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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:
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.
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.
Performing jaw stretches and using a morning repositioning tool (if provided) are important to long-term oral appliance care.
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
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.
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.
- 7 Habits of Highly Successful Sleep Apnea Dental Device Users
- Cleaning and Replacement Products for Your Dental Sleep Device
- Why does my dental sleep device no longer work?