Dentist Intructions

Check models 

The Sleepwell appliance has been checked against a set of models, which have been returned for your records. We recommend assessing the fit of the appliance using these models to help familiarise yourself with both the appliance and its retention.  

Please note that the checked models may contain missing or damaged teeth and are intended for reference purposes only.  

Preparing appliance before fit 

Upon receipt from S4S, the appliance must be cleaned and disinfected prior to being fitted or issued to the patient. Although every effort is made to maintain a high level of cleanliness during manufacturing, the appliance is supplied unsealed and therefore cannot be regarded as sterile. It is the responsibility of the dental practice to ensure appropriate cleaning and disinfection procedures are completed before use. 

Fitting the Sleepwell 

If this is the first Sleepwell that you have fitted, we recommend that you read the “patient instruction” form: https://www.s4sdental.com/pages/patient-instructions. This instructs the wearer to wear the Sleepwell with no advancement for the first two weeks, then to make gradual adjustments until the optimum setting is found. Although there is no ‘hard and fast’ rule for this, you should typically suggest one full clockwise turn of the key per week – this will make an advancement of <0.5mm so should be comfortably tolerated.

Adjusting the Sleepwell

Fitting your first Sleepwell device is likely to be a very different experience to fitting many other dental devices. Should you have any concerns about retention please follow instructions below. Do not trim any fit surfaces with burs.

Adjusting the Retention 

Too Tight or Difficult to Seat: If the appliance is too tight or difficult to seat, submerge one side of the appliance (the tighter side) in freshly boiled water for 10-15 seconds, Take care when handling hot water and allow excess water to drain before placing the appliance, immediately fit the appliance into the patient's mouth or onto the models. Remove the appliance and place it in cold water to allow it to reset. Recheck the fit and retention. If the appliance remains too retentive, repeat the process as required on the opposite side. 

Too Loose: In the unlikely event that the appliance feels too loose or lacks sufficient retention, submerge one side of the appliance in freshly boiled water for 10-15 seconds. Remove the appliance and gently squeeze the appliance in the areas where extra retention is needed to improve the fit. Immediately fit the appliance onto the patient's teeth or models to assess the retention. Once the desired fit has been achieved, place the appliance in cold water to allow it to reset. If further adjustment is required, repeat the process as necessary on the opposite side. 

Important: Freshly boiled water must be used for each adjustment attempt to ensure consistent results. 

Recommended Cleaning Product 

We recommend Puradent tablets. Some cleaning products may damage or reduce the lifespan of the appliance materials. Always follow the cleaning instructions provided. 

You can order directly at www.puradent.co.uk    

Fitting the SCI 

With the SCI in place, the discluding element should only contact the opposing 2-2 area. Check that the patient cannot slide off this contact area in any excursion and that the posterior disclusion is kept to a minimum to ensure maximum comfort whilst wearing the appliance. 

Preparing appliance before fit 

Upon receipt from S4S, the appliance must be cleaned and disinfected prior to being fitted or issued to the patient. Although every effort is made to maintain a high level of cleanliness during manufacturing, the appliance is supplied unsealed and therefore cannot be regarded as sterile. It is the responsibility of the dental practice to ensure appropriate cleaning and disinfection procedures are completed before use. 

Adjusting the Retention 

Too Tight or Difficult to Seat: If the appliance is too tight or difficult to seat, submerge the appliance in freshly boiled water for 10-15 seconds, take care when handling hot water and allow excess water to drain before placing the appliance, immediately fit the appliance into the patient's mouth or onto the models. Remove the appliance and place it in cold water to allow it to reset. Recheck the fit and retention. If the appliance remains too retentive, repeat the process as required. 

Too Loose: In the unlikely event that the appliance feels too loose or lacks sufficient retention, submerge the appliance in freshly boiled water for 10-15 seconds. Remove the appliance and gently squeeze the retentive areas to improve the fit. Immediately fit the appliance onto the patient's teeth or models to assess the retention. Once the desired fit has been achieved, place the appliance in cold water to allow it to reset. If further adjustment is required, repeat the process as necessary. 

Warning 

The SCI is specifically designed to reduce the intensity of muscle parafunctional activity. It does not claim to (or will) eliminate it completely. The appliance should not be worn for more than 8 hours per day. If a particular patient needs to wear their device for longer than 8 hours per day, then this needs to be carefully considered and a specific appliance design needs to be considered for longer-term wear. These situations are rare, nevertheless they present from time to time. 

