Abstract:
Material and methods for constructing custom dental trays quickly and inexpensively, especially dental trays which are useful for the detection, evaluation, and treatment of mandibular parafunction. A manufactured dental tray material includes occlusal pressure indicators, and can include electronics for storing and analyzing occlusal pressures.

Description:
BACKGROUND  
       [0001]     1. Field of Invention  
         [0002]     This invention relates to dental trays, specifically to dental trays that indicate pressure from occlusal contact.  
         [0003]     2. Occlusal Treatment  
         [0004]     Splints, stents, and night guards are types of dental appliances which have been fitted with sensors to indicate pressure from occlusal contact. Generally, such appliances are fairly costly and time consuming to fabricate, and are made by a dental laboratory. They are useful for collecting data on dental occlusion, jaw muscle activity during sleep, and so on. Such appliances are primarily used to diagnose or treat patients exhibiting high levels of activity in the muscles of mastication during various stages of sleep, known as bruxism, or mandibular parafunction. Patients generally take such appliances to their homes, and wear them in the mouth during sleep, typically accompanied by one or more data collection or analysis devices. Generally, patients who receive treatment with these appliances are symptomatic, and are well aware that they have an advanced problem that needs treatment.  
         [0005]     In contrast, there is a large group of people who are unaware that they have a problem that needs treatment. Many people exhibit moderate levels of parafunction, but do not have sufficient symptoms to cause them to believe they need treatment. They are predominantly unaware that they are slowly chipping or wearing away their teeth, slowly spreading fractures through their teeth, weakening exisiting dental restorations, traumatizing the alveolar bone around the teeth, traumatizing their temporomandibular joints, or causing headaches. They tend to become aware of these problems only when they have unnecessarily progressed to obvious symptoms, have lost function or structure, and need more costly treatment.  
         [0006]     Sleep research shows that approximately half of the general population could benefit from use of a simple hard night guard. Generally, hard night guards are made by a dental laboratory, are time consuming to fabricate, require multiple office visits to fit, and are somewhat costly for patients. Therefore, patients must somehow become aware that they could benefit from the use of a night guard before they will want to proceed with night guard fabrication.  
         [0007]     Dental practitioners are able to rapidly assess signs of parafunction, such as linea alba, serrated tongue, TMJ irregularities, dental attrition, vertical bone loss, and so on. However, even if time is taken to show patients these signs, they remain relatively meaningless to them. A practitioner can spend significant time describing the sequelae of these problems to patients, but patients are generally not motivated to treat problems that they see little or no direct evidence of. Dental practitioners therefore have the undesirable task of being obligated to inform patients that they need a somewhat costly night guard to prevent a problem the patient is not sure they have. Therefore, dental practitioners need of a rapid, low cost means to help patients realize that parafunction is indeed occurring.  
         [0008]     3. Description of Prior Art  
         [0009]     Custom trays are trays which are designed to custom fit over at least a portion of a person&#39;s teeth. Custom trays generally fit with a greater accuracy of adaptation to the form of the teeth than stock trays. Custom trays are used in dentistry for performing various functions in the mouth. These functions include impression material carrier, bruxism protection, athletic guard, airway maintenance, surgical stents, medicament carrier, and so on. Medicaments to be carried in custom trays include tooth whitening agents, anticariogenic agents, antibacterial agents, desensitizing agents, and so on. In contrast to the laboratory fabricated splints, stents and night guards with occlusal pressure indicators, custom trays are generally made in a dental office.  
         [0010]     In one common process for forming custom dental trays, the steps include taking impressions of the teeth, pouring plaster into the impressions to form plaster models of the teeth, providing a manufactured square-cut or round-cut thin sheet of custom tray material, said sheet having a specified uniform thickness, heating said sheet of dental tray material until it is moldable, applying a vacuum source to the moldable dental tray material to mold it to the form of the plaster model, allowing the moldable tray material to cool until it becomes non-moldable tray material, and trimming the non-moldable tray material to form a dental tray. Trays made with this process are accurately conformed to the teeth.  
         [0011]     The vacuum source used in the above process is typically a specialized vacuum pump of moderate cost. Therefore this method of forming custom trays is performed in dental offices or dental laboratories by skilled personnel. In addition, while forming custom trays using this process can be accomplished in a single patient visit, it is more common for an additional patient visit to be made to deliver the completed trays, due to the amount of time required to complete the trays. Trays formed with this process tend to be accurately conformed to the teeth, have good retention to the teeth, and have a low rate of fluid leakage.  
         [0012]     In a second process for forming custom dental trays, a low melting point polymer tray material is heated until moldable, and then molded intraorally to conform it to the form of the teeth. The process for molding the tray material intraorally include instructing the patient to bite down lightly, push the tongue against the roof of the mouth, suck air and water out of their mouth, conform the tray material to the shape of the teeth with fingers, then remove and hold under cold water. The custom tray material and process is intended to reduce the time required to form a custom dental tray. It is also intended to permit the formation of a custom dental tray without the need for costly specialized vacuum equipment, or skilled dental office personnel. Such custom dental trays could be constructed rapidly by dental office personnel, or could be constructed by the public at home. However, trays made with this process tend to be less accurately conformed to the teeth.  
