The Klearway Appliance

Image of the Klearway oral appliance

The Klearway Appliance
invented by Dr. Alan Lowe

The Klearway Appliance is an example of a well designed and well researched oral appliance for treating snoring and sleep apnea. It is effective because it keeps the teeth together and holds the lower jaw and tongue forward during sleep to open the airway. It possesses excellent retention characteristics designed to keep the appliance in the mouth during all the various complex jaw movements that can occur during sleep. It provides full coverage of the teeth of both arches and is designed not to encroach on tongue space. Furthermore, it facilitates the slow and gradual movement of the lower jaw by permitting the patient to adjust the appliance according to his or her own comfort level with the guidance of the attending dentist. This appliance is a very reliable device.

This fully adjustable oral appliance is much more comfortable to wear than a single-jaw-position appliance, which often may require time-consuming and expensive remakes to place the lower jaw in the ideal forward position required to adequately open the airway. Fabricated of thermoactive acrylic, The Klearway becomes pliable, with mild heat, for easy insertion and conforms securely to the teeth for an excellent fit while significantly decreasing soft tissue and tooth discomfort. Forty-four forward positions are available in increments of 0.25 mm, which covers a full 11.0-mm range of forward and backward movement. Such small increments help avoid the rapid forward jaw movements that can cause significant patient jaw joint discomfort.

The Klearway allows the patient to feel less restricted and thus less claustrophobic—a sensation experienced by a small number of patients during the first few nights of wear. Once the appliance is warmed under hot water and inserted, the acrylic resin hardens as it cools to body temperature and firmly affixes itself to both upper and lower teeth. Lateral and vertical jaw movement is permitted, with the appliance in place which enables the patient to yawn, swallow and drink water without dislodging the appliance. Patients who grind or clench their teeth are very comfortable with this appliance since it does not prevent jaw movements during sleep. Patients with mild jaw joint discomfort also can usually wear the Klearway with ease, since the jaw position used is very comfortable for both the joint over the long term.

Patients with few or no teeth are not ideally suited for treatment with mandibular advancing devices, because they may not have enough teeth to keep the appliance in the mouth during sleep. A Tongue Retaining Device (TRD) should be considered in such cases. Patients with no teeth require implants to hold the appliance in place.

Some patients stop snoring and feel more rested shortly after the Klearway is inserted, and no further advancement of the lower jaw is required. Other patients may require two or three months of slow and gradual appliance adjustment before a significant treatment effect is achieved. When the patient and bed partner report an end to snoring and a resolution of symptoms, further advancement of the lower jaw may not be required and the appliance is considered to be properly adjusted.

The Klearway appliance is the most extensively researched appliance available today. Data from a large clinical trial, funded by the Canadian government, indicates a 78% success rate for treating sleep apnea. It has been shown to effectively increase airway size, to be worn consistently, and to have a significant effect on both snoring and obstructive sleep apnea.

Acknowledgement: The Klearway was invented by Dr. Alan Lowe D.M.D., Ph.D., F.R.C.D.(C), F.A.C.D. Dr. Lowe is Professor and Chair, Division of Orthodontics, Department of Oral Health Sciences, Faculty of Dentistry at the University of British Columbia. International patents have been obtained by the university and specific licencees are assigned the rights to manufacture and distribute the appliance world-wide. The preceding text extensively borrows from Dr. Lowe’s description of the Klearway.