Resources

What do I do every Day?

Inspect the device prior to each use. Are the fin lock pins in place?
Insert the TOP tray first onto your top teeth
Insert the Bottom tray second while you stick your bottom jaw out a little.
- The trays should not be worn separately.
- You should only take the fins off to clean under them
- This is a prescribed device- only change fin size under advice of your dental professional

How do I clean the device?

Clean the device every day
Use fresh water and cleaner every day
We recommend Aer Clean powder, but you may use any tablet that has Sodium Percarbonate in it – if this ingredient is not present in the cleaner do not use the product.
Rinse the device under running water to remove the night’s saliva.
Soak the device in cool, clean water and cleaner, all day, every day.
If the device gets dirty, it is clear that you are not cleaning it every day and soaking it all day. There is no warranty for dirty devices.

Changing/Cleaning* under the Fins

*Cleaning under the Fins should be done every month for one day clean only

Use the THIN blade on the fin removal tool to push the lock pin out of the fin as shown

Please set the lock pin down on the table according to the fin side it has come from for example:
”right-hand side pin from right-hand side fin on the right-hand side of my table in front of me”

Use the claw on the fin removal tool to lever off the fin from the tray
Use force, we guarantee you will not break anything

Please remember to push the lock pin into the fin before you soak the fin and device trays
This way you will not lose the little lock pins when you empty the water
Remember to take the pins out of the fins before you try to replace the fins on the trays after cleaning

After cleaning replace the fins taking note of the RHS and LHS stamps on the fins
“Right to right and left to left”
Replace the fins with a ”click” and then replace the locks ”left to left right to right”

“Right to right and left to left”
Replace the fins with a ”click” and then replace the locks ”left to left right to right”
Push the locks all the way home with the fin tool as shown

Morning Repositioner

The Aer Dorsal MAS comes with a morning positioner.

The positioner is used to tension and wake up the retractive ligaments and muscles in the mouth after a full night of lower jaw repositioning while using the Aer Dorsal MAS.

The exercises in this document assist the lower jaw to return to a comfortable overbite and overjet (MMR) ”bite” for normal function during the day.*

What do I do?

The exercises in this guide can be done in the morning, while you are still in bed. We suggest you wake up 10 minutes earlier, so you can fit these exercises into your morning routine.

Step 1.

Remove the Aer Shield, and the bottom and then top trays of your device from your mouth

Step 2.

Place the morning positioner in your mouth onto your bottom teeth.

Step 3.

Put the tip of your tongue up and to the back of the roof of your mouth, as far back as you can. Hold your tongue in the position and close your teeth together

Step 4.

Relax your tongue while keeping your mouth firmly closed in this position

Step 5.

Clench your teeth as hard as you can while in the position from step 4. Hold this clench until it becomes slightly uncomfortable to keep going.

It is normal to feel some discomfort in your muscles while doing this exercise.

Step 6.

When you can no longer tolerate the discomfort, release the clench slightly while trying to slide your lower jaw further back. Clench your teeth again as hard as you can tolerate.

Step 7.

After performing a couple of clenching exercises, we recommend that you relax your muscles by opening your mouth as wide as you can and wiggling your lower jaw from side to side comfortably- do not hurt yourself

Step 8.

Repeat steps 3 through 7 for 10 minutes every morning.

If you have any further questions, please consult the dental practitioner that provided the Aer Dorsal to you.

*Normal overjet and overbite (MMR) can be affected by several factors such as the amount of mandibular protrusion set by the appliance, the vertical height set in the appliance, and the individual factors particular to the patient in relation to existing TMJ health and upper and lower jaw class relationship.

Aer Shield – Tongue Posturing Device

The Aer Shield replaces cumbersome chin straps and mouth taping for help with closed mouth posture in CPAP and Oral Appliance Therapy. This is achieved through the encouragement of postural tongue position over a period of weeks.

The Aer Shield is an important part of using an Aer Dorsal MAS. The closed mouth posture that the shield provides and the posturing that is gained from ongoing use of the Aer Shield allows for more effective use of the Aer Dorsal MAS.

FITTING THE AER SHIELD

Fitting the Aer Shield is a quick and easy process.

