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Today we are reviewing home care instructions for your SomnoDent AVANT oral sleep apnea appliance.

We will include what to expect in the first few days, how to advance this device, and how to clean your mouthguard. Preventing side effects from oral appliance therapy will also be reviewed.

The Avant sleep apnea appliance is one of the newest oral appliances devices released by the SomnoMed company.

Features and Benefits of the Avant dental sleep device

The world’s first milled oral device with a soft liner designed for excellent comfort
The CAD-CAM manufacturing system is optimal for a precise fit
SomnoDent Avant advancement straps provide simple adjustments in 1mm increments
The availability of 10 straps with 1 mm increments provides an exceptional range for advancements and patients with a large front-to-back jaw movement capability
3-year manufacturer warranty

What to expect the first time I use my SomnDent AVANT oral appliance?

For the first several days, the appliance will feel awkward in your mouth.

Although most patients adjust quickly to the snug feeling around the teeth in the first several nights, it may take up to several weeks to build up your tolerance to wearing the device.

Patients who have worn a night guard for teeth grinding, orthodontic retainers, or Invisalign often adjust very easily to wearing an Avant sleep apnea device.

The goal is to sleep comfortably, without discomfort and to eliminate symptoms of apnea.

Possible side effects of wearing the SomnoDent AVANT

The side effects of this device are similar to all other custom dental sleep apnea appliances.

To learn more about the possible side effects of oral appliances, click here to read My Sleep Devices blog.

Nighttime success tips

Here are some tips to help you establish a routine:

Brush and floss your teeth before inserting your device(very important)
Apply lip moisturizer (optional)
Rinse your dental device with cool water before inserting (optional)
Drink water only – once inserted, you can swallow easily and usually drink water. Please avoid other beverages
Go to sleep!

How to insert your SomnoDent AVANT sleep device

Step 1. Hold the upper and lower plates together and insert them into your mouth

Step 2. Gently push the lower segment down with your fingers onto your teeth, as demonstrated by your dental sleep apnea team, until it fits securely

Step 3. Bite down into the upper plate or use your fingers to secure the upper segment onto your teeth

The best way to insert an oral appliance is often what is most comfortable. If it feels more comfortable to insert the upper segment first, do so. This is an alternative method:

Step 1: Hold the upper and lower plates together and insert them into your mouth

Step 2: Gently push the upper segment onto the upper teeth

Step 3: Bring your jaw slightly forward and bite into the lower segment, using your fingers if needed to secure firmly

Here is a video that can help you when inserting both plates into your mouth simultaneously.

Removing your SomnoDent AVANT device

Step 1. Using your thumbs on both sides of the lower segment, push upwards

Step 2. Gently pull the upper segment down off your teeth

Step 3. Remove both segments (connected) out of the mouth

Developing a morning routine after removing your AVANT oral appliance

There are three areas of routine to consider after removing your oral appliance:

Cleaning your device
Performing basic jaw stretches
Using a morning realigning tool (if provided)

When you follow through with these routines as recommended, you will increase the longevity of your dental sleep device, prevent unwanted side effects and increase your comfort level during your oral appliance treatment.

How to clean your oral device

Cleaning your Avant device regularly will help improve longevity, reduce odors and avoid discoloration of your device.

Learn more by watching My Sleep Devices educational videos or reading our articles on cleaning your device.

For your specific type of Avant device, you may follow any of the suggestions on our site except for:

Can be cleaned daily and weekly as in Part 1 and Part 2 Cleaning Videos
The SomnoMed company recommends a weekly 10-minute soaking using Somtabs or ½ tablet of retainer-denture cleaning tablets, 1-2 x per week for 10 minutes
Scrub with a soft brush only using liquid detergents (dishwashing liquid or hand soap)
Air dry in an open container
Home ultrasonic units are NOT recommended for the Avant device currently
Dr. Berland’s Cleanadent cleaning solution is NOT recommended currently for the Avant appliance

Minimize bite changes by completing jaw stretches and using a morning aligner

It is normal for your teeth to feel strange after removing your Avant device for up to an hour.

This occurs most commonly from your jaw not being realigned into its regular position. This is commonly experienced and not to be concerned with.

Two actions are recommended to help prevent bite changes and help the jaw realign into its natural position, performing jaw stretches and using a morning aligner tool.

Performing jaw stretches and using a morning repositioning tool (if provided) are important to long-term oral appliance care.

Helpful articles

When do I advance the SomnoDent Avant Appliance?

The Avant device has a preset position that moves your jaw forward. Sometimes it may feel similar to the position when you are awake or slightly more forward.

This is the most effective treatment position for some patients, and you will not need to further advance your jaw. However, further jaw protrusion (advancement) is needed for the dental sleep device to be effective for many others.

Here is a review of when it’s best to begin or stop advancing your device.

The following is a list of positive effects that would indicate that minimal or no changes are needed:

Bed partner or roommate observes that your snoring is significantly reduced or gone
The bed partner witnesses no apnea or waking up gasping for air
Increased dreaming
Decreased or complete elimination of nighttime walking or urination
Decreased leg movements (for those who have Restless Leg Syndrome)
Feeling refreshed upon waking and daytime sleepiness is diminished or gone

Letting your sleep dentist know if any of these changes have occurred will help them determine when to advance the appliance.

