Prerequisite: Sleep Study & Diagnosis

Getting a SomnoDent MAS fitted starts with a sleep study and resulting diagnosis. For existing sleep apnoea sufferers, this step may be skipped of course. During a sleep study, the suspected sufferer of a sleep-related breathing disorder sleeps with diagnostics equipment at the hospital, or more commonly, at home. During the night, a record is kept of parameters like heart rate, blood oxygen levels, respiratory flow, chest movement and body position. This, along with an in-depth questionnaire, will lead to a diagnosis (or elimination) of sleep-disordered breathing. The result will be one of the following:

• No disorder detected (seek alternative diagnosis through further testing)
• Harmless snoring
• Upper Airway Resistance Syndrome (UARS)
• Obstructive Sleep Apnoea (OSA) also known as Obstructive Sleep Apnoea / Hypopnoea Syndrome (OSA/HS)
  • Mild OSA
  • Moderate OSA
  • Severe OSA
• Central or Mixed Sleep Apnoea (not very common, likely to require further in-hospital testing)

In cases of harmless snoring (i.e. no breathing lapses, "just" sound), UARS and mild-to-moderate OSA, oral appliance therapy with the SomnoDent MAS can be prescribed or sought immediately. In the case of severe OSA, positive airway pressure treatment is favoured and should be trialled first.

Dental Check-up & Consultation

With the diagnosis in hand, an appointment with the nearest certified SomnoDent dentist can be booked. The process can be sped up if the patient's own dentist does a thorough check-up to see the patient is free of periodontal disease, TMJ disorders and such. The fitting dentist needs to know whether the patient is dentally appropriate with sufficient oral health to wear a night-time splint and may ask the patient's own dentist for access to his or her dental records. The fitting dentist may call the patient in for a consultation regarding oral appliance therapy and to check whether the patient meets the dental safety criteria. This pre-fit checking and consulting varies per patient and dentist. If all is found to be appropriate, the fitting process can begin.

Step 1: First Appointment*

A trained and certified dentist will take standard impressions of the patient's upper and lower teeth as well as a bite registration. The dentist will also ask the patient to do a short lower jaw movement exercise which allows him or her to record how far the patient can advance the mandible (lower jaw). This is necessary to determine the degree of protrusion, required to keep the throat open so breathing can occur freely. The impressions, bite registration and bite record, along with notes about the patient's dental make-up are sent to a designated specialist lab which checks everything for quality control. It is of course important to make the splint exactly to the patient's needs so we only use experienced labs who have made thousands of orthodontic and sleep appliances before. This ensures a superior fit and optimum treatment.

After quality control, a model of the patient's upper and lower teeth is made in the laboratory. A custom-made, precision-engineered SomnoDent oral sleep appliance is made with laser precision to this model. Further quality control is done and each splint is checked for conformity with the latest medical standards. The splint is then sent to the dentist who calls the patient in for the second appointment, usually three weeks after the first appointment.

Step 2: Second Appointment*

At the second visit to the dental practise, the dentist will show how to put the splint in the mouth, how to remove it and how to maintain it. The appliance is checked to make sure it fits comfortably and can be adjusted if necessary. The dentist will also explain what to expect during the first nights and the following mornings, when the jaw and muscles get used to wearing it. Because the appliance is so simple to use, this appointment tends to be very short indeed.

Step 3: Follow-up Appointment*

Approximately two weeks later, the patient meets the dentist once more to check whether further adjustments are necessary. Because the SomnoDent MAS allows for very precise adjustments, it can be tweaked and fine-tuned until the right balance is found between comfortable protrusion of the lower jaw and maximum reduction of symptoms such as snoring, apnoea events and daytime sleepiness.

After this, the splint can be adjusted at home or by seeing the dentist again.

Ongoing: Annual Check-up

At least once a year you will be given the opportunity to come in for a consultation where also a follow-up in-home test will be suggested to check the breathing disorder is sufficiently under control. This new data allows for informed decisions on further adjustments and gives the patient peace of mind, knowing their health is no longer at risk of the consequences of their sleep disorder.

Please Note:

* Diagnosis needs to be sought via the patient's GP or privately with a specialist sleep diagnostics service as offered by Intus Healthcare and is not included. A preliminary dental check-up and consultation are priced at the dentist's discretion and may not be necessary if the fitting dentist is the patient's own dentist and the patient has visited the dentist regularly in recent years. Optional additional splint adjustments by the dentist beyond step 3 as well as recommended follow-up consultations are priced at the dentist's discretion.