         [0013]     In a third process for forming custom dental trays, there is provided a thin pliable inner sheet of tray material nested in an outer thicker dental tray. The pliable inner tray is pre-loaded with a medicament, such as a sticky whitening gel. The thicker tray is used to seat the pliable inner tray on the dental arch, and is then discarded. The pliable inner tray is adhered to the teeth via the sticky medicament, and is finger-molded to enhance adaptation to the teeth. The moldability of the pliable inner tray material is not substantially altered during this process.  
         [0014]     In a fourth process for forming custom dental trays, a pliable tray is pre-loaded with a sticky medicament. The pliable tray is adhered to the teeth via the sticky medicament, and is finger molded to enhance adaptation to the teeth. The moldability of the pliable tray material is not substantially altered during this process.  
         [0000]     The above processes for forming custom dental trays suffer from a number of disadvantages:  
         [0000]    
       
         
           
              (a) Accurately adapted trays require skilled personnel  
              (b) Accurately adapted trays require costly specialized equipment  
              (c) Accurately adapted trays can require substantial time  
              (d) Trays formed are not capable of indicating occlusal pressure  
              (e) Trays formed intraorally tend to have poor adaptation to the teeth  
              (f) Trays formed intraorally tend to have poor retention to the teeth  
              (g) Trays formed intraorally tend to have substantial fluid leakage  
           
         
       
     
         [0022]     A tray material and process similar to my custom dental tray material and process would not have been as practical prior to the development of low melting polymers, or other materials which are moldable at temperatures which are tolerated intraorally, and then can be caused to become substantially non-moldable.  
       SUMMARY OF THE INVENTION  
       [0023]     The present invention is directed to fabricating custom dental trays quickly and inexpensively, such as by forming custom dental trays intraorally, and especially to forming custom dental trays which can indicate occlusal contact pressure. Custom trays which can indicate occlusal contact pressure can be useful for the detection, evaluation, and treatment of mandibular parafunction.  
         [0024]     The invention provides a first process for forming dental custom trays wherein an imprint is made of a person&#39;s teeth, a moldable sheet of tray material is interposed between the teeth and the imprint, and the imprint is forcefully seated onto the teeth and tray material, thereby molding said tray material.  
         [0025]     The invention provides a second process for forming dental custom trays wherein a moldable sheet of tray material is interposed between the teeth and a moldable material in a pliable container, and said moldable material is forcefully seated onto the teeth and said tray material, thereby molding said tray material.  
         [0026]     The invention provides a third process for forming dental custom trays wherein a moldable sheet of tray material, having a vacuum tube about the perimeter, is seated over the teeth, and a vacuum is introduced into said vacuum tube, said vacuum having the effect of drawing said moldable sheet of tray material onto the surfaces of the teeth, thereby molding said tray material.  
         [0027]     The invention also provides a sheet of custom dental tray material having occlusal pressure indicators, for use in the processes thereof.  
         [0028]     The invention also provides a sheet of custom dental tray material having a connector for attaching said tray material to a dental imprint, to a moldable material in a pliable container, or to a dental tray.  
         [0029]     The invention also provides a dental tray which contains a moldable material, wherein at least a portion of said tray is pliable. Said tray is used to provide pressure to mold custom tray material intraorally.  
         [0030]     The invention also provides a dental tray having a surface which faces the opposing arch of teeth, wherein said surface has a configuration and consistency such that the force with which the opposing arch of teeth can be occluded against said surface is maximized, thereby permitting increased seating pressure of said tray onto the teeth.  
       DETAILED DESCRIPTION OF PROCESSES  
       [0031]     According to one aspect of the invention, there is provided a first process for forming dental trays comprising the steps of: making an imprint of a person&#39;s teeth with a moldable space filling material, causing said moldable space filling material to be substantially non-moldable, forming a non-moldable space filling material, providing a moldable tray material wherein at least a portion of said moldable tray material is a sheet, interposing said moldable tray material between said non-moldable space filling material and the teeth, forcefully seating said non-moldable space filling material over said moldable tray material such that said moldable tray material becomes molded to fit the shapes of the teeth, causing said moldable tray material to become substantially non-moldable, and thereby forming a molded tray material, removing said non-moldable space filling material and said molded tray material from the teeth, removing said molded tray material from said non-moldable space filling material, and trimming said molded tray material to form a custom dental tray.  
         [0032]     It is preferred that said sheet of moldable tray material is embedded with a pressure indicator, such that when a custom dental tray comprised of said moldable tray material is inserted between forcefully occluding dental arches, and the occlusal contacts of the teeth forcefully press against portions of said custom dental tray, then a record is produced on said custom dental tray. Said record therefore can serve as an indicator that records the location, duration, amplitude or times of occlusal pressure upon said custom dental tray.  
         [0033]     It is preferred that said non-moldable space filling material is a substantially accurate dental impression material, such as polyvinylsiloxane, or other suitable dental impression materials. However, said non-moldable impression may be made with materials which produce impressions having reduced accuracy and detail, such as impressions made with some details of the teeth partly blocked out with a blockout material, thermoplastic vinyls, or other suitable materials.  