Insert the upper part of the Aer Dorsal MAS into the mouth, followed by the lower part of the Aer Dorsal MAS.
Insert the Aer Shield over lower teeth and appliance, so that the flap on the shield sits behind lower teeth and tongue extension into upper palate.
Gently bite onto the shield to hold it in place for the next step
Tuck the edges of the shield behind the cheeks and in front of the teeth and appliance. You may now release your bite and relax the jaws
Gently swallow until you feel a suction in the upper palate.
Postural tongue position is correct when you feel that your tongue is positioned up in the palate and your soft palate can feel relaxed against the back of your tongue. You will also feel a suction effect in your mouth.

HOW TO USE THE AER SHIELD

The Aer Shield is a training tool for the tongue and the soft palate.

The patient should wear the shield every night for 30 days.

Use of the Shield is like a gym workout. Every now and then, when the patient feels that they are snoring more often, they should start using the Shield again until the tongue posture effect kicks back in. Usually, one week of wear is enough to bring the effect back for another month.

The frequency of the therapy should be determined on an individual basis by the patient, the above scenario is a rough guide.

Some patients may wear the Shield every night.

It is a good idea to wear the Shield if you are very tired or if you have been drinking alcohol.

HOW DOES THE AER SHIELD WORK

The Aer Shield is an EVA shield that the patient wears behind their lips, and in front of their teeth in combination with the Aer Dorsal MAS (see the diagram below). The use of the Aer Shield completes the function of the Aer Dorsal MAS, by training and controlling the position of the tongue within the room created in the mouth.

Oral mechanoreception is implicated in fundamental functions including speech, food intake and swallowing.

When the user swallows, the Aer Shield creates negative pressure in the mouth. This pressure excites mechanoreceptors on the tongue and in the palate. The negative pressure creates an opportunity to train the soft palate to relax against the dorsum of the tongue and complete the anterior wall of the oropharyngeal airway, creating the optimal postural position for the tongue in the mouth.

This postural position keeps the base of the tongue out of the throat and assists to lift the hyoid bone (complex). This creates good tension in the throat; thus resisting collapse on inspiration. The training component of the Aer Shield happens when the patient is asleep. The tensor veli palatini muscle is supplied by the mandibular nerve, which is the third branch of the trigeminal nerve. This is the only muscle of the palate not innervated by the pharyngeal plexus, which is formed by the vagal and glossopharyngeal nerves.

CLEANING THE AER SHIELD

Clean the Aer Shield every day

Place the Aer Shield in the dental bath (along with your Aer Dorsal if you have one)
Fill the bath with tap water.
Add a heaped teaspoon of Aer Clean powder into the water.
You may leave the MAS appliance in the solution all day, but you must remove the Aer shield from the water after 1 hour or less (min 10 minutes)
At bedtime, rinse the shield thoroughly before use
Replace the solution every morning.
Soak the appliance every day for the best results.
The shield should last 6-12 months, depending on wear and cleaning.

INDICATIONS

Tongue base hypopnoea or apnoea.
Mouth breathers.
TMD patients for whom further advancement of their MAS is out of the question.

CONTRAINDICATIONS

Users who have nasal patency issues.
Some patients may benefit from nasal cones if they have nasal valve patency issues only and their nose is deemed otherwise patent by an ENT.

Important Patient Information

Congratulations on the purchase of your new Aer Dorsal. Your dentist has determined that this is the most appropriate therapy for you. The sleep physician has recommended this as one of the options after you have had a sleep test assessment.

The Aer Dorsal is a 3D laser-sintered appliance that has been custom-designed and made for your mouth. The device is both durable and strong.

The Aer Dorsal will position your lower jaw forward to make more room in your mouth for your tongue at night. This action and position for the tongue is supported by the Aer Shield, which you should have received in the package sent to your dentist.

Your new Aer Dorsal pack contains:

Glossary

OSA: Obstructive Sleep Apnoea
MAS: Mandibular Advancement Splint
Bite: The way your teeth meet when your jaws are in a position normal to you.

Frequently Asked Questions

Is this device comfortable and easy to use?

Yes, the Aer dorsal is designed to be sleek and slim. So it is not bulky in your mouth. Follow Dr. Manish’s instructions on the daily use of the device.

I’ve been fitted with my Aer Dorsal. Do I need any follow-up appointments?

Return to Dr. Manish as has been advised. DO NOT use this device if you have not seen a dentist in over 12 months.

Can I use other cleaning products that I prefer instead of the Aer Clean product?

We recommend Aer Clean because it is simple Sodium Percarbonate.

Other products have this compound in them, and it is up to you to determine that there is enough of this compound present to clean the appliance effectively.

