The design criteria that have been fully satisfied are:
- Unsurpassed retention
- Simple fitting technique, easily completed in less than half an hour
- No need for professional fitting (it is commonplace in Germany, but unusual in the UK)
- Two identical trays
- Minimal bulk
- Minimal vertical opening of the teeth (kindness to the temporomandibular joint)
- Adjustable protrusion that caters for those with normal bites and those with a receding lower jaw (retrognathia)
- Protrusion is in the range - 7 to + 7 mm
- Adjustable width to suit smaller and larger than average mouths
- Free space for the tongue; the adjustable connectors are on the outside of the device (the cheek side)
- Some lateral movement is accommodated, which will suit bruxists (but not severe grinders)
- Limited mouth opening with the device in place is also possible
- Approved for the treatment of mild or moderate Obstructive Sleep Apnoea
- Longevity expected in normal use to be about 18 months.
Although the Tomed SomnoGuard AP, AP2 and SP Soft are excellent medical devices, the Tomed SomnoGuard SPX is in a different league. Unlike these established models, the Tomed SomnoGuard SPX does not have impression material in channelled trays. It has a thin layer of white memory thermoplastic material bonded to flatter trays. This memory material softens when heated and is wrapped around the teeth. When cooled it forms its own thin structure, which is carried on the trays. The trays have redesigned and stronger fixation knobs on which the adjustable connectors are fitted.
The moulding of the memory material is much less demanding on accurate time and temperature control. This means that problems achieving an optimal fit are greatly reduced. It is unnecessary to repeat the moulding process from scratch if adjustments are needed. All adjustments are done in the mouth by sipping hot water until the water temperature cools sufficiently for it to be kept in the mouth to heat the device. If the device was too loose on first moulding, then a little more pressure from the tongue and fingers will be needed on remoulding when in the mouth. If the device was too tight on first moulding then it should be repeatedly taken off and on the teeth while warm to slacken the fit.
If it is necessary to heat the device out of the mouth because the first fit was too tight, then it should be heated for just 5 seconds in the boiled water. If heated for the full 20 seconds required for initial moulding the memory effect material will be far too soft and the perfect fit will not be attainable. Unlike the established 2-part Tomed Somnoguards, the SPX cannot be moulded multiple times. Because we are sure many existing Tomed SomnoGuard users will wish to use the SPX we are supplying spare parts, to replace any that need to be replaced. We also pack the SPX in two separate sealed bags. Bag A contains one tray only for use on the upper teeth. Bag B contains the remaining tray, connection rods and spanner. It should not be opened until the fitting of the upper tray has been successfully achieved. Following the instructions and our fitting video will result in a successful result. Hybridising the process using past experience will undoubtedly give rise to sub-optimal results.
So, if you have a small mouth, a receding lower jaw or a sensitive temporomandibular joint and need an excellently fitted MAD to treat your snoring and OSA this device is exactly what you need.
Of course, if you have none of these, but are looking for the ultimate MAD, then you will not be disappointed. If you buy the Tomed SomnoGuard SPX you will have bought the very best prefabricated device available.