Once you are comfortable with general wearing but still have noticeable apnea symptoms, it’s time for you to advance your dental sleep device.

How to advance the SomnoDent Avant sleep device

General Avant strap info

With your Avant device, you will receive a strap kit. These kits are either of a small (S), medium (M) or large (L) size determined by the Avant manufacturing team.

There are 10 straps, each providing 1 additional 1mm increments of jaw protrusion
Usually, but not always, you will start with the 0 strap
If you need to adjust the device, you will be moving to the next higher number of strap unless the “0” strap gives you jaw discomfort with improvement
In this case, you may move the jaw less protrusive (or less forward) by using the -1 strap (minus one)

Avant appliance advancement basics

Do not adjust the appliance for the first 7 days
If advancements are needed, you will be removing the strap and getting the next size up. Straps are more protrusive in 1 mm increments
Each strap is marked with a letter and a number
Repeat this process using the next strap after about 7 days
Never change to the next strap and advance if you are not comfortable with the device with the current strap

Steps to remove the strap from the oral sleep device
Image credit: SomnoMed

Removing the Avant Strap

Step 1. Open the 2 plates far apart and twist the strap up until it is upright

Step 2. With the strap upright, pull the right strap off the strap hole

Step 3. Repeat on the left side

Step 4. Slide the strap around until the white part of the strap is aligned with the strap clip towards the middle of the upper segment

Step 5. Pull the strap off

Fitting the next Avant strap

To fit the next strap onto your Avant, reverse the steps you took in removing the strap:

Step 1. Obtain the next strap up by looking at the number on the strap.

NOTE: If the original strap causes continued discomfort, you may put on the “minus 1” strap, making your jaw less protrusive or less further out).

Step 2. Hold the upper plate and press the white part of the strap into the strap accommodating groove

Step 3. Slide the strap until the center is inside the strap clip

Step 4. Hold the strap upright and press both right and left strap holes on the lower segment

Step 5. Twist the strap down so that the upper and lower segments meet.

When do I STOP advancing my Avant oral sleep device?

It’s time to stop advancing to the next tray if any one of these occurs:

You are experiencing PAIN

If pain occurs, you may need to skip a night
If comfort doesn’t increase over a few days, you may need to return the appliance to the previous comfortable tray combination by decreasing the advancement setting

All symptoms are resolved, and you feel the device to be working well

At this level, snoring reports have stopped, or you might awaken refreshed, have no morning headaches, and are less sleepy during the day
You reach the last set of straps. In this case, your dental provider may be able to order more straps to advance your device further

If you live alone and snoring is your only symptom

If you live alone or cannot receive feedback on your snoring levels, it may be challenging to know if the device is working and if an adjustment is required. For these circumstances, I recommend using the Snorelab App. Click here to learn more about this useful app.

What do I do if my mouth drops open when wearing my Avant oral appliance?

Avant devices have built-in acrylic hooks that can accommodate small elastic bands.

Elastic bands can be worn on your Avant device if you experience dry mouth or feel your mouth is popping open during sleep.

Nasal breathing, if possible, is encouraged with oral appliance therapy. Nasal breathing may improve the results of your therapy and keep your mouth free from dryness.

Elastics are also available in non-latex material. If you have a latex allergy, it is important to use non-latex elastics. You can find elastics under our Dry Mouth Resources on our Resources Page.

If your device does not have any hooks, your sleep apnea dentist can discuss options. Some providers may suggest using mouth tape. You can find these under Dry Mouth Resources on the Resources Page.

How will I know that my Avant dental sleep appliance is working?

It is important to follow up with a visit to your oral appliance dentist to verify the device is working beyond symptom relief. In many situations, the device may need further advancements to eliminate oxygen desaturations and/or sleep apnea events.

The best way to establish that your device effectively treats your sleep apnea and eliminates oxygen desaturations is to perform another sleep test, either with a home sleep test or polysomnography test performed by your sleep apnea medical or dental team.

Your sleep apnea dentist will help guide you to the proper timing of getting a sleep test with your oral appliance inserted.

If your follow-up oral appliance sleep test is at a sleep testing facility, don’t forget to bring your strap kit.

What follow-up appointments are recommended once I start wearing my Avant sleep appliance?

Several short appointments may be recommended with your sleep apnea dental team to help you maximize the results of your appliances and to troubleshoot issues that may arise.

Once there is verification that your oral appliance effectively controls your symptoms and apnea events, it is recommended you return in 6 months, then annually.

At these visits, your sleep apnea dentist will evaluate the integrity of your oral device and assess for potential dental oral side effects.

Please remember: Please follow the instructions given to you by your sleep apnea dentist. The instructions given above are general but may benefit many Avant users.

Please contact your prescribing sleep apnea dentist If you have questions or need help.

Helpful Articles

IMPORTANT: Many doctor-patient parameters are considered as to which oral appliance is best suited for an individual.

Your oral appliance dentist can help decide which device is most appropriate for you and your dental/oral condition.

These helpful resources are general in nature and for educational purposes only. Please consult with your dentist before making adjustments to your oral appliance device.

SomnoDent AVANT home care and advancement instructions