Patent Grant
11819752
Embodiments described herein relate to devices and methods for preventing trauma and injury to the tongue of a user experiencing a seizure or other neurologic event characterized by excessive and/or uncontrolled movements, and minimizing excessive salivation by the user, while posing minimal hazard to the user.
Movement disorders are defined as neurologic conditions in which there are abnormal, uncontrolled movements. For example, tremors are a type of movement disorder. Diseases of the central nervous system, such as Parkinson's disease, can cause many movement disorders or symptoms of movement disorders characterized by a loss of control over posture and limb movements. Neurologic conditions in which there is a disturbance of brain function can also result in seizures and symptoms akin to those defined by movement disorders. Seizures are most commonly associated with epilepsy, which as a diagnosis, has a complex collection of symptoms. People with epilepsy have a continuing tendency to have seizures which cause disturbances in mental function, consciousness, sensory perception, and body movements. Seizures, convulsions and other spasmodic attacks are not necessarily epileptic in nature and can be a secondary response to an alternative, underlying neurologic condition. Other causes of seizures or convulsions include injuries, autoimmune diseases, infections, and negative responses to certain medicines. Seizures, convulsions, and other spasmodic attacks are generally diagnosed based on the history of the patient's symptoms, in conjunction with neurological exams, (i.e. EEG, MRI).
Disturbances in brain function, movement disorders and seizure induced complications can include injuries to parts of the body that are affected during episodes. Tongue biting is a common injurious consequence that can result from uncontrollable shaking and movements of the body, including the mouth. Additionally, seizures are frequently associated with excessive salivation and sialorrhea or drooling. During tonic-clonic seizures, the most common form of seizures, the jerking movements that may occur during the seizure poses a high risk of trauma or injury to the tongue and hypersalivation, which may result in foaming at the mouth or drooling. The tightening of jaw and face muscles during seizures may cause the person to bite down incessantly in the form of a chewing motion. These symptoms increase the likelihood of an unintentional injury to the tongue. Neurologic conditions in which tongue biting and/or drooling may occur include, but are not limited to: epilepsy, Parkinson's disease, traumatic brain injury (TBI), eclampsia, cerebral palsy, stroke, hypoglycemia, syncope, psychogenic seizures (PNES), and brain tumors. All of the aforementioned conditions represent forms of movement disorders, seizures, or are characterized by the possibility of having seizures, which increases the likelihood of tongue biting. Tongue biting is a physical finding associated with seizures, more specifically, a diagnosis of epilepsy. In addition to epilepsy, tongue biting is a consequence or concomitant of other rare neurological disorders such as conversion disorder, ataxia, choreaacanthocytosis, and tardive dyskinesia.
The most common of the aforementioned conditions include: epilepsy, Parkinson's disease, stroke, syncope, post-traumatic seizures from TBI, and PNES. According to the Epilepsy Foundation, approximately 3 million people have epilepsy in the United States, and 65 million people suffer from epilepsy worldwide. According to Citizens United for Research in Epilepsy (CURE), each year roughly 200,000 new cases of epilepsy will be diagnosed, with a higher incidence in young children and older adults. Additionally, it is estimated that between 30-45% of people with epilepsy do not respond to medication and thus suffer from intractable or refractory seizures. According to the Parkinson's Disease Foundation, Parkinson's disease affects about 1 million people in the United States and more than 4 million people worldwide. About 60,000 people are diagnosed each year in the United States. The Heart and Stroke Association estimates that approximately 800,000 people experience a stroke per year in the United States, and is a leading cause of serious, long-term disability, (i.e. paralysis of limbs and limited ability to perform autonomic functions). Approximately 1 million people are evaluated and treated for syncope in the United States each year. TBI affects roughly 2 million people per year in the United States and the Epilepsy Foundation estimates that the prevalence rate of PNES is comparable to that of multiple sclerosis. The cost of caring for epilepsy in the United States, including medications and first-aid treatment, accounts for approximately $15.5 billion each year. The indirect costs associated with uncontrolled seizures are seven times higher than that of the average for all chronic diseases.
Healthcare professionals continue to advise that no objects be placed in a person's mouth that is seizing. This is due to the risk of the patient breaking and/or swallowing the object and/or their teeth. Additionally, an object may also obstruct the person's respiration and/or ability to salivate appropriately. The most important thing to do during a seizure is to protect the person experiencing the seizure. Unfortunately, there are limited products and means with which to prevent oral injury and protect those who experience seizures. As such, the severity and pain associated with tongue lacerations have left patients who experience seizures limited options of protecting their tongues. As one of the most sensitive organs of the body, trauma or injury to the tongue causes great discomfort to patients and may impede their ability to talk and eat. Injuries to the tongue can create additional anxiety and feelings of embarrassment for patients with epilepsy and other movement disorders. While it is advised that nothing be placed in the mouth of a patient seizing, as a remedy, some patients have resorted to the use of traditional dental guards, mouthguards, bite blocks, and the like to prevent injury to the tongue. These devices are medically and financially unsuitable for seizure/movement disorder patients to use in preventing injury. They are designed with the primary functionality of protecting teeth and as such, the configuration of the devices require expensive, specialty fitting, and are bulky and uncomfortable. Furthermore, dental appliances made for dental applications are commonly made of materials or polymers that are not conducive to the compressive forces between the jaws during a seizure and thus, result in deformation or penetrability of the objects. This increases the risk of the dental appliance becoming dislodged, causing a choking or swallowing hazard. These products also fail to adequately prevent hypersalivation or drooling. The structural design of these oral devices are suitable for their aforementioned utility, and are thus unsuitable for seizure/movement disorder patients based on the nature of the physical symptoms associated with seizures/movement disorders. There is a need for a medical device that is specifically designed to prevent trauma and injury to the tongue, and minimize excessive salivation, while posing minimal hazard to patients while they are experiencing a seizure.
