. 3: a correct position corresponds to incisors set face to face
Using the filling strip
In case of a minor set of teeth, the doctor has the option to raise the mouthpiece molar segment (rear teeth), using the filling strip (same material as the mouthpiece) which is present in each package. SomnoGuard 2.0 is already provided with a thickening on both sides of the mouthpiece, so that using the filling strip is seldom used.
A minor set of teeth is recognizable by a lack of deep impression on both dental arches toward the mouthpiece grooves, after it has been formed. Immerse separately the filling strip and the mouthpiece (a segment where a raising is necessary) in hot water for about 15 seconds. Then, press the heated up filling strip against the adequate place on the mouthpiece. The unused strip part must be cut with scissors. A raising of other segments on the mouthpiece could turn out to be necessary, in this case, proceed as already explained, using the rest of the filling strip. Generally speaking, a raising somewhere on the mouthpiece is considered successful when a regular jaws impression is obtained after the forming procedure. After adjusting the filling strip into the dental flute, immerse the segments of the modified mouthpiece in hot water for about 20 seconds. Clench once more your teeth cautiously on the mouthpiece for the final adjustment (with the same forward jaw advancement as previously done), and finally immerse it in fresh water to harden it. It is then ready for use.
Distortions and damages, as for example bites on lateral sides can be mended several times through reshaping, applying the previous instructions. Shaping can be repeated 2 to 3 times depending on the degree of the mouthpiece request. A reshaping could be found necessary to reduce the jaw advancement (as for example when muscular pain toward the jaw link appears), or on the contrary, to extend it in case of snoring not yet sufficiently reduced.
In order to obtain a satisfactory therapeutic result, it is advisable to let a doctor (ENT specialist or a dentist or a doctor working in a sleep lab) or his staff, carry out the SomnoGuard 2.0 mandibular advancement mouthpiece shaping.
Lifetime of your SomnoGuard 2.0
Lifetime of your SomnoGuard 2.0 lays between 9 and 12 months. To ensure an optimum service of your SomnoGuard 2.0, we recommend to change it after 12 months at most.
SomnoGuard 2.0 mandibular advancement mouthpieces are of a great help to fight snoring and mild to moderate obstructive sleep apnea. People affected by obstructive sleep apnea must use this device only under strict medical supervision, after assessing the benefits and risks to their health (cardiovascular diseases) and after considering other available alternative therapeutic forms (particularly CPAP for Continuous Positive Air Pressure or CPP for Continuous Positive Pressure). People affected by sleep apnea should move forward their jaw at least by 7 mm.