Staci: What was the genesis of the MyTAP product & how can it be
used in a general dentistry practice?
Dr. Thornton: The original MyTAP was made as a teaching device. It
w/ DS3 member Dr. Keith Thornton
by Staci Giuffrida
DS3 Member Support Specialist
Staci: What prompted you to develop the TAP line of
products?
Dr. Thornton: My father was a real pioneer in this area
so it was routine when I joined his practice. I honed my
skills in appliance therapy from Henry Tanner at the
Pankey institute where I was part of the faculty for 25
years. Several of the “teaching assistants” came up
with the flat plane version that is still taught and we
also learned to make a “Lucia jig” for immediate
therapy until we could get a patient into a full coverage splint. That led to my first invention, a manufactured, flat plane anterior jig, which is still being sold by
the Pankey Institute as the “Pankey Jig”.
While training in anesthesia in my Navy general
practice residency, I learned then I could “manage”
anyone’s airway with proper head and jaw position,
which was a requisite while a patient is anesthetized
and being ventilated. In 1992, I was approached by an
ENT colleague to help treat sleep apnea patients who
had failed CPAP or surgery. The only device available at
that time was a tongue-retaining device. With this
knowledge of airway management and splint therapy,
I came up with my first TAP appliance.
Staci: I’ve heard that all devices do the same thing & if
that's the case, why continue to develop new products?
Dr. Thornton: The argument that there is no need for
improvement is about as good an argument for Henry
Ford not to keep improving the car after the Model T
was made. The evidence is robust about the TAP device
being more effective than any other on the market. In
the last review of the literature by the AASM and the
AADSM, in almost all outcomes categories the TAP was
equal or superior to any other appliance. It is the only
appliance that has been shown to be “not inferior” to
CPAP. Also, too many dentists think it is just oral
appliances. I have also invented numerous devices that
combine both mandibular protrusion and positive
airway pressure called the TAP-PAP. One recent study
has shown that the TAP-PAP has rescued over 2/3rds of
the patients who failed both CPAP and oral appliances
separately.
was a plastic tray that came in three sizes, filled with Thermacryl, and
used the TAP I hardware. I would teach dentists how to fit and titrate
them at dental conferences. The devices were highly effective but
bulky so it was never intended to be a commercial product. The real
demand to commercialize the MyTAP came from the need for a highly
effective “interim” or “trial” device that would be as effective as the TAP
but at a cost that would encourage both patients and physicians to
consider oral appliance therapy as a first line of treatment.
The MyTAP can be used in numerous ways by dentists who are doing
any custom appliance. First, it could be used as part of the diagnosis
and as a trial, particularly with patients who have had a sleep study but
do not have an official diagnosis of OSA. These are the patients who
have significant symptoms which may include fatigue, headaches,
TMD, and snoring and due to high, upper airway resistance. It is the
ideal titration device to determine the best protrusive position for the
custom appliance. Finally, it is a superb “intermediate” solution to
prove the concept of mandibular protrusion and for those who cannot
afford a custom one and for those who are only interested in their
snoring. I include it with all of my custom appliances for titration
purposes and as a backup if there is an issue with the custom one.
Every dentist treating SDB should have a few stashed away for emergency situations.
Staci: What 2 things are MUST HAVES in your DSM practice?
Dr. Thornton: To have an effective sleep practice requires
effective systems both for treatment and practice management.
The first is a therapy system that can treat the broad range of
patients that are finding their way to the dentist. These include the
simple snorer, patients with high upper airway resistance, and
failed CPAP patients.
The second is an effective practice management system that
includes both the dental and medical aspects of treating the sleep
patient. Documentation, insurance, billing, scheduling, communication, security, government mandates, fees, among other issues
make incorporating sleep a daunting task. I have found that I
almost couldn’t practice without the DS3 system which addresses
these needs.
Staci:Anything new we can look forward to in the future?
Dr. Thornton: As always, we have a lot of innovative products in
the pipeline plus some improvements and modifications of our
present products. Stay tuned….
For information on Airway Management & the TAP line of products, visit
www.amisleep.com or call 1-866-AMISNOR