Dental Sleep Medicine Insider January 2017 | Page 7

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PATRICK TESSIER , BSME , MBA

dreamTAP

AN ENGINEERS PERSPECTIVE

In 2016 , Airway Management released the latest version of the TAP appliance . For those of us in the DSM world , this appliance is a significant upgrade in a 20-year evolution of the TAP brand .
As a Mechanical Engineer , as well as , the founder and former owner of the largest dental lab in the Northwest , I tend to use an engineering framework to look at dental appliances .
When I was first shown the dreamTAP prototype , I was instantly smitten . Airway had fixed all the issues with the previous versions and more . In fact , it looked like this “ dreamTAP ” could be one of the most successful devices in the history of Dental Sleep Medicine . I ’ d like to share my analysis of the device and why I am a huge fan of the dreamTAP .
TAP FUNDAMENTALS
For over 20 years , the TAP appliances have been proven to function , very well . Over 36 peer reviewed studies have demonstrated efficacy in treating sleep disordered breathing . The fundamental design works .
• Single point adjustment
This feature allows the patient , or doctor , to advance the mandible as needed with by twisting the screw . Most alternative devices , require the user to advance two screws equally . Should one be advanced more than the other , the mandible is forced to one side , which can lead to TMD . This actually happened to me and was very painful .
• Prevents open mouth breathing
It is clear in the literature that allowing the jaw to open makes the condition worse , in almost every case . This is prevented with the single hinge in the anterior and is considered one of the primary reasons the TAP appliances perform better than appliances that allow the jaw to swing open .
• Medicare approved
The Centers for Medicare and Medicaid Services ’ ( CMS ) apparently agrees with the TAP design . The TAP devices are approved for Medicare reimbursement . Most appliances that allow the jaw to open at night are not approved . Since this represents a significant portion of the patients , prescribers can be confident that the dreamTAP is covered under the broadest range of insurance plans .
NEW HARDWARE FEATURES
• Increased Tongue Space
The biggest and most easily recognized improvement is moving the hardware out of the tongue space . The bars are located facial to the anterior teeth . Instead of the upper tray pulling the lower forward , the lower pushes against the upper . Compared to the previous TAPs , the hardware has been flipped and moved it out of the tongue space .
• Force Spreading Bar
The new dreamTAP has another unique engineering feature .