Saliva management system with continuous flow through oral device

Abstract

Systems for maintaining a vacuum in a patient's oral cavity comprises an oral device, a vacuum control system, and an assembly including first and second tubes for connecting the vacuum control system to the oral device. The oral device has an internal plenum, and a vacuum is drawn in the plenum by a vacuum pump connected by a first tube of the tubular assembly. The vacuum is maintained by an air source which is connected to the plenum by the second tube of the tubular assembly. By maintaining a constant circulating air bleed through the oral device and the connecting tubes, saliva may be removed from the system and collected in a saliva trap located before the vacuum pump.

Claims

1. A method for drawing a vacuum in a patient's oral cavity, said method comprising: placing an oral device in the patient's oral cavity, said device having an inlet, an outlet, a plenum there between, and at least one vacuum port on a posterior region of the plenum; drawing a vacuum on the outlet to establish air flow into the inlet, through the plenum, and out from the outlet; restricting the airflow into the inlet to draw a vacuum in the plenum; and wherein at least one of the drawing of the vacuum and the restricting of the airflow into the inlet is controlled to maintain a vacuum wherein moist air will be drawn into the plenum from the patient's oral cavity.

2. A method as in claim 1, wherein the vacuum is maintained in the range from 20 mmHg to 70 mmHg.

3. A method as in claim 1, further comprising removing moisture from the air drawn by the vacuum.

4. A method as in claim 3, wherein moisture is trapped in a trap placed between the device output and the vacuum pump.

5. A method as in claim 1, wherein restricting comprises placing a fixed orifice before the device inlet.

6. A method as in claim 1, wherein the vacuum is controlled by controlling a vacuum pump connected to the device output.

7. A method as in claim 1, further comprising measuring pressures or flow of gas between a first point on the inlet and a second point on the outlet and comparing the measured pressures or flow of gas to determine if the system is functioning properly.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) FIG. 1 illustrates a system constructed in accordance with the principles of the present invention in use by a patient.

(2) FIG. 2 is a schematic illustration of an oral device in combination with a vacuum control system in accordance with the principles of the present invention.

(3) FIG. 3 is a perspective view of an oral device useful in the systems of the present invention.

(4) FIG. 4 is a partial cross-sectional view of the oral device of FIG. 3.

(5) FIG. 5 is a schematic illustration of an alternative embodiment of the oral device of the present invention, said embodiment having a bypass port for passing the air bleed stream through the patient's oral cavity.

(6) FIG. 6 is a schematic illustration of a further alternative embodiment of the oral device of the present invention showing air bleed inlet and outlet paths through a single bite structure or leg of the device.

DETAILED DESCRIPTION OF THE INVENTION

(7) Referring to FIG. 1, a system 10 constructed in accordance with the principles of the present invention includes an oral device 12 (shown in broken line in the oral cavity of a patient P), a control enclosure 14 which is suitable for placement on the top of the table T, and a connector line assembly usually including first and second tubular connectors 18 and 20, better illustrated in FIG. 2-6.

(8) Referring now to FIG. 2, the oral device 12 includes an internal plenum 22 which extends from an inlet 24 to an outlet 26. The plenum 22 is typically integrally formed within the oral device 12, usually being formed as part of a molding process. Alternatively, the plenum 22 could be formed separately and attached to a separate body of the device. In addition to the inlet 24 and outlet 26, the oral device will include one or more vacuum ports 27, where the inlet s are typically formed on an anterior end of the device which will be held near the patient's lips in the oral cavity while the vacuums 27 are on the posterior end of the device which will be near the patient's soft palate when the device is in the patient's oral cavity.

(9) A vacuum is drawn in the plenum 22 by vacuum pump 28 which is connected to the outlet 26 by tubular connector 20. To maintain a controlled vacuum in the plenum 22, an air source 30 is placed in front of the inlet 24, typically being connected by tubular connector 18. The vacuum pump 28 will typically be a diaphragm or other positive displacement pump where the pump speed may be varied in order to control the volume and/or pressure of air pulled from the device 12. In order to control the pressure, the delivery capacity of the air source 30 may be selected and/or controlled. Typically, the air source 30 will comprise a flow restrictor having a fixed orifice, more usually having an orifice area in the range from 0.01 mm.sup.2 to 0.025 mm.sup.2. Optionally, however, the air source 30 could comprise an adjustable orifice valve or a pump which is operated to deliver a fixed volume of air bleed into the plenum 22. In such cases, the controller could automatically control either the valve or the positive pressure pump to help maintain the target vacuum within the plenum of the oral device.