         [0034]     It is preferred that said moldable tray material is mounted over said non-moldable space filling material prior to interposing said moldable tray material between said non-moldable space filling material and a person&#39;s teeth. It is further preferred that said moldable tray material is made to be moldable after mounting said moldable tray material to said non-moldable space filling material.  
         [0035]     It is preferred that said moldable tray material is mounted to said non-moldable space filling material using connectors which detachably connect said moldable tray material to said non-moldable space filling material. However, said moldable tray material may be mounted to said non-moldable space filling material without use of said connectors, or may be placed directly onto the teeth prior to seating said non-moldable space filling material over the teeth.  
         [0036]     It is further preferred that said moldable tray material is caused to be moldable by the operator immersing a dental tray material in warm water, such as by immersing a low-melting thermoplastic sheet of dental tray material into water warmed to a specified temperature within the approximate range of 40° to 85° C. As such, the low-melting thermoplastic tray material becomes moldable at a sufficiently low temperature to be tolerated in the mouth. However, said moldable tray material may be made to be moldable by the operator by other means, such as by exposing a dental tray material to chemicals, gasses, radiation, and so on, or said moldable tray material may be moldable as provided from the manufacturer.  
         [0037]     It is preferred that a negative pressure vacuum is caused in a vacuum tube, said tube connected to at least a portion of the perimeter of said moldable sheet, said tube having a permeable portion, such that undesirable air and fluids may be removed from between said tray material and the teeth and gingiva, and such that said moldable sheet is drawn toward the teeth and becomes molded to fit the shapes of the teeth.  
         [0038]     It is preferred that said moldable tray material be made to be non-moldable by cooling at least to body temperature. However, said moldable tray material can be made to be non-moldable by allowing time to elapse, or by exposing said moldable tray material to oxygen, saliva, chemicals, gasses, radiation, and so on.  
         [0039]     It is preferred that said custom tray is molded to fit as closely to the shape of the teeth as possible. However, said custom tray may be molded with a space reserved for an attachment, such as an occlusal pressure sensor. In addition, because said custom trays may be readily fabricated by persons unskilled in the art, said custom tray may be molded with a space reserved for an oral decoration, or for an attachment thereof, such as by temporarily adhering an oral decoration, or similarly shaped spacer thereof, to the teeth or gingiva prior to interposing said moldable tray material between said non-moldable space filling material and the teeth.  
         [0040]     According to another aspect of the invention, there is provided a second process for forming dental trays comprising the steps of: providing a moldable tray material wherein at least a portion of said moldable tray material is a sheet, providing a substantially moldable space filling material, interposing said moldable tray material between said moldable space filling material and a person&#39;s teeth, forcefully seating said moldable space filling material over said moldable tray material such that said moldable tray material becomes molded to fit the shapes of the teeth, causing said moldable tray material to become substantially non-moldable to form a custom dental tray.  
         [0041]     It is preferred that said custom dental tray is removed from the teeth and trimmed to form a trimmed custom dental tray. However, said custom dental tray may remain in the mouth, and remain untrimmed, such as when applying a medicament to the teeth, said medicament being placed on said moldable tray material prior to interposing said moldable tray material between said moldable space filling material and a person&#39;s teeth.  
         [0042]     It is preferred that said moldable space filling material is not heated during the process. However, said moldable space filling material may be heated during the process. Further, said moldable space filling material may be heated to affect the viscosity of said moldable space filling material, to affect the chemical reactivity of said moldable space filling material with itself, with said moldable tray material, with a medicament carried by said moldable tray material or said custom dental tray, and with the teeth or gingiva, such as when said moldable tray material or said custom dental tray material is permeable, and so on.  
         [0043]     It is preferred that said moldable space filling material is not caused to be non-moldable after said moldable tray material becomes molded to fit the shapes of the teeth. However, said moldable space filling material may be caused to be non-moldable after said moldable tray material becomes molded to fit the shapes of the teeth.  
         [0044]     It is preferred that said moldable space filling material is contained within a sealed container, said container comprising at least a portion which is substantially pliable. It is preferred that said portion of said container which is substantially pliable is comprised of said moldable tray material. However, said portion which is substantially pliable may be comprised of a material which is separate and distinct from said moldable tray material.  
         [0045]     It is preferred that said sheet of moldable tray material is embedded with a pressure indicator, such that when a custom dental tray comprised of said moldable tray material is inserted between forcefully occluding dental arches, and the occlusal contacts of the teeth forcefully press against portions of said custom dental tray, then a record is produced on said custom dental tray. Said record therefore can serve as an indicator that records the location, duration, amplitude or times of occlusal pressure upon said custom dental tray.  
         [0046]     It is further preferred that said moldable tray material is caused to be moldable by the operator immersing a dental tray material in warm water, such as by immersing a low-melting thermoplastic sheet of dental tray material into water warmed to a specified temperature within the approximate range of 40° to 85° C. As such, the low-melting thermoplastic tray material becomes moldable at a sufficiently low temperature to be well tolerated in the mouth. However, said moldable tray material may be made to be moldable by the operator by other means, such as by exposing a dental tray material to chemicals, gasses, radiation, and so on, or said moldable tray material may be moldable as provided from the manufacturer.  
