Frequently Asked Questions
Patient Consent Form
Request Information Form
Instructions for Patients
How to bill insurance
1. Bill through MEDICAL INSURANCE,
not Dental Insurance.
2. Use MED CPT code EO486.
3. We also recommend patient
to submit a sleep study diagnosis to the insurance provider.
The EndSnor™ appliance, a dentist prescribed mandibular
repositioning (MRP) device, is worn during sleep and is indicated
for persons 18 years or older, who wish to reduce the incidence
of snoring and/or mild to moderate obstructive sleep apnea.
Before a dentist prescribes an EndSnor™ appliance for
treatment, it is recommended that the patient receive a medical
examination including a sleep study diagnosis, and a dental
examination including cephalometric and tomography analysis
to determine the need for an EndSnor™ appliance.
Dentists should consider
the medical history of patients, including history of asthma,
breathing, or respiratory disorders, or other relevant health
problems, and refer the patient to the appropriate health
care provider before prescribing the EndSnor™ appliance.
Safety and effectiveness in children under the age of 18 years
old has not been established.
1. Take maxillary and mandibular alginate impressions.
2. Pour impressions in dental stone immediately after taking
impressions to minimize model distortion.
3. Decide if the patient will have enough retention with height
of contour or if they will need to have retention created
with the use of ball clasps due to lack of height of contour.
4. Take a wax bite with mandible end to end with maxillary
incisors 4mm’s open. Be sure to maintain centric midline
relationship when the patient moves into the end to end bite
5. Recommended to use a George Gauge Bite Fork when taking
the wax bite to insure an accurate bite registration.
Note: Patients tend to deviate their jaw position
when meeting resistance of the wax. You may need to take more
then one wax bite. IT
IS CRITICAL THAT MIDLINES ARE LINED UP PROPERLY AND ARE THE
SAME AS WHEN THE TEETH ARE IN CENTRIC OCCLUSION!
6. Instruct patients that are being treated for mild to moderate
sleep apnea to schedule a follow up appointment for a sleep
study analysis while wearing the EndSnor™ appliance.
Schedule a consultation between you and the sleep medicine
physician to discuss the results.
Click here to
print EndSnor™ RX form to ship with your case. To view
the pdf form, you will need Adobe Reader 5.0 or higher.
Ship to Dockstader
Orthodontic Lab, Inc. Call
1-800-433-7168 for shipping information.
Delivery of EndSnor™ Appliance to Patient
IT IS CRITICAL TO CHECK PATIENT WITH THE ENDSNOR™
APPLIANCE IN THE MOUTH THAT MIDLINES ARE LINED UP PROPERLY AND ARE
THE SAME AS WHEN THE TEETH ARE IN CENTRIC OCCLUSION. IF NOT, TAKE
NEW BITE REGISTRATION, IMPRESSIONS AND MODELS AND HAVE A NEW ENDSNOR™
APPLIANCE FABRICATED BY THE LAB! DO NOT DELIVER APPLIANCE TO PATIENT
UNLESS MIDLINES ARE CORRECT!
2. Check acrylic buccal flanges, may need to adjust as fitting a
denture if uncomfortable to patient.
3. Make sure retention is a snug fit, if not ball clasps can be
added to create more retention.
4. Always deliver with the enclosed adjusting screw closed down
all the way. Most patients will have their snoring eliminated at
this setting. If that setting does not control snoring then place
the adjustment key into screw and turn in the direction of arrow
which will open vertical and bring the jaw forward creating more
opening. Each adjustment of the screw is equal to .25mm.
IT IS IMPORTANT THAT THE NUMBER OF
SCREW TURNS ARE PERFORMED EQUALLY ON BOTH SIDES TO EACH SCREW!
5. Instruct patient if reduction in the incidence of snoring and/or
mild to moderate sleep apnea does not occur to contact you for instruction
on how to turn the adjusting screw for mandibular adjustment. Require
the patient to return to your office for an appointment the first
time that a screw adjustment is necessary so that you can instruct
them how to adjust screws properly.