Apparatus and methods are described herein for preventing trauma and injury to the tongue of a user experiencing a seizure or other neurologic event characterized by excessive and/or uncontrolled movements, and minimizing excessive salivation by the user, while posing minimal hazard to the user. In some embodiments, an oral device can include a tongue protector configured to be disposed beneath the tongue of a user. The oral device can have a tongue receptacle configured to receive the tip of the tongue of the user and cover a distal portion of the top surface of the tongue. The oral device can also include a left tooth protector configured to be disposed over only the left lower molars and canine of the user and a right tooth protector configured to be disposed over only the right lower molars and canine of the user. A left coupler can be coupled to the left tooth protector and the tongue protector and a right coupler can be coupled to the right tooth protector and the tongue protector. The left coupler and the right coupler can be configured to allow limited relative movement of the tongue protector with respect to the left tooth protector and the right tooth protector while retaining the tongue protector in the user's mouth.
An oral device and method of use are disclosed that provide both a structural and functional response for the problem of tongue biting (during seizures and other conditions in which the body experiences spasmodic attacks, jerking, teeth clenching, uncontrollable movements that increase the likelihood of biting the tongue), and hypersalivation. The device is cost effective, has simple structure, safe (clinical) use, and easily inserts in the mouth. It is both a clinical and household aid in preventing trauma and injury to the tongue and hypersalivation during seizures.
The oral device protects the tongue during seizures/movement disorders and mitigates the trauma created from the chewing motion of the upper and lower teeth, specifically the molars and canines. The configuration and material used to create the device is based on research regarding how seizures present (the physical symptoms that occur during seizures), and how these symptoms affect the interaction between the teeth and the tongue of a patient who seizes. The configuration of the device is based on the anatomical physiology of the mouth, teeth, and tongue.
The tongue protector 120 includes a tongue receptacle 122 in which the tip of a user's tongue can be disposed during use. In some embodiments, the tongue protector 120 can be shaped such that the tongue protector 120 includes a rounded front portion (e.g., formed by the tongue receptacle 122) intended for engagement with the tip of the user's tongue and a back portion intended for engagement with the top side of the user's tongue. The back portion can have any suitable shape, such as, for example, a rectangular shape. In some embodiments, the tongue protector 120 can be U-shaped. In some embodiments, the tongue protector 120 can have a shape corresponding to a user's tongue. The back portion can also include a rear cut out (not shown) having any suitable shape, such as, for example, a triangular cut out or a rounded cut out.
The tongue protector 120 and the tongue receptacle 122 can have any suitable length and width. For example, in some embodiments, the tongue protector 120 can be shaped and sized such that the tongue protector 120 can enclose the bottom side of the user's tongue and half of the length of the top side of the user's tongue. In some embodiments, the tongue protector 120 can be shaped and sized such that the tongue receptacle 122 can enclose only a front portion of the user's tongue such that less than the entire bottom side of the user's tongue is enclosed and the tongue protector 120 can extend over less than half of the length of the top side of the user's tongue. In some embodiments, the tongue protector 120 can be shaped and sized such that the tongue receptacle 122 can enclose only a front portion of the user's tongue such that less than the entire bottom side of the user's tongue is enclosed and the tongue protector 120 can extend over half or more than half of the length of the top side of the user's tongue. In some embodiments, the tongue protector 120 cannot include a tongue receptacle 122 and only contact the top side of a user's tongue in use. In some embodiments, the tongue receptacle 122 have a length (e.g., the length of the tongue receptacle extending along the center of the tongue of the user) can be half as long as the length of the tongue protector 120 including the tongue receptacle 122. In some embodiments, the tongue receptacle 122 can have a length that is less than or more than half the length of the tongue protector 120.
With respect to the width of the tongue protector 120, in some embodiments the tongue protector 120 can be shaped and sized such that the tongue protector 120 can cover the entire width of the top side of the user's tongue. In some embodiments, the tongue protector 120 can be shaped and sized such that the tongue protector 120 can cover less than the entire width of the top side of the user's tongue.
