I am a dentist working in dental sleep medicine. When I read all of this, I can't help, but think how much safer and less complex a simple oral sleep apnea appliance would be for most people. A real shame that the insurance companies and the sleep medical profession still pay so little attention to it. I understand that people who have severe OSA may not have the option, but the vast majority of patients do, including a portion of severe patients. Arthur B. Luisi, Jr., D.M.D.. The Naples Center for Dental sleep Medicine.
I am a dentist working in dental sleep medicine. I have been practicing many years and have seen the bruxism breakage problems many times. The fix that I have found is a special appliance called the Luco Hybrid OSA appliance. It is made out of sturdy metal and actually SUPRESSES clench and bruxing. See: www.lucohybridosa.com. Arthur B. Luisi, Jr., D.M.D. The Naples Center for Dental Sleep Medicine.
Nice to hear from you again. I am glad that the Tap-pap with my mouth shield is working for you. Kindly contact me again directly. I lost your contact information from my phone by mistake. I have been in talks with Airway Management. They may be getting close to green lighting it for volume production. I am in the process of redesigning it to incorporate something called an entrainment valve. The valves are present in most full face masks. It is a back-up safety feature that creates more room air breathing if the CPAP machine stops working. The present vent system is sufficient in reality, but the F.D.A. would need to see the extra valve for approval. I would like you to have the improved version when ready. I am committed to making this happen. May be able to use Zoom in the way you suggest. Get back to me. Dr. Luisi
The general thinking about using the TapPap and any other type of oral appliance device that is affixed to the teeth is that these devices can be used with any kind of oral restorations that are SECURE, WELL EXECUTED, and NOT LOOSE. That would include dental implants, crowns, bridges, root canals with crown and post and cores. and fillings. The teeth must not be loose or involved with serious active gum disease. Generally, you must also have at least 8 teeth in each arch. There are exceptions to that rule. It is a good idea to get any of these devices from an experienced sleep dentist vs. OTC because they will evaluate your teeth to make sure that they are in good enough condition. Arthur B. Luisi,Jr.,D.M.D., The Naples Center For Dental Sleep Medicine.
Thank you so much for the mention Sherry. I want to explain the situation to all the CPAP patients with mouth and mask leakage. Believe it or not, the dream of a totally leak free CPAP mask has COME TRUE! I have modified the TAP-PAP nasal pillow mask with a stand-alone accessory called a mouth shield. AND IT WORKS. NO EXCUSES. EVERY TIME. Seals off your mouth from the inside. VERY COMFORTABLE. Could help literally MILLIONS of sufferers. O.K., so why can't you get it? Well the F.D.A. must approve every change in equipment, no matter how trivial. The approval costs hundreds of thousands of dollars. I have the right idea, but I am only one man with limited resources. ResMed I am not. Even though this is true I am planning to do a large scale clinical trial. at my own expense. This will give participants access to the product. Right now I can only deliver it in person in my own office. If you need it right now I can only do it in my office, but if you are willing to travel, I will do so. PATIENTS, I NEED YOUR SUPPORT. I CAN'T DO THIS ALONE. All you people who can't use CPAP because of leakage- HELP ME TO SAVE YOUR HEALTH! Push this through. Arthur B. Luisi, Jr., D.M.D.. The Naples Center For Dental Sleep Medicine. Naples, Florida
I am a dentist working in dental sleep medicine. Excess saliva is a typical early reaction to oral sleep apnea appliances and should go away in time. Usually within one to two weeks. One quick fix is to take one OTC Benadryl allergy pill before bedtime. That will dry up the saliva so you can sleep. After about a week you can usually ween yourself off the tablet. Only do this with the permission of your health care providers and after they have checked your medical and medication history. The funny noise may be caused by incomplete treatment and it might mean that your appliance must be adjusted. Again, consult your provider. It also may mean that you are getting post nasal drip. Be SURE that any post nasal drippage is treated and under control. The dry mouth may be caused by mouth breathing. You may need to be well hydrated before bedtime, or use a saliva substitute, or have your provider install an optional mouth shield after the excess saliva goes away. Arthur B. Luisi, Jr.,D.M.D. The Naples Center For Dental Sleep Medicine.
I am a dentist working in dental sleep medicine. As I said repeatedly on this forum, masks that strap to the head for seal are inherently subject to leakage. Skin is deformable and the movement can cause loss of seal. A better approach is to use masks that are supported by the teeth. Case in point is AirWay Management's MyTapPap product. See:www.Tapintosleep.com. I am working on a version that can also seal the mouth internally to avoid leakage. My efforts have been somewhat sidelined by Covid. Arthur B. Luisi, Jr., D.M.D. The Naples Center For Dental Sleep Medicine.
I am a dentist working in dental sleep medicine. What grinderfrank means is that the lower tray of the device is moving backward and losing protrusion which tends to reclose the airway. Mandibular advancement devices like the Tap3 keep the airway open at night by holding the mandible forward(protruded). This opens up your airway and prevents apneas and hypopneas. The Tap3 has a screw adjustment to bring the mandible forward. The patient adjusts it to the optimal protrusion and then leaves it at this setting. If the screw adjustment device wears or fails, the mandible can drift backward and reclose the airway. The patient starts to get more symptomatic. This is a sign that the device has to be repaired in some way, which, presumably, Airway Management will do. Not unusual, happens with some frequency. Arthur B. Luisi,Jr., D.M.D.. The Naples Center For Dental Sleep Medicine.
I am a dentist working in dental sleep medicine. I would respectfully disagree that it would be impossible to fabricate an oral sleep apnea appliance for a patient who is even a severe gagger. I have done it many times but it does take some creativity. I will give you one example. An appliance called a DreamTap is designed to fit over all the teeth. Obviously, you could not wear that. However, a variant can be created that fits over just the upper and lower six front teeth and I have yet to see a gagger that can't tolerate THAT. Getting the impressions can still be a problem, but digital impressions and some other special techniques can overcome that too. Arthur B. Luisi, Jr.,D.M.D.. The Naples Center For Dental Sleep Medicine.
I am a dentist working in dental sleep medicine. I really hate to say this but, using the alcohol, in addition to the usual addictive potential, is probably causing you SERIOUS medical harm. Alcoholic products relax your muscles and this muscle relaxant effect probably is making your obstructive sleep apnea exponentially worse. You were already at AHI 50, which puts you in clear and present for heart attack and stroke. Now you would be in even more peril. Sorry, but true. Arthur B. Luisi, Jr., D.M.D.. The Naples Center For Dental Sleep Medicine.