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PETER T. GEORGE, DDS
Honolulu

Arch Otolaryngol Head Neck Surg. 1987;113(12):1340-1341.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—Viewing obstructive sleep apnea as a mechanical problem in which the tongue is sucked back against the posterior pharyngeal wall, I modified an activator to prevent it. An activator is an appliance used by orthodontists to posture the mandible forward to stimulate its growth in children. Since the tongue musculature is attached to the anterior of the mandible, advancement of the jaw pulls the tongue away from the pharynx.

Activators fit loosely in the mouth so that the patient is encouraged to continually bite into the appliance. Each closure applies pressure to the teeth and jaws, thereby activating the appliance. To eliminate the orthodontic activation, I put clasps on the appliance to prevent jaw opening. This serendipitously enhanced the antiapnea effect of the appliance for two reasons.

1. 1. As the mouth opens, the front of the mandible describes an arc around the glenoid fossa. This results in
   

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