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One of the most common known side effects of oral appliance therapy is morning malocclusion, or temporary morning bite change. Dr. Keith Thornton developed the first repositioners for oral appliances for sleep apnea in 1994. At that time, he observed some orthodontic and orthopedic movement of the teeth and jaws. Dr. Thornton reported on this in a paper published in the Journal of Oral and Maxillofacial Surgery in 1996. The initial repositioners were bite tabs made from football mouthguard material. Since then, Airway Management, Inc., has developed numerous ones including the present AM Aligner™.