Aqualizer: Selecting the right fill level

In addition to the correct shape, it is important to determine the correct fill level of the Aqualizer. Occasionally you will find incorrect altitude information for the Aqualizer. Please note the following:

  1. The Aqualizer slowly loses water when worn. A specified bite elevation of x millimeters can therefore only be correct at the beginning of the wearing time.

  2. Whether the bite on the Aqualizer can relax depends on whether the anterior teeth are effectively decoupled. These usually overlap vertically. This is why it is not enough just to look at the height of the Aqualizer, because as soon as the lower jaw shifts slightly forward during relaxation, interfering contacts between the anterior teeth can still occur.

  3. If you bite on it, the Aqualizer yields, water is displaced from the padding on one side to the other, etc. Therefore the exact indication of a bite elevation is rather misleading, because this depends among other things also on how the teeth stand, where the water cushions rest and how strongly one bites on it.

To give you an idea of the height when selecting your Aqualizer, we will also be happy to give you height information in millimetres, but in the load-dependent fluctuation widths that can actually be expected:

  • Filling height "low": 2-6 mm

  • Filling height "medium": 3-7 mm

  • Filling height "high": 4-8 mm

However, we prefer to recommend clinical criteria for the correct selection of the fill level, which are based on the experience of CMD patients and dentists. If a deep bite is present (the incisors overlap very strongly), relief can probably be better achieved with a high Aqualizer (high), as this gives the lower jaw more freedom to achieve a comfortable position.

Aqualizer high und medium im Vergleich
Left filling height "high", right "medium".

On the other hand, you may involuntarily press the Aqualizer if it is set too high. Instead of the desired muscle relaxation, the chewing muscles then become tense, and after prolonged wear you feel "irritated" rather than relieved. If you press too hard on the Aqualizer, it can even burst.

In case of doubt, the medium fill level is the one that works well in most cases. The rows of teeth are sufficiently supported so that interfering contacts on the teeth, except in extreme cases, no longer force the jaw musculature to unbalanced holding work, it can relax and one feels the desired relief.

The "low" filling level is suitable for cases where a bite elevation is generally not well tolerated and one feels as if there is hardly enough space between the teeth anyway. Here the water cushions contain only a small filling. However, since water vapour penetrates the Aqualizer's shell over time, the life expectancy of an Aqualizer "low" is also the shortest.


Example: low bite


With deep bites the incisors overlap more than normal, so to speak one can bite too far, the chin comes closer than normal in the bite of the wet. A distinction is made here between two variants:

Deep covering bite

The upper incisors stand like a fence directly in front of the lower ones and cover them more or less strongly.

Tiefer Deckbiss

The left picture shows the steep incisor position. This often forces the jaw muscles to guide the lower jaw further backwards to avoid precontacts between the incisors. The ideal relation of the molars in the bite would be given if the pencil lines would coincide. However, a "wrong" molar relation can also result from tooth loss and misgrowth.

If discomfort and pain occur, it is easy to test the connections with the Aqualizer. On the right you can see that in this case a neutral molar relationship can already be achieved with an intermediate Aqualizer Ultra medium without the incisors interfering if the musculature wishes this. In more serious cases, or when pre-contacts still occur between the anterior teeth despite the Aqualizer medium, the high filling level (high) can create even more free space.

Deep rebite

Here the incisors also overlap strongly from the front, but the characteristic of this malocclusion is the pronounced back of the lower jaw, although the upper incisors are not steep. Occasionally the lower incisors even bite into the gums behind the upper ones. The ideal molar relationship sometimes deviates by a premolar width, or more, as shown on the left.

Tiefer Rückbiss

Here, tooth 46, 47 has migrated into the gap in the lower jaw, so that a third premolar was formed in the denture instead of the molar. The distal buccal tuberosity of the missing 46 may have been approximately in the region of the lower line.

Sometimes there is also a deficiency development of the lower jaw, so that even in a muscularly balanced jaw position no real molar relationship develops. Nevertheless, here too, the muscles are often forced to hold the lower jaw behind in order to avoid interfering contacts between the front teeth. As can be seen on the right, the Aqualizer is able to create a great deal of free space here; the lower jaw could already position itself significantly further anteriorly in a neutral molar relationship at the "medium" filling level if the muscles so desire.


Deep bite with lateral displacement

Tiefbiss mit Seitverlagerung

Above one sees a deep bite, with which the front teeth stand very steeply (thus also a so-called "covering bite"), however here additionally the lower middle line is shifted relative to the upper to the left.


Was this discrepancy caused by a displacement of the lower jaw from the middle position, or simply by a displacement of the teeth in the bone? The sample with the Aqualizer can provide information here.

Tiefbiss mit Aqualizer

However, the Aqualizer must also be high enough to ensure that no tooth contact (e.g. on the right canine) prevents the jaw from being neutral. If necessary, the "high" filling level is required.

After a few hours of wearing, stand upright in front of the mirror, bite slightly on the Aqualizer and pull up only your lips slightly so that you can see the incisors. If the lower midline has now automatically adjusted itself in line with the upper one, there may really be a malalignment of the lower jaw, which is not compatible with relaxed muscles.

In the case of deep bites in general, the "high" filling level can be used to test whether the symptoms can be further reduced with higher support in the bite, irrespective of whether occlusal interfering contacts still occur. This also gives the dentist valuable indications as to whether a bite elevation (prosthetically or with a bite block) would be well tolerated or not.


►  Choosing the right Aqualizer shape
►  Apply the Aqualizer correctly
►  Differences between Aqualizer, AquaSplint mini and FreeBite
►  Buy the Aqualizer