In some embodiments, the tongue protector 120 can be elastic. For example, the tongue receptacle 122 can be sufficiently elastic such that the tongue receptacle 122 can have a smaller length and/or width when the tongue receptacle 122 is not engaged with a user's tongue than when the user's tongue is inserted within the tongue receptacle 122 and/or moved relative to the user's teeth while within the tongue receptacle 122. In some embodiments, the elasticity of the tongue protector 120 can vary within the tongue protector 120. For example, the tongue receptacle 122 can have a higher elasticity than the remainder of the tongue protector 120.
The tongue protector 120 can have any suitable flexural modulus. In some embodiments, the tongue protector 120 can have a low flexural modulus such that the tongue protector 120 is easily bendable. For example, the tongue protector 120 can have a flexural modulus sufficiently low such that the tongue protector 120 can be bendable by the user's tongue. In some embodiments, the tongue protector 120 can have a high flexural modulus such that the tongue protector 120 is rigid. For example, the tongue protector 120 can have a flexural modulus sufficiently high such that the tongue protector 120 is not bendable by a user's tongue. In some embodiments, the flexural modulus of the tongue protector 120 can vary within the tongue protector 120. For example, the tongue receptacle 122 can be more or less rigid than the remainder of the tongue protector 120.
The left tooth protector 130 and the right tooth protector 150 are configured to be secured to the teeth of the user. The left tooth protector 130 and the right tooth protector 150 can be configured to be secured to any suitable tooth or range of teeth. For example, in some embodiments, the left tooth protector 130 and the right tooth protector 150 can be shaped and sized such that the left tooth protector 130 and the right tooth protector 150 can be disposed over the left and right lower molars (e.g., the first and second premolars and first and second molars) and canines of the user, respectively. Said another way, the left tooth protector 130 and the right tooth protector 150 can be disposed over teeth on the left and right side of a user's mouth, respectively, leaving the user's incisors uncovered. In some embodiments, the left tooth protector 130 and the right tooth protector 150 can be shaped to be disposed over the user's range of teeth from the lower canine to the lower third molar (if the user has a lower third molar) on each side of the user's mouth. In some embodiments, the left tooth protector 130 and the right tooth protector 150 can only be disposed over the lower molars or the lower canines.
In some embodiments, the left tooth protector 130 and the right tooth protector 150 can be shaped to be disposed over the upper molars and canines of the user. In some embodiments, the left tooth protector 130 and the right tooth protectors 150 can each include two or more separate portions configured to engage a user's teeth. For example, a first portion of the left tooth protector 130 can be disposed over the lower canine and a second portion of the left tooth protector 130 can be disposed over the first molar and second molar, leaving the first premolar and the second premolar uncovered. In some embodiments, rather than including a distinct left tooth protector 130 and a distinct right tooth protector 150, one unitary teeth protector, including the left tooth protector 130 and the right tooth protector 105, can extend all the way around the user's lower or upper teeth, including over the user's lower or upper incisors.
The left tooth protector 130 and the right tooth protector 150 can be secured to the teeth of the user via any suitable means. In some embodiments, the left tooth protector 130 and the right tooth protector 150 are secured to the teeth of the user via a friction fit. In some embodiments, the left tooth protector 130 and the right tooth protector 150 can be configured to “snap” or “lock” into place over the teeth of the user. In some embodiments, the left tooth protector 130 and the right tooth protector 150 can engage each tooth along the entire height of each tooth (e.g., from the top of the tooth to the gum line). In some embodiments, the left tooth protector 130 and the right tooth protector 150 can engage only a portion of each tooth, such as the top half of each tooth. In some embodiments in which the left tooth protector 130 and the right tooth protector 150 are each disposed over a range of teeth, the left tooth protector 130 and the right tooth protector 150 can be secured to each tooth in the range. In some embodiments in which the left tooth protector 130 and the right tooth protector 150 are each disposed over a range of teeth, the left tooth protector 130 and the right tooth protector 150 can only be secured to the teeth on the edges of the range.
The left tooth protector 130 and the right tooth protector 150 can be formed as any suitable shape. In some embodiments, the left tooth protector 130 and the right tooth protector 150 can each have a rectangular shape such that the left tooth protector and the right tooth protector can be slid over the teeth of the user. In some embodiments, the left tooth protector 130 and right tooth protector 150 can each be shaped with a curve similar to the curve of the corresponding teeth of a user's mouth. In some embodiments, the left tooth protector 130 and the right tooth protector 150 can be shaped to conform to the shape of each individual tooth in the range over which the left tooth protector 130 and the right tooth protector 150 are to disposed. For example, the left tooth protector 130 and the right tooth protector 150 can be molded such that the left tooth protector 130 and the right tooth protector 150 are personalized for a particular user.