(10) A saliva or moisture trap 32 will be placed in the flow path from the outlet 26 of the oral device 12 to the vacuum pump 28 in order to receive most or all of the air flow from the oral device and to remove saliva and moisture from the air flow before entering the vacuum pump. Usually, the trap 32 will be placed close to the inlet to the vacuum pump although it could be elsewhere in the system.

(11) Usually, at least one pressure and/or flow sensor 40 will be provided in the air bleed inlet flow path between the air source 30 and the inlet 24, or optionally though less desirably within the plenum 22 of the device itself. The pressure/flow sensor 40 will detect the pressure/flow within the plenum either directly or indirectly, allowing controller 34 to control either the vacuum pump 28 and/or the air source 30 in order to maintain a target vacuum within the plenum, typically in the range from 20 mmHg to 75 mmHg, preferably in the range from 30 mmHg to 55 mmHg.

(12) Optionally, a second pressure and/or flow sensor 42 may be provided between the outlet 26 of the oral device 12 and the vacuum pump 28, typically between the saliva trap 32 and the vacuum pump 28. The pressure and/or flow measured by sensor 42 can be compared with the reading from sensor 40 to make sure that the flow and/or pressure within the plenum 22 of the oral device 12 are within proper operating ranges. For example, should saliva or any other material or failure block flow within the plenum 22, the readings between the sensor 40 and sensor 42 would be expected to deviate substantially, indicating a system failure.

(13) Referring now to FIGS. 3 and 4, an exemplary oral device 50 is illustrated. The oral device is fabricated from a polymer such as a polycarbonate or a polyvinyl acetate polymer (e.g., Versaflex polymer), which may be molded or otherwise formed to have an anterior end 52 and a cross-member 54 at a posterior end. Bite plates 56 are formed on each side of the oral device 50, and the cross-member 54 includes a plurality of vacuum ports 58 formed on an upwardly and forwardly inclined surface 60 of the cross-member 54. Plenum 62 is formed in the interior of the oral device 50 and provides a circulation path shown by the arrows in FIG. 4. While the oral device 50 is exemplary of those useful in the systems and methods of the present invention, many other devices having the vacuum plenum, inlet and outlet, and vacuum ports would also be useful.

(14) Referring to FIG. 5, an oral appliance 70 constructed in accordance with an alternative aspect of the present invention comprises a first bite structure or leg 74 and a second bite structure or leg 76. The first and second bite structures are joined at a posterior end by a cross-member 79 having a plurality of vacuum ports 84 formed over a posterior surface thereof. An air bleed, as generally described above, enters an interior passage or a lumen within the first bite structure 74 through an inlet 78. Instead of circulating through a continuous plenum to outlet 80, as with previous embodiments, the air entering through inlet 78 will pass into the patient's oral cavity through a bypass outlet 82. That air, or at least an equivalent volume or mass of air, will pass back into the plenum through the vacuum ports 84 together with any additional air which may have leaked into the patient's oral cavity which needs to be removed. The combined air streams will then flow down through the second bite structure or leg 76 and out the outlet 80, to the vacuum control system as described previously for other embodiments. In order to isolate the higher pressure region of the plenum in the first leg 74 from the lower pressure region of the plenum in the second leg 76, a barrier 86 will usually be disposed in the plenum between the bypass port 80 and the vacuum ports 84.

(15) Referring now to FIG. 6, an oral appliance 90 incorporating still alternative features of the present invention includes a first bite structure or leg 92 and a second bite structure or leg 94. The first bite structure 92 has an interior passage or lumen which is divided into inlet and outlet segments by a barrier or wall 100. A plenum inlet 98 is located at the anterior end of a first of the divided passages so that air bleed entering the inlet can flow in a posterior direction until it reaches cross-member 95 disposed between the bite structures 92 and 94. A wall or partition 100 terminates at that point so the air inflow can turn to pass in the opposite direction through the second portion of the divided air plenum so that a continuous air bleed is constantly maintained by vacuum port(s) 102 located on a posterior surface of the cross-member. The combined flows of the air bleed and any air which is drawn in through the vacuum port(s) then extends in an anterior direction through the other segment of the passage within the first bite structure so that it can exit through outlet 96. Usually, but not necessarily, the interior of the second bite structure or leg 94 will be blocked and isolated from the air flow so that it does not become contaminated.

(16) While the above is a complete description of the preferred embodiments of the invention, various alternatives, modifications, substitutions, and equivalents may be used. Therefore, the above description should not be taken as limiting the scope of the invention, which is defined by the appended claims.