Morning Aligner (MA) for Oral Appliance Therapy (OAT) 

Purpose: to help maintain tooth position during OAT.

Exam before fabrication of MA

  • Check bite to make sure the posterior is hitting on both sides with articulating paper
  • If not, then note in chart and alert the doctor before proceeding
  • Fabricate BEFORE trying in the MAS

Fabrication

  • Either cut the MA material into a section about 1” long, or get a teaspoon of thermocryle
  • (with Kevlar beads (Tan))
  • Heat the MA material (over 160 degrees) until soft and pliable. Make sure not too hot.
  • Mold onto upper anterior teeth from canine to canine. Push up in the back palatal area
  • and mold onto the front.
  • Have patient bite down hard until they feel back teeth touching. Have them push the MA
  • against the front teeth with their tongue. Mold from the front with your fingers. Note that
  • this will probably bite through the MA material in certain points. That is OK.
  • Let cool and remove
  • Once totally cool, reinsert and use articulating paper to confirm posterior teeth are
  • touching with MA in place
  • Instruct patient to use this every morning after taking out the MAS. Wait 5 min after
  • removing the MAS before inserting the MA.
  • Note in chart that you fabricated and gave instructions, and esp warned the patient that if
  • they do not do this, they will get tooth movement (in treatment section – “browse”).

Patient Instructions

  • Put into mouth 5 -10 minutes after the MAS is removed upon waking up
  • Chew down onto the MA until the back teeth are hitting together
  • Easy to do in the shower as it helps relax the muscles
  • Rinse off after use and allow to dry

Follow-up appointments

  • Check for posterior contacts with articulating paper
  • If not contact, ask patient if they have been using the MA every day and for how long
  • Insert the MA and use articulating paper to confirm contacts
  • If no contact, then remake MA
  • If no contact without the MA, then give bit tabs for 3 weeks and have them return for new MA
  • Note all these findings in the chart 

Morning Aligner PDF