As described above, the left coupler 140 couples the left tooth protector 130 to the tongue protector 120, and the right coupler 160 couples the right tooth protector 150 to the tongue protector 120. Each of the left coupler 140 and the right coupler 160 can allow for limited movement of the tongue protector 120 relative to the left tooth protector 130 and the right tooth protector 150 (e.g., for speaking, eating, and/or drinking). For example, the left coupler 140 and the right coupler 160 can allow the user's tongue to move the tongue protector 120 within a mouth of the user and/or such that the user's tongue and the tongue protector 120 can extend beyond a user's incisors. In some embodiments, the left coupler 140 and the right coupler 160 can prevent the tongue protector 120, and therefore the user's tongue when within the tongue protector 120, from extending a particular distance from the left tooth protector 130 and the right tooth protector 150. In some embodiments, the left coupler 140 and the right coupler 160 can be configured such that the resistance to movement of the tongue protector 120 is increased as the tongue protector 120 is moved farther from the left tooth protector 130 and/or the right tooth protector 150. In some embodiments, the left coupler 140 and the right coupler 160 can be sufficiently rigid to not allow movement of the tongue protector 120 relative to the left tooth protector 130 and the right tooth protector 150. In some embodiments, the left coupler 140 and the right coupler 160 can each be a predetermined length such that the tongue protector 120 can only move a predetermined distance relative to the left tooth protector 130 and the right tooth protector 150.
In some embodiments, the left coupler 140 and the right coupler 160 can each provide an elastic support for the tongue protector 120 relative to the left tooth protector 130 and the right tooth protector 150. For example, the left coupler 140 and the right coupler 160 can each be formed of an elastomeric material. In some embodiments, the left coupler 140 and the right coupler 160 can include a spring made of, for example, metal. In some embodiments, the left coupler 140 and the right coupler 160 can be fixedly attached to the left tooth protector 130 and the right tooth protector 150, respectively, and/or to the tongue protector 120. In some embodiments, the left coupler 140 and the right coupler 160 can be releasably attached (e.g., via a magnetic attachment mechanism) to the left tooth protector 130 and the right tooth protector 150, respectively, and/or to the tongue protector 120.
In some embodiments, as illustrated in the bottom perspective views of device 600 in
In some embodiments, instead of couplers fitting over the back molars, a device can include two or more thin filaments, attached to the tongue protector, that can fit between teeth of the user (e.g. the molars or other top or bottom teeth). For example,
Although
As described above, in some embodiments, the ends of the two thin filaments 1267 and 1367 can be attached the tongue protector to anchors and/or weighted anchors (also referred to as “attachments”), such as attachments 1235 and 1255 shown in
In some embodiments, the device configuration ensures that the tongue protector is secure during spasmodic or jerking movements that may occur during convulsive seizures. It also allows the tongue protector to stay in place while the teeth and tongue are moving during a seizure. It also allows the mouth to open and close, and the tongue to move, without the device becoming dislodged. Whereas in some embodiments the tongue protector receives the tip of the tongue, in other embodiments, such as devices 1300 and 1400 illustrated in
In some embodiments, as indicated in the schematic in
In some embodiments, the electromechanical component can include a motor controlled by a printed circuit board (PCB) and powered by a power source. A vibrating element, such as, for example, a small weight, can be attached to the motor. The electromechanical component can also include a housing in which the motor, power source, vibrating element, and/or PCB can be disposed. The power source can be, for example, a small, rechargeable battery. The battery can be selected to optimize space efficiency and power. The PCB can control the motor to provide various patterns and multiple speeds of vibration. In some embodiments, a single button can be used to perform multiple functions (e.g., turn the motor on/off and select one of the various patterns and multiple speeds of vibration). In some embodiments, the PCB can include two or more controls to induce specific changes to the length and resistance of the wires and/or circuit of the PCB to adjust the pattern and speed of vibration of the vibrating element. The housing can be relatively thin and can be formed of, for example, plastic or another hard material.
In some embodiments, the electromechanical component, or a portion of the electromechanical component, can be encapsulated by the material (e.g., polymer) of one of the couplers 140, 160 and/or the tongue protector 120. Although only one electromechanical component has been described, in some embodiments each of the left coupler 140 and the right coupler 160 can be associated with a separate electromechanical component.
In some embodiments, the oral device can contain a sensor that enables the device to sense saliva production and/or force of bite during seizures. This sensor can be configured to be housed inside the tongue protector, inside the couplers, and/or inside the sockets. The wearable sensor automatically collects data that is used to detect seizures or movement disorders or neurologic disorders characterized by hypersalivation, excessive drooling, and/or teeth clenching (biting) in association with a probable seizure or convulsive activity. This wearable sensor allows the device to be used to track biometric data and thus can be used as not only a preventative intervention but also as a diagnostic tool for tracking or diagnosing seizures based on this symptomatology. In some embodiments, such a device could be used in the clinic as a diagnostic and preventative intervention. In similar or some other embodiments, such a device could also be used in an outpatient setting and/or as a consumer technology. In some embodiments, the device can be fashioned to provide critical support especially during nocturnal seizures when a person may not be aware that they are experiencing a seizure, and thus evidence of these symptoms could provide information about whether the person experienced a seizure, and for how long, and how severe an episode based on the force of bite measured using the sensor on the tongue protector. This will allow patients to track their seizure activity while wearing the device for protection, and/or be used as means for refining or improving treatment plans for symptom management.