         [0047]     It is preferred that a negative pressure vacuum is caused in a vacuum tube, said tube connected to at least a portion of the perimeter of said moldable sheet, said tube having a permeable portion, such that undesirable air and fluids may be removed from between said tray material and the teeth and gingiva, and such that said moldable sheet is drawn toward the teeth and becomes molded to fit the shapes of the teeth.  
         [0048]     It is preferred that said moldable tray material be made to be non-moldable by cooling at least to body temperature. However, said moldable tray material can be made to be non-moldable by allowing time to elapse, or by exposing said moldable tray material to oxygen, saliva, chemicals, gasses, radiation, and so on.  
         [0049]     It is preferred that said custom tray is molded to fit as closely to the shape of the teeth as possible. However, said custom tray may be molded with a space reserved for an attachment, such as an occlusal pressure sensor. In addition, because said custom trays may be readily fabricated by persons unskilled in the art, said custom tray may be molded with a space reserved for an oral decoration, or an attachment for an oral decoration, such as by temporarily adhering an oral decoration, or similarly shaped spacer thereof, to the teeth or gingiva prior to interposing said moldable tray material between said non-moldable space filling material and the teeth.  
         [0050]     According to yet another aspect of the invention, there is provided a third process for forming dental trays comprising the steps of: providing a tray material wherein at least a portion of said tray material comprises a moldable sheet, said moldable sheet having a vacuum tube connected to at least a portion of the perimeter thereof, wherein at least a portion of said vacuum tube is permeable, seating said tray material over a person&#39;s teeth, causing a negative pressure vacuum in said tube such that undesirable air and fluids may be removed from between said tray material and the teeth and gingiva, and such that said moldable sheet is drawn toward the teeth and becomes molded to fit the shapes of the teeth, causing said moldable sheet to be substantially non-moldable to form a molded sheet, removing said molded sheet from the teeth, and trimming said molded sheet to form a custom dental tray.  
         [0051]     It is preferred that a space filling material is forcefully seated over said moldable sheet when said moldable sheet is seated over the teeth, such that said moldable sheet is further molded to fit the shapes of the teeth. However, said moldable sheet may be vacuum-molded to fit the shapes of the teeth without seating said space filling material.  
         [0052]     It is preferred that said moldable sheet of tray material is embedded with a pressure indicator, such that when a custom dental tray comprised of said moldable tray material is inserted between forcefully occluding dental arches, and the occlusal contacts of the teeth forcefully press against portions of said custom dental tray, then a record is produced on said custom dental tray. Said record therefore can serve as an indicator that records the location, duration, amplitude or times of occlusal pressure upon said custom dental tray.  
         [0053]     It is further preferred that said moldable tray material is caused to be moldable by the operator immersing a dental tray material in warm water, such as by immersing a low-melting thermoplastic sheet of dental tray material into water warmed to a specified temperature within the approximate range of 40° to 85° C. As such, the low-melting thermoplastic tray material becomes moldable at a sufficiently low temperature to be well tolerated in the mouth. However, said moldable tray material may be made to be moldable by the operator by other means, such as by exposing a dental tray material to chemicals, gasses, radiation, and so on, or said moldable tray material may be moldable as provided from the manufacturer.  
         [0054]     It is preferred that said moldable tray material be made to be non-moldable by cooling at least to body temperature. However, said moldable tray material can be made to be non-moldable by allowing time to elapse, or by exposing said moldable tray material to oxygen, saliva, chemicals, gasses, radiation, and so on.  
         [0055]     It is preferred that said custom tray is molded to fit as closely to the shape of the teeth as possible. However, said custom tray may be molded with a space reserved for an attachment, such as an occlusal pressure sensor. In addition, because said custom trays may be readily fabricated by persons unskilled in the art, said custom tray may be molded with a space reserved for an oral decoration, or an attachment for an oral decoration, such as by temporarily adhering an oral decoration, or similarly shaped spacer thereof, to the teeth or gingiva prior to seating said moldable tray material over a person&#39;s teeth.  
       OBJECTS AND ADVANTAGES  
       [0056]     Accordingly, several objects and advantages of my invention and process are to facilitate the formation of accurately adapted custom dental trays: 
        (a) by persons unskilled in the art without the use of costly equipment     (b) in a short time     (c) which can indicate occlusal contact pressure     (d) which have low fluid leakage     (e) which have substantial retention to the teeth     (f) by persons unskilled in the art in order to retain attachments        
 
         [0063]     Further objects and advantages are to provide a custom dental tray which can by made by persons of the general public. Still further objects and advantages will become apparent from a consideration of the ensuing description and drawings. 
     
    
     DRAWING FIGURES  
       [0064]     In the drawings, closely related figures have the same number, but different alphabetic suffixes.  
         [0065]      FIG. 1  shows a perspective view of an unmolded dental tray material connected to a vacuum source, and ready for mounting on a tray. The tray is filled with a molded space filling material.  
