How is a sleep appliance fitted?

The fit process starts chairside. The dentist captures upper and lower arch records, either via PVS impression or intraoral scan, and takes a George Gauge or equivalent bite registration to establish the initial mandibular advancement position, typically 50-75% of maximum protrusion for first delivery. That bite record is the most critical variable: too little advancement and the device underperforms; too much and the patient wakes up with joint discomfort and stops wearing it.

At the lab, those records drive CAD design or direct fabrication depending on the appliance type. Titratable devices like the Herbst or EMA are engineered so the dentist can advance the mandible in 0.25-0.5 mm increments post-delivery without returning the case. Dani Dental fabricates each appliance to the specific bite record received, not a generic starting point, which reduces the number of titration appointments before the patient reaches therapeutic position.

For referring general dentists managing sleep cases alongside a full restorative schedule, turnaround is the friction point. A case sent Monday with a clean digital scan and a proper bite registration ships back by end of the following week, ready for the delivery appointment already on the books. Poor impressions or a missing bite registration add 3-5 days. Sending both records correctly the first time is the fastest path to a fitted, working appliance.