In use, the oral device 100 can prevent the damage from teeth to teeth and/or teeth to tongue impact that can occur during biting or chewing (e.g., during a seizure). For example, during a seizure, damage to the teeth and/or lateral lacerations and/or other injuries to the tongue can be caused by the molars and/or canines. Due to the surface area ratio, the lower molars (i.e. molars and premolars) and canines can experience the most impact during the chewing motion. Additionally, lacerations and/or other injuries to the tip of the tongue can be caused by the incisors. The oral device 100 can prevent damage and injury to the teeth and tongue via the dissipation and mitigation of the force of impact between, for example, the top and bottom molars and canines and between the teeth and the tongue.
Specifically, the left tooth protector 130 and the right tooth protector 150 can have both a device-securing function and a teeth-protecting function. The left tooth protector 130 and the right tooth protector 150 can have a device-securing function in that the oral device 100 can be maintained in position within the mouth of the user via the left tooth protector 130 and the right tooth protector 150 being secured and maintained on the teeth of the user. As a result of the left tooth protector 130 and the right tooth protector 150 being secured and maintained on the teeth of the user, the tongue protector 120 can be held in position and/or can have limited movement relative to the teeth of the user via the left coupler 140 and the right coupler 160.
Second, the left tooth protector 130 and the right tooth protector 150 can have a teeth-protecting function in that the left tooth protector 130 and the right tooth protector 150 can dissipate and mitigate the force of impact between, for example, the top and bottom molars and canines. For example, in some embodiments, the material forming the portion of each of the tooth protectors 130, 150 disposed over the top surface of the lower teeth can be sufficiently thick to absorb the force of the top teeth impacting the lower teeth such that the top teeth and the lower teeth are not damaged. Additionally, in some embodiments, if the lateral portions of the tongue are disposed between the tooth protectors 130, 150 and the upper teeth, the tooth protectors 130, 150 can prevent the lateral portions of the tongue from being damaged due to the ability of the tooth protectors 130, 150 to absorb some of the force resultant from the upper teeth impacting the tongue. In some embodiments, the tooth protectors 130, 150 can be shaped and sized such that lateral portions of the tongue are prevented from being disposed in the space between the upper teeth and the lower teeth.
The tongue protector 120 can prevent lacerations and/or other injuries to the tip of the tongue (e.g., caused by the incisors). In some embodiments, the tongue protector 120 can also prevent lateral lacerations and/or other injuries to the lateral portions of the tongue caused by the canines and/or molars by protecting the tongue from direct contact with the teeth. The tongue protector 120 can serve as a barrier between uncovered teeth and the tongue of the user. In use, when the user's tongue is placed inside the tongue receptacle 122 of the tongue protector 120, the tongue protector 120 can protect the bottom of the tip of the tongue, the top of the tip of the tongue, and a portion of the remainder of the tongue. In some embodiments, the tongue protector 120 can cover the bottom of the tongue and the tip of the top of the tongue to the middle of the top of the tongue.
The tongue protector 120, the tooth protectors 130, 150, and/or the couplers 140, 160 can be made of any suitable material(s). The material(s) can be selected based on considerations including: a) withstanding the force with which chewing and biting may occur during seizures; and b) efficacy in minimizing hypersalivation.
With respect to withstanding force, the material selected for the tongue protector 120 can have a compressive strength sufficient to resist the compression caused by the teeth of the user on the tongue protector 120. The material selected for the tongue protector 120 can have a shear strength sufficient to resist piercing by the teeth through the material of the tongue protector 120, thus preventing injury to the tongue. Additionally, the material of the tongue protector 120 can be sufficiently elastic to allow lateral and vertical mobility of the tongue protector 120 when engaged with a user's tongue. Additionally, the material of the tongue protector 120 can be sufficiently elastic to allow the mouth of the user to open and close as needed. The elasticity of the tongue protector 120 can also assist in reducing teeth clenching, which can cause muscles to tighten. In some embodiments, the elasticity of the tongue protector 120 can provide mobility support for the tongue and enable users with tongue weakness, such as stroke patients, to rehabilitate tongue strength.
The tooth protectors 130, 150 can be formed of a material with a high compressive strength to resist compression by the teeth during a biting or chewing movement. Additionally, in some embodiments, the tooth protectors 130, 150 can be formed of a material with low elasticity such that the tooth protectors 130, 150 can snap lock into place over the teeth of the user. In some embodiments, the tooth protectors 130, 150 can be formed of a material resulting in sufficient surface friction such that the tooth protectors 130, 150 can remain secured to the teeth via a friction fit.
In some embodiments, the left coupler 140 and the right coupler 160 can be formed of the same material as the tongue protector 120 and/or the tooth protectors 130, 150. In some embodiments, the oral device 100 can be formed as a one piece, unitary structure. For example, the oral device 100 can be molded. The thicknesses of each portion of the oral device 100 can be selected based on the desired characteristics of that portion. For example, the left coupler 140 and the right coupler 160 can have a particular thickness corresponding to a particular elasticity. Similarly, the tongue receptacle 122 can have a particular thickness that is the same or different from the thickness of the left coupler 140 and the right coupler 160 such that the tongue receptacle 122 has a particular elasticity. Thus, the degree of movement of the tongue relative to the left tooth protector 130 and the right tooth protector 150 can be limited as desired by adjusting the thicknesses of each of the components of the oral device 100.
