FAQ - Dentist

COMMONLY ASKED QUESTIONS ABOUT THE DRY MOUTH APPLIANCE

Background: One of our doctors has had nocturnal xerostomia for years. He has not been diagnosed with Sjogrens syndrome or any other etiologic cause but has found it to be very uncomfortable. He occasionally experienced apnea, waking at night with his uvula adhering to his tongue.

It occurred to the doctor that he might be able to modify his bruxism appliance and utilize some form of delivery system to provide moisture. Presently his nightguard is widened at the buccal flange to accommodate a flexible, thin tubing which exits the mouth at the commissure and is connected to an infusion pump.

This device has proven to be very effective for our patients. For instance, a current patient who has a history of radiation to the base of the tongue was waking up four times a night with his lips sealed shut. It was necessary for him to hold a glass of water to the corners of his mouth and eventually pry his lips open. He was fatigued all day because he was not able to get a good night's sleep. Now he does not wake up at night due to xerostomia and is well rested during the day.

We demonstrate to the patient how to operate the device. The patient fills the infusion pump at bedtime with 40ccs of distilled water. We use different infusion pumps depending on the patient's needs and tolerance. We usually start with the 2cc per hour pump which delivers one drop approximately every 90 seconds. The mucosa absorbs this quantity without the need for swallowing. In the morning there are approximately 5ccs remaining which continue to run, thus flushing out the system.

Q. How does the pump work?

A. The pump, which resembles a plastic baby bottle, is approximately 3 inches in height and 1.5 inches in diameter and has an inflatable balloon inside. There is a one-way valve, which allows the balloon to be filled with distilled water.

The infusion pump does not require any electrical connection or batteries and delivers distilled water at the rate of 2, 3, 4, or 5ccs per hour. An outflow tube runs from the infuser and connects to the patient's intraoral appliance. It has the capability of delivering solutions against gravity and can be placed on the bed next to the patient or tucked into a pocket, or attached to a Velcro arm holder depending upon the position in which the patient sleeps. Because it's so small, it is easily transported on trips.

Q. What do I do if I have a dry mouth patient? Who makes this dry mouth appliance?

A. A patient may come into your office for a routine hygiene visit and complain about dry mouth. You may notice an increased caries incidence,possibly class V caries, in the same pattern as radiation caries, increased periodontal breakdown, candidiasis possibly manifesting as angular cheilosis, mucositis, burning tongue, etc.

If your patient lives in the Chicago area and you prefer our doctors to perform the entire procedure, we can evaluate your patient, fabricate and deliver the MoistYourMouth appliance.

If your patient is out of state and cannot travel to our office or if you prefer to be involved in the delivery and maintenance of the MoistYourMouth appliance, we will gladly work with you in the fabrication, explanation of use and the delivery process.
The process requires two main visits.

1. If the patient is amenable to pursuing treatment, take an upper and lower alginate and a bite registration. Indicate to us the type of appliance you would prefer to be fabricated. Pour up the models and send them to us via the mail or delivery service.
2. Once we receive the models, we will fabricate and assemble the MoistYourMouth appliance. The appliance will be sent to your office assembled in two weeks.
3. The patient then returns to your office for delivery and adjustment of the appliance which will be exactly like adjusting a nightguard or an orthodontic retainer. You will instruct the patient on the use and maintenance of the appliance. You will then see the patient for your regularly scheduled hygiene visits, at which time you can check for fit, leukoplakia, etc. Of course you can always call us with questions.

Q. How long can the patient expect the infuser to last?

A. The life expectancy of each infuser is variable and depends on the flow rate, quality of distilled water, and patient's hygiene. We generally expect an infuser to last 4 weeks. The higher flow rate infusers should last longer as compared to the 2cc/hr infusers. The patient will receive three infuser bottles at the appliance delivery appointment which would be included in the initial purchase of the appliance. Subsequent infusers can be purchased directly from us by the patient.

Q. What if the patient doesn't want to wear a nightguard? For instance, I have a patient whose TMJ got worse when she wore a nightguard.

A. We can fabricate different types of appliances. If a patient wears a nightguard, we adapt that nightguard and do not change the patient's occlusal relationship. If a patient does not require a nightguard, then we utilize an appliance in which there is no occlusal contact and doesn't change vertical dimension. If the patient wears a full or partial denture, it can be adapted or a duplicate can be generated, modified, and used at night.

Q. Is this covered by insurance or Medicare?

A. Similar to dental implants, some medical or dental policies may cover part of the fees. We will try to help patients with any insurance issues that may arise. We can also help your staff with insurance codes if needed. Although we are not Medicare providers, we can offer a finance company that has proven to be helpful to our patients.

Q. How can I obtain patient information packets for my reception room?

A. Please call us at 847-296-6100 to request patient brochures, free of charge.

Patent pending