Dental Sleep Medicine Insider January 2015 | Page 10

To Tripod or
Not to Tripod.
By. Dr. Richard Drake

One of my mentors has
been Dr. Keith Thornton, inventor of the TAP devices for obstructive sleep apnea (OSA). I
made my first TAP over 13 years
ago and estimate that I have
delivered more than 1,000 TAPs
since then, and it remains a key
part of my armamentarium. I
don’t use it for every patient,
but I find it is almost always at
the top of my list. It does a
fabulous job of treating moderate to severe apnea. We have
multiple case studies now
where with the TAP we have
reduced Apnea Hypopnea Indexes (AHI) from 100 to below
10.
Regardless of efficacy, wearing

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a Mandibular Repositioning
Device (MRD) can be a challenge for some patients, and
part of that challenge is overcoming side-effects. One potential side-effect is ongoing
TM Joint issues. Sometimes it is
muscle, sometimes the joint
itself, sometimes both. Here
are a few clinical tips to address ongoing joint pain and
generalized achiness in the
joint area.

three planes, NOT just the anterior posterior.

Unilateral Pain
Make sure the TAP hits only in the anterior area. Frequently, pain on just
one side is caused by an imbalance from the device hitting on only one side in the
posterior area. Typically the
side that is hitting is the side
that is hurting. Simply reduce
the posterior
First, determine if the pain is thickness on
unilateral or bilateral, acute or that side until
chronic. Remember that doc- it no longer
touchumenting joint and TMJ dyses. You’ll see
function in DS3 beforehand is
this happen
ALWAYS a good idea! Also,
more in paremember that we work in