In some embodiments, the thickness of the tongue protector 120 can be sufficiently thin to minimize the space between the front teeth and the tip of the tongue such that the user can communicate verbally (e.g., with a minor lisp) and such that the oral device 100 is comfortable for the user. The tongue protector 120 must also be of sufficient durability (e.g., thickness, shear strength, and/or compressive strength) to effectively protect the tongue from injury by the user's teeth.
In some embodiments, the dimensions of the oral device 100 can be selected such that the oral device 100 can conform to the mouth size of an adult. In some embodiments, the dimensions of the oral device 100 can be selected such that the oral device 100 can conform to the mouth size of a child. For example, the dimensions of the tongue protector can be selected such that the tongue protector 120 can conform to the tongue size of an adult or a child.
As described above, the material(s) of the oral device 100 can be selected based on the material(s) efficacy in minimizing hypersalivation. A person experiencing a seizure, for example, often has difficulty swallowing. This can cause saliva to be retained in the mouth, which can lead to choking. Thus, the oral device 100 or a portion of the oral device 100 can be made of a polymer having both sufficient durability to withstand a chewing or biting force and absorbent properties to prevent the accumulation of saliva and foaming at the mouth. For example, the oral device 100 or a portion of the oral device 100 can include superabsorbent polymers (SAPs) and/or synthetic hydrogels engineered to absorb and retain large amounts of a liquid relative to their own mass. In some embodiments, the oral device 100 or a portion of the oral device 100 can include a non-toxic, sponge-like or foamed polymer having super absorbent properties. The use of an oral device 100 having such material properties will allow a user of the oral protector to maintain a comfortable position during a seizure. While it is commonly advised by healthcare professionals to turn a patient on his/her side to allow saliva to drain from the mouth, the oral device 100 will allow patients who experience a seizure to maintain any comfortable position, such as sitting upright, lying supine, or lying on either side, without the concern of choking or foaming at the mouth.
In some embodiments, the shape of the tongue protector 120 can be selected to yield the highest probability of limited salivation, protection and non-injury. For example, as described above, the shape of the tongue protector 120 can be substantially U-shaped, similar to that of the user's tongue, and the tooth protectors 130 and 150 holding the device in place on the teeth can be shaped akin to a rectangle.
In some embodiments, the tongue protector 120 can optionally define one or more perforations or apertures 128. The one or more apertures 128 can strengthen the tongue protector 120 due to their tendency to oscillate under impact. Additionally, the one or more apertures 128 can allow airflow through the tongue protector 120 to the tongue and assist in reducing the buildup of saliva which may occur as a result of excessive salivation (e.g., during seizures). The one or more apertures 128 can also facilitate the administration of liquids to a user by mouth using a straw or other hydration device, such as, for example, in a hospital or outpatient clinic. More specifically, the one or more apertures will assist in delivering liquid directly to the tongue of the patient without needing to remove the device.
In some embodiments, the oral device can include a space within and/or under the tongue receptacle configured to receive an absorbent pad. For example, device 1100 shown in
Some patients have expressed an unpleasant taste occurring as a consequence of having a seizure. As such, a flavoring agent can be embedded in the material of the tongue protector 120. In some embodiments, designs can be printed on the tongue protector 120 for aesthetic purposes. For example, designs on the tongue protector 120 can make the oral device 100 more child-friendly, reduce anxiety, and improve patient compliance. In some embodiments, the material of the oral device 100 can have shock absorption properties. In some embodiments, the material of the oral device 100 can have anti-microbial properties. In some embodiments, the oral device 100 can be disposable after each use. In some embodiments, the oral device 100 can be made of a durable material such that the oral device can be reusable for a period of time, such as, for example, one month or several months.
In addition to a flavoring profile, in some embodiments a drug can be embedded into the polymer of the tongue protector. The oral device could then act as a method of drug delivery. For example, a drug like Zofran or a muscle relaxant, could be embedded into the polymer of the tongue protector. Once the user inserts the device into their mouth, the medicine would disintegrate into the user's mouth while the seizure or neurologic episode is in progress. This medicine would relax the user, while the device protects the user from oral injury and drooling.
The oral device 100 can be worn for any suitable duration of time. In some circumstances, patients who have been diagnosed with a neurological condition that causes seizures can consult with their physician and identify possible triggers or warning sign factors before seizure onset. Such people, when experiencing a trigger or an aura, can insert the oral device 100 into his/her mouth before a seizure begins. For users who do not experience warning signs prior to seizure onset, or users with conditions resulting in continuous uncontrollable movements that may result in tongue injury, the device can be worn at all times and removed only for limited periods, such as, for example, for eating. Due to the structure of the oral device 100, the user can position the oral device 100 quickly and easily without requiring a fitting by a specialist or teeth impressions taken in advance. Said another way, the oral device 100 can be an off-the-shelf device that can be configured to engage with a number of potential user's mouths. In some embodiments, the oral device 100 can be retailed over the counter. In some embodiments, the oral device 100 can be considered durable medical equipment and made available to patients by way of a medical prescription. In some embodiments, the oral device 100 can be available to EMT staff, in hospitals, and/or in clinics for a patient who is experiencing an ongoing seizure and/or while a patient who had a seizure is being evaluated further. In some embodiments, the oral device 100 can be administered to stroke patients or patients requiring oral motor therapy or speech therapy to supplant tongue rehabilitation and improve tongue strength lost due to tongue paresthesia or numbness.