         [0066]      FIG. 2  shows a perspective view of an unmolded dental tray material connected to a vacuum source, and mounted on a tray. The tray is filled with a molded space filling material.  
         [0067]      FIG. 3  shows a perspective view of a molded dental tray material connected to a vacuum source, and mounted on a tray. The tray is filled with a molded space filling material.  
         [0068]      FIG. 4  shows a cross-sectional view of an unmolded dental tray material connected to a tray, said tray being filled with a moldable space filling material.  
         [0069]      FIG. 5  shows a perspective view of a tray covered with an unmolded dental tray material. The unmolded dental tray material is shown cutaway to show a moldable space filling material in the tray, and is shown connected to a vacuum source. An electrical connector is shown at the anterior of the tray.  
         [0070]      FIG. 6  shows a cross-sectional view of a tray with a pliable cover containing a moldable space filling material.  
         [0071]      FIG. 7  shows a perspective view of an arch-shaped pliable cover which contains a moldable space filling material, and is seated into a tray. A cutaway shows said moldable space filling material.  
         [0072]      FIG. 8  shows a perspective view of a dental tray with an occlusion wedge and finger rests.  
         [0073]      FIG. 9  shows a perspective view of an unmolded dental tray material having a handle, and is connected to a vacuum source. A cutaway shows a frame about the perimeter that is at least partly rigid.  
         [0074]      FIG. 10  is an enlarged perspective cutaway view of unmolded dental tray material having pressure indicator.  
         [0075]      FIG. 11  shows a perspective view of a formed custom dental tray that has recorded occlusal contact pressures.  
         [0076]      FIG. 12  shows a top view of an unmolded custom tray material having multiple pressure indicators connected by circuitry to an electronic chip.  
         [0077]      FIG. 13  shows a front view of a custom dental tray retaining attachments, specifically, oral decorations, including lights, tooth facings, costume jewelry, and false teeth.  
                                                 Reference Numerals in Drawings                                20   sheet   22   connector       24   tray   26   non-moldable filler       28   border   30   ports       32   extension   34   valve       36   vacuum   38   moldable filler       40   pad   42   socket       44   skin   46   rest       48   notch   50   frame       52   handle   54   indicator       56   custom tray   58   record       60   circuit   62   chip       64A-F   attachments                    
     
    
     DESCRIPTION  
     FIGS.  1  to  13   
       [0078]     According to another aspect of the invention, there is provided a tray material for use in the process of the invention, a typical embodiment of which is shown in  FIG. 1 . Said tray material is comprised of a sheet of material, sheet  20 , which can be caused to be plastically deformable, or substantially moldable, and can subsequently be caused to be substantially non-moldable.  
         [0079]     It is preferred that sheet  20  is comprised of a material that can be caused to be substantially moldable by the operator during process of the present invention. However, sheet  20  may be provided substantially moldable by the manufacturer of sheet  20 , or may be caused to be substantially moldable by the operator prior to the process of the present invention.  
         [0080]     It is preferred that the size dimensions of sheet  20  are sufficient to substantially cover an entire arch of teeth. However, sheet  20  may be sized to cover only a portion of an arch of teeth.  
         [0081]     It is preferred that the surface of sheet  20  is non-textured. However, the surface of sheet  20  may be textured, such as to improve retention of an oral medicament, or to influence the rate of delivery of an oral medicament.  
         [0082]     It is preferred that sheet  20  material is associated with a pressure indicator, such that when a custom dental tray comprised of said moldable tray material is inserted between forcefully occluding dental arches, and the occlusal contacts of the teeth exert occlusal pressure against portions of said custom dental tray, then a record of said occlusal pressure is produced. Said record may be a change in said pressure indicator itself, or may be a signal sent to a recorder, such as an electronic chip. Said record therefore can serve as an indicator that records the location of occlusal pressure areas upon said custom dental tray.  
         [0083]     It is preferred that sheet  20  is connected to at least one connector, connector  22 , such that connector  22  is a means for detachably connecting sheet  20  to a dental tray, tray  24 , or to a material contained within tray  24 , such as non-moldable filler  26 . It is further preferred that connector  22  is comprised of the same material as sheet  20 , such that connector  22  is an extension of sheet  20  material. However, connector  22  may be comprised of clips, snaps, wires, elastics, and so on.  
         [0084]     It is preferred that an enlarged border, border  28 , is connected to at least a portion of the perimeter of sheet  20 , border  28  being comprised of a flexible material, such that border  28  is adaptable to fit the configuration of the oral vestibules about an arch of teeth, such that fluids and air are inhibited from passing border  28 .  
         [0085]     It is further preferred that border  28  is comprised of a material which will not be substantially moldable when sheet  20  is moldable. However, border  28  may be comprised of a material which can be caused to be moldable when sheet  20  is moldable.  
