SleepDent

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.

Unfortunately, you have it right. In many countries, including my own, the USA, they blew the initial opportunity for containment. Now the toothpaste IS out of the tube. Huge numbers of people are going to get sick and die and we just have to take our licks until they get enough testing done, plus vaccines, and discovering medical treatments. This is going to take serious amounts of time and, meanwhile, the economy will tank and go into recession or depression. Just shows you the price you pay with these things unless you are super sharp. Dr. Luisi

Remember that the exhaust air coming out of the vent ports on the masks is STILL PRESSURIZED. There would clearly still be potential to expel virus particles out of these vent ports for a significant distance. Dr. Luisi

I am a dentist working in dental sleep medicine. Unfortunately, I have some really bad news for the people on this forum. In a post dated 3/22/20 the American Academy of Sleep Medicine states that the use of CPAP by patients with COVID-19 infections does, indeed, pose a significant risk to other family members in the household because it disseminates the virus into the air regardless of what face mask you use. Please check out the FAQs on their web site about this. There is also some risk of spread during the routine cleaning process. Oral sleep apnea appliances are specifically cited as being a safer alternative, as are some other things. Now, I am not suggesting that you dump your CPAPs, but you MUST be absolutely sure that you are totally isolated from other household members and it may make some sense to move some very vulnerable family members(or yourself) to a different location. Arthur B. Luisi, Jr., D.M.D.. The Naples Center For Dental sleep Medicine.