As shown in
The kit can house the oral device when not in use. In some embodiments of the kit, the kit can contain a button that is powered by a battery or other source of electric power. The button can be located on the kit or as a separate component attachable to the kit. This button can be pressed by the user when they experience an aura or physiological/sensory change to their body or environment that alerts an impending seizure, and precedes the user opening their kit to remove the oral device and administer it into their mouth prior to seizure onset. This button can be connected via, for example, Bluetooth to an app on a smartphone or similar device that keeps track of how many times the button is pressed and in what intervals of time. This “smart kit” can be useable during a pilot study or clinical trial in order to interpret how well patients notice or track auras. The data gathered from similar kits can also be mined and used by physicians to collect patient compliance data regarding how often the oral device is used.
The oral device 200 can be the same or similar in structure and/or function to any of the oral devices described herein, such as, for example, oral device 100. For example, the tongue protector 220 can include a tongue receptacle 222. The tongue receptacle 222 can define an interior space 225 in which the tip of a user's tongue can be disposed during use. As shown in
The tongue protector 220 and the tongue receptacle 222 can have any suitable length and width. For example, in some embodiments, the tongue protector 220 can be shaped and sized such that the tongue protector 220 can enclose the bottom side of the user's tongue and half of the length of the top side of the user's tongue. In some embodiments, the tongue protector 220 can be shaped and sized such that the tongue receptacle 222 can enclose only a front portion of the user's tongue such that less than the entire bottom side of the user's tongue is enclosed and the tongue protector 220 can extend over less than half of the length of the top side of the user's tongue. In some embodiments, the tongue protector 220 can be shaped and sized such that the tongue receptacle 222 can enclose only a front portion of the user's tongue such that less than the entire bottom side of the user's tongue is enclosed and the tongue protector 220 can extend over half or more than half of the length of the top side of the user's tongue.
With respect to the width of the tongue protector 220, in some embodiments the tongue protector 220 can be shaped and sized such that the tongue protector 220 can cover the entire width of the top side of the user's tongue. In some embodiments, the tongue protector 220 can be shaped and sized such that the tongue protector 220 can cover less than the entire width of the top side of the user's tongue.
In some embodiments, the tongue protector 220 can be elastic. For example, the tongue receptacle 222 can be sufficiently elastic such that the tongue receptacle 222 can have a smaller length and/or width when the tongue receptacle 222 is not engaged with a user's tongue than when the user's tongue is inserted within the tongue receptacle 222 and/or moved relative to the user's teeth while within the tongue receptacle 222. In some embodiments, the elasticity of the tongue protector 220 can vary within the tongue protector 220. For example, the tongue receptacle 222 can have a higher elasticity than the remainder of the tongue protector 220.
The tongue protector 220 can have any suitable flexural modulus. In some embodiments, the tongue protector 220 can have a low flexural modulus such that the tongue protector 220 is easily bendable. For example, the tongue protector 220 can have a flexural modulus sufficiently low such that the tongue protector 220 can be bendable by the user's tongue. In some embodiments, the tongue protector 220 can have a high flexural modulus such that the tongue protector 220 is rigid. For example, the tongue protector 220 can have a flexural modulus sufficiently high such that the tongue protector 220 is not bendable by a user's tongue. In some embodiments, the flexural modulus of the tongue protector 220 can vary within the tongue protector 220. For example, the tongue receptacle 222 can be more or less rigid than the remainder of the tongue protector 220.
The left tooth protector 230 and the right tooth protector 250 are configured to be secured to the teeth of the user. As shown in
As described above, the left coupler 240 couples the left tooth protector 230 to the tongue protector 220, and the right coupler 260 couples the right tooth protector 250 to the tongue protector 220. Each of the left coupler 240 and the right coupler 260 can allow for limited movement of the tongue protector 220 relative to the left tooth protector 230 and the right tooth protector 250 (e.g., for speaking, eating, and/or drinking). For example, the left coupler 240 and the right coupler 260 can allow the user's tongue to move the tongue protector 220 within a mouth of the user and/or such that the user's tongue and the tongue protector 220 can extend beyond a user's incisors. In some embodiments, the left coupler 240 and the right coupler 260 can prevent the tongue protector 220, and therefore the user's tongue when within the tongue protector 220, from extending a particular distance from the left tooth protector 230 and the right tooth protector 250. In some embodiments, the left coupler 240 and the right coupler 260 can be configured such that the resistance to movement of the tongue protector 220 is increased as the tongue protector 220 is moved farther from the left tooth protector 230 and/or the right tooth protector 250. In some embodiments, the left coupler 240 and the right coupler 260 can be sufficiently rigid to not allow movement of the tongue protector 220 relative to the left tooth protector 230 and the right tooth protector 250. In some embodiments, the left coupler 240 and the right coupler 260 can each be a predetermined length such that the tongue protector 220 can only move a predetermined distance relative to the left tooth protector 230 and the right tooth protector 250.