         [0086]     It is further preferred that border  28  is comprised of a vacuum tube having a wall which surrounds a lumen, wherein at least a portion of said wall is permeable, forming a permeable portion, such that undesirable air and fluids may be drawn through said permeable portion and into said lumen of border  28 , such that undesirable air and fluids may be removed from between sheet  20  and the teeth and gingiva, and such that sheet  20  is drawn toward the teeth to become molded to fit the shapes of the teeth.  
         [0087]     It is further preferred that said permeable portion is comprised of a multiplicity of distinct openings, ports  30 , spaced at regular intervals along a portion of the length of border  18 . However, said permeable portion may be comprised of small irregular pores within foam, or within an area of porous membrane, and so on.  
         [0088]     It is preferred that a tube having a lumen, extension  32 , connects to border  28 , such that the respective lumens are continuous across the connection. It is further preferred that extension  32  detachably connects to a valve  34 , wherein valve  34  is able to regulate the flow of gasses and fluids, valve  34  further connected to a source of negative air pressure, vacuum  36 , wherein vacuum  36  can suction fluids and air through extension  32 , border  28 , and ports  30 .  
         [0089]     It is preferred that vacuum  36  is an economical valved container substantially evacuated of gasses. However, vacuum  36  may be a manual vacuum pump, or a powered vacuum pump.  
         [0090]     Tray  24  is shown filled with a material, non-moldable filler  26 . Non-moldable filler  26  is shown having been molded to fit the shapes of the teeth, thereby forming an impression of the teeth. However, tray  24  may contain other materials, such as moldable fillers.  
         [0091]     It is preferred that non-moldable filler  26  material is comprised of a mixture from a two part, base-catalyst putty system, such that it is easily preparable by unskilled operators using simple hand mixing. However, non-moldable filler  26  material may be comprised of base-catalyst paste or mousse, thermoplastic, light-cured impression materials, and so on.  
         [0092]      FIG. 2  shows sheet  20  detachably connected to tray  24  and non-moldable filler  26  by means of connector  22 , wherein connector  22  stabilizes the position of sheet  20  over non-moldable filler  26  and tray  24 . Sheet  20  is shown having been caused to be moldable, such as by immersing in a heated water bath, and is ready for insertion into the mouth, and for seating onto a dental arch. Ports  30  are visible along border  28 . Extension  32  is connected to valve  34 , and thence to vacuum  36 .  
         [0093]      FIG. 3  is a perspective view showing sheet  20  after first, being molded to fit the shapes of the teeth, and second, being caused to be non-moldable when seated on the dental arch, and third, being removed from the mouth. Connector  22  is shown connecting sheet  20  to tray  24  and non-moldable filler  26 . Ports  30  are shown along border  28 . Extension  32  is connected to valve  34 , and thence to vacuum  36 .  
         [0094]      FIG. 4  is a cross-sectional view showing an additional embodiment, wherein sheet  20  and border  28  are connected to tray  24 , tray  24  being filled with a moldable space filling material, moldable filler  38 . It is preferred that sheet  20  is sealingly connected to border  28  and tray  24 , so as to sealingly contain moldable filler  38 , thereby inhibiting leakage of moldable filler  38  from tray  24  when tray  24  is forcefully seated onto a dental arch.  
         [0095]     It is preferred that moldable filler  38  is comprised of a material which is provided moldable from the manufacturer, such as saline, silicone gel, wax, light-cured impression materials, air, or other plastically deformable materials. However, moldable filler  38  may be comprised of a material which is substantially non-moldable until said material is caused to be moldable by the operator, such as thermoplastic vinyl, and such.  
         [0096]     It is further preferred that moldable filler  38  remain moldable after sheet  20  becomes molded to fit the shapes of the teeth. However, moldable filler  38  may be caused to be non-moldable after sheet  20  becomes molded to fit the shapes of the teeth.  
         [0097]     It is preferred that filler  28  is comprised of a material having a high heat capacity, such that filler  28  can retain heat for an extended time, such as for use with heat activated medicaments, or to facilitate molding of sheet  20 . However, filler  28  may have a low heat capacity, such as to affect the cooling time of moldable sheet  20 . It is further preferred that filler  28  does not contain electrically conductive elements. However, filler  28  may contain electrically conductive elements, such as electrical conductors for connection to external electrical power sources, heating elements, and so on. Filler  28  may also contain exothermic or endothermic chemicals.  
         [0098]     At the base of tray  24  is a seat, pad  40 , for the teeth of the opposing arch to forcefully occlude against. Ports  30  are shown along border  28 .  
         [0099]      FIG. 5  shows a perspective view of sheet  20  and border  28  sealingly connected to tray  24 , tray  24  being filled with moldable filler  38 , such that moldable filler  28  is contained in tray  24  at least by sheet  20 .  
         [0100]     An electrical connector, socket  42 , is shown at the anterior of tray  24  and sheet  20 . It is preferred that socket  42  resealably contains a data storage chip for recording data from pressure-indicator elements of sheet  20 . However, socket  42  may be a connection for any or all of the following: electrical power for heating elements in sheet  20  or in filler  28 , electrical power for occlusal pressure indicators, data output amplification, data transmission, and so on. Also shown are ports  30 , extension  32 , valve  34 , vacuum  36 , and pad  40 .  