Before issuing the appliance, it is important to ensure that the patient fully understands its purpose and is clear on the correct instructions for use. 

Recommended Cleaning Product 

We recommend Puradent tablets. Some cleaning products may damage or reduce the lifespan of the appliance materials.

Always follow the cleaning instructions provided. 

You can order directly at www.puradent.co.uk

Fitting the trays 

For best results, clean and thoroughly dry your teeth before treatment. Dispense a small amount of Vitalisse Whitening gel into each designated dosing reservoir in your custom trays. Fit the trays comfortably over your teeth and gently wipe away any excess gel to protect the surrounding gum tissue. 

Preparing appliance before fit 

Upon receipt from S4S, the appliance must be cleaned and disinfected prior to being fitted or issued to the patient. Although every effort is made to maintain a high level of cleanliness during manufacturing, the appliance is supplied unsealed and therefore cannot be regarded as sterile. It is the responsibility of the dental practice to ensure appropriate cleaning and disinfection procedures are completed before use. 

Recommended Cleaning Product 

We recommend Puradent tablets. Some cleaning products may damage or reduce the lifespan of the appliance materials.

Always follow the cleaning instructions provided. 

You can order directly at www.puradent.co.uk    

Fitting the Bite Raising Appliances 

When fitting a bite-raising appliance, the dentist should confirm that the appliance has been manufactured according to the prescription, check for any sharp or rough acrylic areas, and ensure it engages and seats securely on the dental arch while maintaining patient comfort and avoiding soft tissue irritation or injury. 

Preparing appliance before fit 

Upon receipt from S4S, the appliance must be cleaned and disinfected prior to being fitted or issued to the patient. Although every effort is made to maintain a high level of cleanliness during manufacturing, the appliance is supplied unsealed and therefore cannot be regarded as sterile. It is the responsibility of the dental practice to ensure appropriate cleaning and disinfection procedures are completed before use. 

Adjusting the Retention 

Fully Soft appliances should not be adjusted and should be sent back to lab to be adjusted. 

Too Tight or Difficult to Seat: If the appliance is too tight or difficult to seat, submerge one side of the appliance in freshly boiled water for 10-15 seconds, Take care when handling hot water and allow excess water to drain before placing the appliance, Immediately fit the appliance into the patient's mouth or onto the models. Remove the appliance and place it in cold water to allow it to reset. Recheck the fit and retention. If the appliance remains too retentive, repeat the process as required on the opposite side 

Too Loose: In the unlikely event that the appliance feels too loose or lacks sufficient retention, submerge one side of the appliance in freshly boiled water for 10-15 seconds. Remove the appliance and gently squeeze the retentive areas to improve the fit. Immediately fit the appliance onto the patient's teeth or models to assess the retention. Once the desired fit has been achieved, place the appliance in cold water to allow it to reset. If further adjustment is required, repeat the process as necessary on the opposite side. 

Recommended Cleaning Product 

We recommend Puradent tablets. Some cleaning products may damage or reduce the lifespan of the appliance materials. Always follow the cleaning instructions provided. 

You can order directly at www.puradent.co.uk    

Fitting the Michigan/Tanner 

The fitting of a Michigan or Tanner appliance involves a thorough assessment and adjustment of the hard acrylic appliance to ensure optimal retention, stability, and even occlusal contact. The procedure includes evaluating the initial fit, assessing mandibular movements, and making precise occlusal adjustments to achieve balanced contact and patient comfort. Articulating paper is used to identify and refine occlusal contact points, ensuring even, bilateral contacts in centric relation and appropriate anterior or canine guidance during excursive movements. Any occlusal interferences are selectively adjusted to provide smooth guidance, minimise parafunctional loading, and optimise appliance function. 

Preparing appliance before fit 

Upon receipt from S4S, the appliance must be cleaned and disinfected prior to being fitted or issued to the patient. Although every effort is made to maintain a high level of cleanliness during manufacturing, the appliance is supplied unsealed and therefore cannot be regarded as sterile. It is the responsibility of the dental practice to ensure appropriate cleaning and disinfection procedures are completed before use. 

Adjusting the Retention 

Too Tight or Difficult to Seat: If the appliance is too tight or difficult to seat, submerge one side of the appliance in freshly boiled water for 10-15 seconds, Take care when handling hot water and allow excess water to drain before placing the appliance, Immediately fit the appliance into the patient's mouth or onto the models. Remove the appliance and place it in cold water to allow it to reset. Recheck the fit and retention. If the appliance remains too retentive, repeat the process as required on the opposite side. 

