Mandibular Repositioning Appliance Activation Instructions

• During the first five (5) nights of sleep, wear your appliance with the top component engaged to the lower component, however, do not turn your key (the advancement mechanism should remain in the inactivated position).
• On the sixth (6th) night, insert the key into the appliance and turn it one complete turn (360 degrees). This will advance your bottom jaw 0.5mm.
• Maintain this amount of advancement for five (5) nights. Every subsequent five (5) nights advance your appliance by turning the key one complete turn.
• You should turn the key every 5 nights for 4 weeks, This will advance your bottom jaw a total of 3 mm.
• After awakening in the morning, remove the appliance, and insert the “AM Aligner” in order to restore your bite to its normal position. Bite on the am aligner for 20 seconds then release for 20 seconds. Perform this 8-10 repetitions, or until your bite “feels normal”.
• Clean your appliance by brushing it and storing it in its case with a small amount of water.
• If your diagnosis is primary snoring (without obstructive sleep apnea) you may stop turning the appliance when your bed partner no longer observes snoring.
• If you should experience joint, muscle, or teeth pain that does not subside during the day, please call our office.
• The only time you should advance the appliance during the first five nights is if you awaken in the morning and the appliance has become “unclipped”. If this occurs, advance the appliance with one complete turn in order to allow the appliance to remain “engaged” throughout your sleep. Then continue advancing the appliance every five nights as the instructions indicate above.