Are all oral appliances for the treatment of obstructive sleep apnea the same?
Most mandibular appliances improve the shape of the upper airway to prevent collapse by bringing the jaw and tongue forward. However, patients may have varying and/or multiple levels of obstruction in the upper airway such as tongue, soft palate and lateral wall collapse.
While these appliances are limited to those aforementioned areas of collapse, there is a common and important missing contributor to facilitate more effective treatment. The missing contributors are nasal issues. These include nasal congestion, resistance and anatomical factors all of which promote mouth breathing.
The Oventus Medical O₂Vent® device with its patented airway management technology, allows air to flow through the device to the back of the throat. This technology addresses all areas of collapse including the nose, allowing uninterrupted airflow and increasing treatment outcomes.
How is the Oventus Medical O₂Vent® device different from other oral appliances?
The Oventus Medical O₂Vent® device incorporates a unique patented airway technology directly into the appliance. This airway enables an uninterrupted flow of air even in the presence of nasal obstruction, therefore ensuring the patient has efficient and effective therapy.
Does the Oventus Medical O₂Vent® device promote mouth breathing?
No. Patients will breathe through their nose to the extent they can, and when they can’t, they mouth breathe. This is because as nasal resistance increases during the night, patients have an adaptive response to switch over to mouth breathing. Once mouth breathing occurs, there is an actual increase in upper airway collapse.
With the Oventus Medical O₂Vent® device in place the patient will instead of opening their mouth, automatically begin to breathe through the “mouthpiece/duckbill” which will result in a stable airway and normal ventilation.
How does breathing through the O₂Vent® device differ from mouth breathing?
Mouth breathing offers up to 2.5 times more resistance than nose breathing1. This increase in resistance will result in higher negative pressure swings in the airway, possibly causing airway collapse. Breathing through the O₂Vent® device offers little to no resistance which will reduce negative pressure swings and provide a more stable airway. The design and cross-section of the bi-lateral airway management technology was made to mimic an average patent airway.
Why is it important to have an airway built into the oral appliance?
With multiple areas of the airway associated with collapse and contributing to airway instability, an airway channel effortlessly increases the likelihood of efficacious treatment. Nasal restriction may be intermittent, given that allergies may be seasonal or environmental, whilst obstruction such as a deviated septum may be a more chronic condition. The integrated airway allows the patient to maintain a closed mouth while still receiving the airflow needed to breathe without compromising the stability of the airway. It also allows for continued, uninterrupted therapy and sleep for the patient. Cutting a hole in an oral appliance to facilitate mouth breathing can now be negated. This practice creates risk of airway destabilization.
Is there a way to know if a patient is having difficulty breathing through their nose?
Yes. A common physical exam is often used whereby the patient holds one nostril closed while trying to breathe through the other and the clinician can assess nasal breathing restriction. However, as previously mentioned congestion may be intermittent depending on allergies, environment or weather related factors.
Another tool that is easily performed and complements the physical examination is the use of a validated questionnaire called the NOSE questionnaire. Consisting of five questions that the patient will answer based on their level of nasal congestion, the questionnaire also includes a scoring severity scale. Using this questionnaire can assist in properly diagnosing nasal congestion which is critical for oral appliance compliance. Download NOSE Questionnaire (PDF) for your patients
Why is there metal in the appliance?
The material used is titanium, it is a biocompatible material that is strong yet very light weight. It allows Oventus Medical to provide patients with a customized 3D printed durable airway within the device that is very comfortable and easy to use.
The Oventus Medical O₂Vent® device looks larger than some of the other appliances, will it fit in smaller mouths?
The customized airway gives the illusion that it is larger but when properly fitted the O₂Vent® device can be used by almost everyone. Oventus Medical devices are approximately the same size as other dorsal and Tap style appliances. The fact that it is printed in titanium allows a reduction in wall thickness to around 0.5mm. This means that the appliance can have an airway with the same cross-sectional area as a human nose incorporated into it while maintaining the normal dimensions of a dorsal style appliance.
Why should I choose an Oventus Medical device over what I am currently using?
Oventus Medical O₂Vent® devices are the only devices that offer a tangible solution for patients who suffer from multiple levels of obstruction; including soft palate collapse, nasal obstruction, tongue-based obstruction and epiglottal obstruction.
By breathing through the incorporated airway, it has been shown to reduce negative pressure swings in the airway which can lead to airway instability and collapse. Therapy adherence has been shown to be 82.8% . It has also been demonstrated that by using Oventus Medical O₂Vent® devices, effectiveness has improved by up to 50%,.
Is there going to be adequate room for the tongue when using this appliance?
Yes. All Oventus Medical O₂Vent® devices allow for adequate tongue space and with cases where an extremely large tongue is involved the lingual acrylic on the upper arch and the distolingual acrylic on the lower arch can be reduced to create additional space.
Can I take digital scans of the patient for this appliance?
Yes. Digital scans as well as impressions can be used to fit the appliance to the patient. More information about digital scans can be found in the Dentist Resource link: https://oventus.box.com/v/DentistsKit
Are there special considerations that need to be addressed when taking patient records?
The only consideration is that there is a 5mm vertical bite clearance when taking the scans or impressions. More information about taking patient records is provided in the Dentist Recourse link: https://oventus.box.com/v/DentistsKit
How can I order the Oventus Medical O₂Vent® device?
The digital order form (PDF) is provided in the Dentist Resource link:
https://oventus.box.com/v/DentistsKit or reach out to Oventus Medical Customer Support for assistance at firstname.lastname@example.org
Are there more training materials available?
Yes, Oventus Medical offers several no cost options for training that include print, video and on-demand webinars provided in Dentist Resource link: https://oventus.box.com/v/DentistsKit
Which Oventus Medical O₂Vent® device should I be ordering for my patients?
The following guide provides information on which device is best suited to which patient.
Patient conditions including severe bruxism must be suitably assessed prior to the prescription of O₂Vent® devices.
|Indications||Where titration, opening and anterior movement may be present reduced bulk is of benefit.||Where titration and lateral movement may be suspected or confirmed.|
|Suited to||Patients who clench or grind their teeth anteriorly.||Patients who clench or grind their teeth laterally.|
Patients that mouth breathe or mouth falls open during sleep – may need to add elastics.
|Benefits||Ability to open and speak while wearing, less bulk, robust titration mechanism.||Titration component simple and accessible from outside the mouth (lab titration), lateral movement possible.|
|Risks||Wings disengage with extreme opening, patient reverts to mouth breathing without elastics.||Patients cannot open with appliance in.|