Dental Sleep Medicine Insider January 2015 | Page 11

tients with a steep Curve of
Spee. Also check that the
advancement mechanism is
not misaligned, pulling the
patient too far to the right or
left as they protrude. Again,
the joint that is being restricted from moving is usually the
one that hurts. Lastly, sleeping only on one side with a
hand under the face can
cause unilateral joint issues. Consider tripod in all
of these cases as discussed
below.
Bilateral Pain
Most often, pain on both
sides is caused from titrating
too far forward too
fast. Slow down. Back up a
bit. Utilize the Cl II hook on
the TAP 3 Elite. Check to
make sure there are no posterior interferences as the
patient moves forward (just
like above). Consider adding posterior stops so that
you “tripod” the TAP. It hits in
front on the ad م