1. The stainless steel parts contain Nickel (Ni). A prolonged and
frequent contact may cause skin irritation and other allergic reactions
in patients sensitive to nickel.
2. The acrylic is made with Methyl Methacrylate. A prolonged and
frequent contact may cause skin irritation and other allergic reactions
in patients sensitive to Methyl Methacrylate.
3. If you have an allergic reaction, remove your EndSnor™
appliance immediately and contact your dentist that prescribed your
EndSnor™ or your personal physician for instructions on how
to treat the allergic reaction.
The EndSnor™ appliance is contraindicated for patients who:
- have central sleep apnea
- have severe respiratory disorders
- have loose teeth or advanced periodontal
- are under 18 years of age
Possible Side Effects
Use of the EndSnor™ appliance may cause:
Temporary Side Effects
- Obstruction of oral breathing, remove
appliance immediately if this occurs
- Pain or soreness in the temporomandibular
- Dry mouth or excessive salivation
- Itraoral gingival or dental soreness
- Temporary change in bite after
appliance is removed in the morning
Long Term Side Effects:
Joint (TMJ) Dysfunction
Permanent change in bite
Tooth movement or changes in dental occlusion
of dental restorations
for Patient Use:
1. Instruct patient to
insert EndSnor™ appliance before going to sleep.
2. Instruct patient to grasp EndSnor™ appliance
by the labial bar.
3. Labial bar must be on the bottom, lined up with lower
4. Instruct patient to hold EndSnor™ appliance
by the labial bar, open mouth and insert appliance,
acrylic end first.
5. Instruct patient to bite down into EndSnor™
appliance to seat appliance in mouth.
6. Instruct patient to remove EndSnor™ appliance
by opening their mouth, grasp labial bar wiggling gently
from side to side to release appliance retention. Once
retention is released, remove from mouth.
7. Instruct patient if they experience any possible
side effects, remove EndSnor™ appliance immediately
and contact you to discuss the side effect and what
actions you should take.
8 . Instruct patient if reduction in the incidence of
snoring and/or mild to moderate sleep apnea does not
occur to contact you to setup an appointment for instruction
on how to turn the adjusting screw for mandibular adjustment.
Patient Care of EndSnor™ appliance:
1. Instruct patient, after
removing EndSnor™ appliance, place it in their
appliance box that they received when you deliver the
EndSnor™ appliance or a container that allows
the whole EndSnor™ appliance to be submersed in
either orthodontic appliance cleaner or denture cleaner.
Instruct patient to follow the directions on the cleaner
2. Instruct patient before using their EndSnor™
appliance to rinse it for a minimum of 2 minutes under
cold running water to remove all appliance cleaner residues.
1.Schedule patient for
an appointment the day following the EndSnor™
appliance delivery. Use this appointment to address
patient concerns and to assess and make adjustments
to appliance if needed. Use this appointment to determine
if screws need to be adjusted and to instruct patient
in the proper way and when to turn the screws.
2. Schedule patient appointment for one month after
delivery of EndSnor™ appliance.
3. Schedule next patient appointment according to your
4. Instruct patient to contact you immediately if they
have any side effects or concerns.
5. Instruct patients that are being treated for mild
to moderate sleep apnea to schedule a follow up appointment
for a sleep study.
For technical assistance:
Contact Rob Bausman
EndSnor is trademarked
and the design legally protected.
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EndSnor™ is presented exclusively by EndSnor, LLC, a Fresno, CA based company.
EndSnor, LLC exclusively contracts all manufacturing of the EndSnor™ snore & mild
to moderate obstructive sleep apnea solution to Dockstader Orthodontic Lab, Inc.,
also a Fresno based, full service dental lab.
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| EndSnor, LLC. | All rights reserved.