         [0101]      FIG. 6  shows a cross-sectional view of another embodiment, a cover, skin  44 , wherein at least a portion of skin  44  is pliable, and skin  44  at least partly covers and contains moldable filler  38 .  
         [0102]     Skin  44  is sufficiently pliable such that it will conform to the shapes of the teeth when forcefully pressed onto the teeth, such as when sheet  20  is interposed between the teeth and skin  44 . As such, when moldable filler  38  is plastically deformable, and when pressure is applied, skin  44  will conform to the shapes of the teeth.  
         [0103]     It is preferred that skin  44  is substantially puncture resistant, resistant to stretching, resistant to wrinkling while conforming to the shapes of the teeth, and non-adherent to sheet  20  when sheet  20  is moldable. Materials which would be suitable for skin  44  include advanced polymers, such as those suitable for breast implant shells, as well as other materials. However, skin  44  may be somewhat stretchable, somewhat prone to wrinkling, and may be require the use of a separator, such as a lubricant gel to prevent adhesion to sheet  20 .  
         [0104]     Tray  24  is shown partly containing moldable filler  28 , and pad  40  is on the surface of tray  24  which opposes the opposing arch of teeth.  
         [0105]      FIG. 7  shows a cutaway perspective view of an embodiment of skin  44  nested into tray  24 , wherein skin  44  is configured to entirely contain moldable filler  38 . As such, skin  44  forms a bladder having a U-shape which corresponds to the shape of a dental arch. In this embodiment, skin  44  may be removed from one tray  24  and placed into another tray  24 , such as when tray  24  is sized or shaped for different dental arches.  
         [0106]     It is preferred that the entirety of skin  44  is pliable. However, a portion of skin  44  may be substantially rigid, or skin  44  may contain a substantially rigid member, such that skin  44  may be pressed against a person&#39;s teeth utilizing fingers, without the use of tray  24 , such as when sheet  20  is interposed between skin  44  and the teeth.  
         [0107]     According to another aspect of the invention, there is provided a tray, tray  24 , for use in the process of the invention, a typical embodiment of which is shown in perspective view  FIG. 8 . Tray  24  is comprised of an at least partly rigid dental tray and pad  40 , a surface for the teeth of an opposing arch to forcefully occlude against, shown on the base of tray  24 .  
         [0108]     It is preferred that pad  40  is angled and configured so as to maximize the area of contact with the opposing teeth. Pad  40  is further angled and configured so as to maximize the muscular force a person&#39;s jaw can exert against pad  40 , and therefore upon tray  24 . It is preferred that pad  40  is wedge shaped, such that pad  40  has a greater thickness toward the anterior of tray  24 , and a lesser thickness toward the posterior of tray  24 . It is further preferred that at least the outer surface of pad  40  is comprised of an elastomeric material, to enhance comfort during forceful occlusion of the opposing teeth against pad  40 , and to maximize the area of contact with the opposing teeth. As such, pad  40  facilitates forceful occlusion of the opposing teeth against tray  24 , which facilitates forceful seating of tray  24  onto an arch of teeth.  
         [0109]     It is preferred that tray  24  have a least one finger rest, rest  46 , to facilitate further seating pressure of tray  24  onto an arch of teeth. It is preferred that a rest  46  is comprised of a depression in tray  24  and pad  40 , and a buccal or facial protrusion of tray  24 .  
         [0110]     It is preferred that the surface of pad  40  is notched in at least one location, notch  48 , such that at least one connector  22  may lay recessed within said notch, thereby stabilizing the position of connector  22 , and reducing occlusal interference from connector  22 .  
         [0111]     According to another aspect of the invention, there is provided a tray material for use in the process of the invention, a typical embodiment of which is shown in perspective cutaway view  FIG. 9 . Said tray material is comprised of sheet  20 , border  28 , ports  30 , and an at least partly rigid frame, frame  50 , wherein frame  50  is connected to at least a portion of the perimeter of sheet  20 .  
         [0112]     It is preferred that frame  50  lies within a lumen within border  28 , along the perimeter of sheet  20 . However, frame  50  may be connected to the exterior of border  28 , or embedded within the perimeter of sheet  20 , and so on.  
         [0113]     It is preferred that various cross-sectional dimensions and configurations of border  28  are engineered to work with various cross-sectional dimensions and configurations of frame  50  so as to assist in positioning border  28  in the oral vestibule to enhance formation of a vacuum seal, and to assist with intraoral placement and removal of sheet  20 . For example, at a given point along the length of border  28 , frame  50  could provide support pressure along vectors in a first plane, while permitting free movement of border  28  along vectors in a second plane. At a different point along the length of border  28 , frame  50  could provide support pressure along different vectors, and permit free movement along different vectors. In another example, frame  50  could exhibit deformation memory along a given portion of the length of border  28 , yet be dead soft along a different portion of the length of border  28 .  
         [0114]     It is preferred that the anterior portion of frame  50  is connected to a handle, handle  52 , to facilitate intraoral placement and removal of said tray material. It is further preferred that extension  32  is connected to border  28  at a point along the length of handle  52 .  FIG. 9  also shows extension  32  connected between border  28  and valve  34 , and vacuum  36 .  