As shown in
As shown in
In use, the oral device 200 can prevent the damage from teeth to teeth and/or teeth to tongue impact that can occur during biting or chewing (e.g., during a seizure). For example, as described above with reference to oral device 100, during a seizure, damage to the teeth and/or lateral lacerations and/or other injuries to the tongue can be caused by the molars and/or canines. Due to the surface area ratio, the lower molars and canines can experience the most impact during the chewing motion. Additionally, lacerations and/or other injuries to the tip of the tongue can be caused by the incisors. The oral device 200 can prevent damage and injury to the teeth and tongue via the dissipation and mitigation of the force of impact between, for example, the top and bottom molars and canines and between the teeth and the tongue. As shown in
As described above with reference to the oral device 100, the tongue protector 220, the tooth protectors 230, 250, and/or the couplers 240, 260 can be made of any suitable material(s). The material(s) can be selected based on considerations including: a) withstanding the force with which chewing and biting may occur during seizures; and b) efficacy in minimizing hypersalivation.
In the embodiment shown in
The tongue protector 420 can include a tongue receptacle 422. The tongue receptacle 422 can define an interior space 425 (shown in
The left tooth protector 430 and the right tooth protector 450 are configured to be secured to the teeth of the user. As shown in
As described above, the left coupler 440 couples the left tooth protector 430 to the tongue protector 420, and the right coupler 460 couples the right tooth protector 450 to the tongue protector 420. Each of the left coupler 440 and the right coupler 460 can allow for limited movement of the tongue protector 420 relative to the left tooth protector 430 and the right tooth protector 450 (e.g., for speaking, eating, and/or drinking). As shown in
In use, the oral device 400 can prevent the damage from teeth to teeth and/or teeth to tongue impact that can occur during biting or chewing (e.g., during a seizure), as with the previous embodiments.
As described above with reference to the oral device 100, the tongue protector 420, the tooth protectors 430, 450, and/or the couplers 440, 460 can be made of any suitable material(s). The material(s) can be selected based on considerations including: a) withstanding the force with which chewing and biting may occur during seizures; and b) efficacy in minimizing hypersalivation.
In some embodiments, the oral devices described herein, such as the oral device 100 or the oral device 200, can be used to treat ventilator-associated pneumonia (VAP). For example, a user (e.g., a patient in the intensive care unit (ICU)) can insert the oral device into engagement with the user's teeth and tongue. Alternatively, a healthcare provider (e.g., a doctor or a nurse) treating a patient on a ventilator in the ICU can insert the oral device into engagement with the user's teeth and tongue. The device can be ergonomically designed such that the ventilator tube and the device do not interfere with each other and such that the device can be easily administered or removed by a healthcare provider (e.g., the device may need to be changed or removed periodically for other procedures). The oral device can include and/or be formed of material configured to prevent bacteria growth within the mouth (e.g., anti-microbial material). As described herein for other embodiments, the oral device can include a sensor enabled, for example, to monitor or sense saliva production and/or bacteria growth. Additionally, as described herein for other embodiments, the oral device can include a drug delivery mechanism. For example, the oral device can be configured to dispense a cleansing agent within the mouth from a reservoir. In some embodiments, the oral device can dispense the drug from a reservoir disposed on any suitable portion of the device, such as on a tongue protector, a coupler, a tooth protector, and/or an anchor of the device. In some embodiments, the oral device can be configured to dispense the drug from the reservoir based, at least in part, on data collected by the sensor. The oral device can also be configured to dispense the drug from the reservoir based, at least in part, on a timer.
Additionally, although some oral devices shown herein are shown as having edges formed as about 90 degrees or as acute angles (e.g.,
While various embodiments have been described above, it should be understood that they have been presented by way of example only, and not limitation. Where methods described above indicate certain events occurring in certain order, the ordering of certain events may be modified. Additionally, certain of the events may be performed concurrently in a parallel process when possible, as well as performed sequentially as described above.
Where embodiments described above indicate certain components arranged in certain orientations or positions, the arrangement of components may be modified. While the embodiments have been particularly shown and described, it will be understood that various changes in form and details may be made. Any portion of the apparatus and/or methods described herein may be combined in any combination, except mutually exclusive combinations. The embodiments described herein can include various combinations and/or sub-combinations of the functions, components and/or features of the different embodiments described.
This application claims priority to and the benefit of U.S. Provisional Application No. 62/448,005, filed Jan. 19, 2017, entitled “Oral Device to Protect the Tongue of a User, and Methods of Use,” and U.S. Provisional Application No. 62/511,604, filed May 26, 2017, entitled “Oral Device to Protect the Tongue of a User, and Methods of Use,” the entire contents of which are hereby expressly incorporated by reference for all purposes.
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