Water Works
Robert A. Lerman is the president of Aqualizer and has been with the company since 1991. From 1972 until 1990, Lerman was a member of the Chicago Board of Trade and the Chicago Board Options Exchange, where he was a market maker and floor broker. His father, Martin D. Lerman, DDS, founded Aqualizer in 1986 and invented the Aqualizer™ hydrostatic splint.

OP:What is the Aqualizer, and how is it different from other oral splints on the market?

Lerman: The Aqualizer is a premade, temporary, self-adjusting temporomandibular joint (TMJ)/occlusion splint, used for fast pain relief of acute TMJ and pain dysfunction syndrome (PDS) symptoms, muscle deprogramming, and functional reprogramming for diagnosis and bite registration. Other splints may distort or disable the natural action of the muscles and “guess” at what the occlusion should be. The Aqualizer, on the other hand, does not impose any set, hard-and-fast adjustment. By contrast, the Aqualizer’s fluid system “floats” the jaw to allow the body to decide where the jaw should be positioned. Without the Aqualizer’s fluid system, it is almost impossible to be sure that the “bite” is in harmony with the rest of the body.

OP:Please describe the technology behind the Aqualizer. How does it work?

Lerman: The answer is simple: physics. The Aqualizer is an application of Pascal’s Law, which states that an enclosed fluid will simultaneously balance, equalize, axialize, and distribute force. In other words, when you bite down on the Aqualizer, the fluid evenly distributes axial bite forces across the entire bite, creating the perfect fit anywhere within the envelope of function. The Aqualizer’s fluid system creates perfect bite balance and stability, allowing the muscles to automatically reposition the jaw to where it naturally works best.

OP:How does the Aqualizer treat TMJ/PDS symptoms?

Lerman: The Aqualizer determines whether the patient has a TMJ/occlusal problem, or whether the symptoms, which may be mistaken for TMJ symptoms, are from a different cause. If the symptoms are from a different cause, TMJ/occlusal treatment is a mistake and orthodontists need to make a logical decision as to whether or not to continue treatment. If the symptoms resolve quickly, it indicates a TMJ/occlusal problem, and treatment usually takes one of two directions: If the symptoms have lasted only a short time (only a single episode of pain), wearing Aqualizers for a few weeks should relieve the symptoms. Changing the bite is usually not necessary; if the patient has had symptoms for a long time, it may be necessary to correct the bite. The easiest way to do this is by making a permanent splint that corrects the bite.

OP:Your company offers three different Aqualizers. Which one is the most popular?

Lerman: Our best seller is the Aqualizer Ultra, which is an improved version of the Aqualizer. It is designed for increased gum comfort and retention, and it is used in average-size mouths. The Aqualizer Mini is the improved Ultra shape with smaller pads and a smaller arch size. It is used for kids and in small mouths. The Aqualizer Classic is our original design—the first fluid-cushioned and balanced splint. The deep “V” in the front irritated some patients, so we designed the Ultra.

OP: How long does treatment with the Aqualizer usually take?

Lerman: Treatment is very efficient and predictable. First, we preview our treatment goal by having the patient wear the Aqualizer for 30 minutes in the waiting room—a day or 2 for severe and chronic symptoms. If wearing the Aqualizer provides enough symptom relief and functional improvement, occlusal treatment is indicated. An Aqualizer bite registration is then taken to guide the correction of the bite physiologically.