Too Loose: In the unlikely event that the appliance feels too loose or lacks sufficient retention, submerge one side of the appliance in freshly boiled water for 10-15 seconds. Remove the appliance and gently squeeze the retentive areas to improve the fit. Immediately fit the appliance onto the patient's teeth or models to assess the retention. Once the desired fit has been achieved, place the appliance in cold water to allow it to reset. If further adjustment is required, repeat the process as necessary on the opposite side. 

Recommended Cleaning Product 

We recommend Puradent tablets. Some cleaning products may damage or reduce the lifespan of the appliance materials.

Always follow the cleaning instructions provided. 

You can order directly at www.puradent.co.uk    

Preparing appliance before fit 

Upon receipt from S4S, the appliance must be cleaned and disinfected prior to being fitted or issued to the patient. Although every effort is made to maintain a high level of cleanliness during manufacturing, the appliance is supplied unsealed and therefore cannot be regarded as sterile. It is the responsibility of the dental practice to ensure appropriate cleaning and disinfection procedures are completed before use. 

Adjusting Fixed Appliances 

If you are unable to achieve a satisfactory fit, or if there are any concerns regarding the appliance, please return it to S4S for assessment. Our team will review the appliance and make any necessary adjustments to ensure it fits and functions as intended. 

Recommended Cleaning Product 

We would recommend using interdental brushes or water floss around the appliance 

Preparing appliance before fit 

Upon receipt from S4S, the appliance must be cleaned and disinfected prior to being fitted or issued to the patient. Although every effort is made to maintain a high level of cleanliness during manufacturing, the appliance is supplied unsealed and therefore cannot be regarded as sterile. It is the responsibility of the dental practice to ensure appropriate cleaning and disinfection procedures are completed before use. 

Fitting the Removable Retainers 

Check the fitting surface for any areas of roughness Any rough acrylic should be smoothed using an acrylic Try the appliance in the patient's mouth. If any teeth have been lost or extracted since the impressions were taken, further adjustment may be required to ensure an accurate fit. 

Adjust the posterior retention first, followed by the anterior retention, until a satisfactory fit and level of retention is achieved. 

Demonstrate how to insert and remove the appliance, using a mirror where appropriate. Emphasise the importance of removing the appliance correctly to avoid damage. 

Allow the patient to practise inserting and removing the appliance several times under your supervision, ensuring they are confident with the process before they leave the practice. 

Recommended Cleaning Product 

We recommend Puradent tablets. Some cleaning products may damage or reduce the lifespan of the appliance materials.

Always follow the cleaning instructions provided. 

You can order directly at www.puradent.co.uk    

Preparing appliance before fit 

Upon receipt from S4S, the appliance must be cleaned and disinfected prior to being fitted or issued to the patient. Although every effort is made to maintain a high level of cleanliness during manufacturing, the appliance is supplied unsealed and therefore cannot be regarded as sterile. It is the responsibility of the dental practice to ensure appropriate cleaning and disinfection procedures are completed before use. 

Fitting the Removable Orthodontic Retainers 

Check the fitting surface for any areas of roughness and inspect wire tags for sharp edges. Any rough acrylic should be smoothed using an acrylic bur, while sharp wire tags should be adjusted using a green stone. 

Try the appliance in the patient's mouth. If any teeth have been lost or extracted since the impressions were taken, further adjustment may be required to ensure an accurate fit. 

Adjust the posterior retention first, followed by the anterior retention, until a satisfactory fit and level of retention is achieved. 

Demonstrate how to insert and remove the appliance, using a mirror where appropriate. Emphasise the importance of removing the appliance correctly to avoid damage. 

Allow the patient to practise inserting and removing the appliance several times under your supervision, ensuring they are confident with the process before they leave the practice. 

Adjusting the Removable Orthodontic Appliances 

If you are unable to achieve a satisfactory fit, or if there are any concerns regarding the appliance, please return it to S4S for assessment. Our team will review the appliance and make any necessary adjustments to ensure it fits and functions as intended.  

Recommended Cleaning Product 

We recommend Puradent tablets. Some cleaning products may damage or reduce the lifespan of the appliance materials.

Always follow the cleaning instructions provided. 

You can order directly at www.puradent.co.uk