There are simple instructions to follow to keep your appliance clean. If you choose to use another cleaner, or you do not clean this device every day as recommended, we cannot support any warranty claim for unclean and damaged devices due to an improper cleaning process.

Will this device damage my teeth and bite?

Dr. Manish will assess the apparent health of your teeth and you will be instructed on the correct use of this device.

Any damage to teeth will not be due to the use of this product.

The material cannot damage the teeth so as long as the teeth are sound nothing should happen.

You may feel a sense of change in the way you bite in the morning. This will be a temporary change and should resolve on its own. If this change lasts longer than 1 hour, your dental professional will encourage you to use the included morning positioner.

I have some missing teeth. Will this affect the Aer Dorsal?

You must have at least 8 natural teeth, in a good and healthy state in the lower arch. This device can be used in patients with lower teeth and no upper teeth. Implant fixtures in the lower arch can be used to secure the device in the absence of a sufficient number of teeth.

I am about to have some dental work done. Will this affect the fit of my Aer Dorsal?

Seek advice from Dr. Manish. If the dental work is substantial, the top or bottom tray may need to be remade, and a fee for this will apply. This kind of non-fitting event is not covered by warranty.

My jaw feels sore. What should I do?

In the event of muscle or jaw pain, discontinue the use of the device immediately and contact Dr. Manish

There is blood in my device when I take it out of my mouth in the morning, What should I do?

Blood in your Aer Dorsal may be an indication that your teeth and gums need a professional cleaning. Please talk to Dr. Manish about strategies on how to keep your teeth and gums healthy.

Do not allow the blood to dry on the device, rinse it well and soak the device in Aer Clean solution as directed.

My Aer Dorsal is damaged. What should I do?

Discontinue use immediately and consult your dental professional

I have lost all of my lock pins, can I keep using the device without them?

Do not use the device without the lock pins in place at any time for any reason. Please contact Dr. Manish to help you with this problem.

When I use the Aer Shield, I cannot breathe out of my mouth. What should I do?

You may experience obstruction of oral breathing with any oral appliance in the mouth. The Aer Shield, combined with the Aer Dorsal, ”retrains” your breathing so that you breathe exclusively through your nose. Ensure that you can breathe through your nose BEFORE using this device.

My nose feels ”too small” when I use the Aer Shield and I feel like I can not breathe well even though my nose is clear. What should I do?

Sometimes your nose can collapse at the front when you breathe through at night. Nasal cones or strips can help with this issue.

WARNINGS

Read all the instructions before using your Aer Dorsal.

The Aer Dorsal is intended to reduce or alleviate nighttime snoring and OSA. If symptoms, breathing difficulties, or other respiratory disorders exist or persist, with or without the device, contact your dental professional immediately.
The Aer Dorsal should only be used as directed. Do NOT misuse the product, only wear this device while sleeping.
The Aer Dorsal should only be provided by a dentist and only be fitted by a dental professional who is working with that dentist and has the scope to fit such an appliance under the supervision and guidance of the dentist.
Do not store or transport your Aer Dorsal outside the temperature range between-20 degrees and 50 degrees Celsius.
Discontinue use if experiencing discomfort and consult your dental professional.
Do NOT use the Aer Dorsal if you cannot remove the device yourself.
Do NOT use the Aer Dorsal if the device becomes damaged or ill-fitting, and consult your dental professional.
Do NOT use the Aer Dorsal if vomiting or feeling nauseous.
Do NOT store your Aer Dorsal in direct sunlight
The operating temperature range of the Aer Dorsal is 5 degrees to 40 degrees Celsius.
If you think that you may be having an allergic reaction to the device, stop using it immediately and consult your dental professional who may direct you to consult a medical doctor.

Possible Side Effects

There are possible side effects associated with the use of your Aer Dorsal. These side effects are not common. If you experience any of the following, consult your dental professional immediately.

Slight tooth or gingival discomfort due to pressure of the appliance, and soreness in the temporomandibular joint.
Excessive salivation. This will improve as you become accustomed to wearing the Aer Dorsal.
Slight jaw soreness or tightness, initially, and with adjustment.
Temporary bite change.
An issue with obstruction to oral breathing
Unconsciously taking the Aer Dorsal out of your mouth at night
Pain in the jaw joint
Permanent bite change.

Contraindications

This device is contraindicated for patients who:

Have central Sleep Apnoea.
Have severe respiratory disorders.
Have loose teeth or advanced periodontal disease.
Are under 18 years of age.

This device is only to be prescribed by a medical/dental sleep professional.