Maintaining and Adjusting a Sleep Apnea Appliance

Overview: Learn how to properly insert, adjust, and clean Adjustable Herbst and Dorsal sleep apnea appliances to ensure patient comfort and device longevity.

Manage the Adjustable Herbst Appliance

The Adjustable Herbst device uses a two-piece construction for snoring and obstructive sleep apnea treatment.

Adjust the Adjustable Herbst Appliance

Hold the upper Adjustable Herbst device with the calibration screw facing toward the user.

  • Forward Adjustment: Fit the calibration tool into the adjustment keyhole. Rotate the tool 90 degrees in the direction of the plus sign (+) or the red dot.

  • Backward Adjustment: Fit the calibration tool into the adjustment keyhole. Rotate the tool in the opposite direction of the plus sign (+) or the red dot.

Insert the Adjustable Herbst Appliance

Users must follow these steps to securely seat the Adjustable Herbst device:

  1. Insert the Upper Device: Place the upper Adjustable Herbst device in the mouth. Press up on the device with both thumbs to ensure a secure and comfortable fit.

  2. Insert the Lower Device: Place the lower Adjustable Herbst device in the mouth. Press down on both sides of the device using the index fingers to ensure a comfortable fit.

Use Rubber Band Elastics

The use of medium force (3/16th inch) elastics is optional but helps train muscles and promote nasal breathing.

  • Frequency: Wear elastics nightly.

  • Replacement: Change elastics whenever the bands become loose.

Remove the Adjustable Herbst Appliance

Always remove the lower Adjustable Herbst device first.

  1. Remove Lower Device: Use thumbs on both sides to gently pull the lower device upward.

  2. Remove Upper Device: Use index fingers and thumbs to gently pull the upper device down and forward.


Manage the Dorsal Appliance

The Dorsal sleep apnea device is a two-piece construction designed for patient comfort.

Adjust the Dorsal Appliance

Hold the upper Dorsal device with the calibration screw facing toward the user.

  • Forward Adjustment: Fit the calibration tool into the keyhole. Rotate the tool 90 degrees in the direction of the arrow on the Dorsal device.

  • Backward Adjustment: Fit the calibration tool into the keyhole. Rotate the tool in the direction of the arrow to reach the desired millimeter adjustment.

90° Turns102030405060
Adjustment:1.0mm2.0mm3.0mm4.0mm5.0mm6.0mm

Insert and Remove the Dorsal Appliance

Proper handling ensures the Dorsal appliance fits securely without damage.

  1. Insert Upper Device: Place the upper Dorsal device in the mouth and press up with both thumbs.

  2. Insert Lower Device: Place the lower Dorsal device in the mouth and press down on both sides with index fingers.

  3. Engage the Wings: Move the lower jaw slightly forward to allow the appliance wings to engage. Slowly close the mouth until the lips lightly touch.

  4. Remove the Appliance: Always remove the lower Dorsal device first by pulling upward with both thumbs. Remove the upper device by pulling down and forward with the index fingers and thumbs.


Clean and Maintain Sleep Apnea Appliances

Maintaining cleanliness prevents discoloration and device damage.

  • Morning Cleaning: Clean the device every morning immediately after removing it from the mouth.

  • Brushing Technique: Use a soft toothbrush to thoroughly brush the device. Rinse the appliance under cool running water.

  • Drying and Storage: Dry all parts of the appliance and the storage case carefully with a clean towel. Store the device in the storage case when not in use.

  • Precautions: Never use hot water, as it damages the device and invalidates the warranty. Do not soak the device in cleaner, as this may cause delamination.


Identify Potential Side Effects

Users may experience temporary side effects, including sore jaw joints, increased salivation, dry mouth, or sore teeth. These symptoms typically diminish within one hour of removing the device. Contact a dentist immediately if side effects continue.

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