         [0115]      FIG. 10  is an enlarged perspective cutaway view of unmolded sheet  20  with a pressure indicating material, indicator  54 . When a custom tray comprised of molded sheet  20  with indicator  54  is inserted between forcefully occluding dental arches, and the occlusal contacts of the teeth forcefully press against portions of said custom dental tray with indicator  54 , then a record is produced. Said record therefore can indicate the location and area of occlusal contacts on said custom tray.  
         [0116]     It is preferred that indicator  54  is comprised of a material that facilitates distinguishing relative pressure differences between multiple points of occlusal contact.  
         [0117]     It is preferred that indicator  54  is embedded within the sheet  20  material. However, indicator  54  may be at least partly located on an external surface of sheet  20 .  
         [0118]     It is further preferred that indicator  54  is comprised of semi-conductive pressure-sensitive ink elements, such as pressure-sensitive ink which can output electrical signals regarding the location, duration, amplitude, and timing of occlusal contact pressure from forcefully occluding teeth on a custom dental tray comprised of sheet  20  with indicator  54 .  
         [0119]     However, indicator  54  may be comprised of other pressure-sensing electrical elements. Indicator  54  may also be comprised of other pressure sensitive non-electrical elements. For a first example, indicator  54  may also be comprised of PTFE embedded in sheet  20 , wherein said PTFE is substantially opaque in appearance, such as a grid of small squares of PTFE, or even small particles of PTFE randomly dispersed in sheet  20  material. Occlusal pressure exerted on portions of opaque PTFE will cause said portions of opaque PTFE to become translucent. In addition, degrees of occlusal pressure exerted on opaque PTFE, can be correlated with degrees of translucency caused in opaque PTFE. As such, translucent portions of indicator  54  PTFE are visually distinguishable from the opaque portions of PTFE, and therefore can serve as records  58 , indicating occlusal contact areas. In addition, occlusal contact pressures applied to indicator  54  PTFE cause greater translucency to form in areas of greater pressure, and lesser translucency to form in areas of lesser pressure.  
         [0120]     For a second example, indicator  54  may be comprised of a half-thickness upper sheet  20 , and a half-thickness lower sheet  20 , wherein said upper sheet  20  is printed with a grid blue ink, and said lower sheet  20  is imprinted with a grid of yellow ink, such that when occlusal contact pressure is applied to sheet  20 , the blue and yellow inks are pressed together to form a green record  58 .  
         [0121]      FIG. 11  shows a completed custom dental tray, custom tray  56 , having indicator  54 , after having been subjected to forceful occlusal contact pressures. Custom tray  56  has recorded occlusal contact pressures, record  58 , which are shown as visually distinguishable.  
         [0122]      FIG. 12  shows a top view of an unmolded sheet  20  with multiple indicators  54  connected by circuits, circuits  60 , to an electronic chip, chip  62 . The drawing is not intended to be an electrical schematic, but rather a general plan for routing of circuits. Indicators  54  shown here are electrical or electromechanical pressure sensors. Chip  62  records electrical input data from indicators  54 , such as data regarding the location, duration, amplitude, and timing of occlusal contact pressure exerted upon custom tray  56 . Chip  62  is connectable to a data port, so that the data may be copied from chip  62 . Chip  62  may also include a power source, Circuits  60  are arranged to follow the curvature of a dental-arch shape, thereby decreasing the likelihood that critical circuits  60  will be cut away when sheet  20  is trimmed to form custom tray  56 , thereby cutting away peripheral circuits  60 . In contrast, methods of fabricating occlusal pressure sensing appliances of the prior art do not include routine trimming of pressure indicators.  
         [0123]     Circuits  60  are comprised of a material which will not significantly disrupt conductivity properties due to the process of molding sheet  20 . It is preferred that circuits  60  are comprised of a non-elastic conductive material, such that the sheet  20  material surrounding circuits  60  undergo substantial plastic deformation during molding of sheet  20  to form custom tray  56 , but not circuits  60  themselves. However, circuits  60  may be comprised of an elastic, stretchable conductive material.  
         [0124]      FIG. 13  shows a custom dental tray retaining attachments. It is preferred that said custom tray is molded with a space reserved for an attachment that is an occlusal pressure sensor. However, space may be reserved for other attachments, such as oral decorations. Attachments shown include a multiplicity of oral decorations, attachments  64 A through  64 F. Since custom trays  56  may readily be fabricated by persons unskilled in the art, custom trays may now be used for retaining oral decorations. Prior to the processes of the current invention, custom tray fabrication was generally too costly for routine use in retaining oral decorations.  
         [0125]     For example of an oral decoration, attachment  64  may be comprised of a tooth-replacement material, wherein a tooth-colored material is placed against surfaces of custom tray  56  in a location where a tooth is missing, or a portion of a tooth is missing, thereby providing the appearance of a natural tooth. Other examples of oral decorations include electrically powered lights, light emitting substances, costume jewelry, colorations over the gingiva, tooth facings, and so on. Examples of tooth facings include a blackened facing which creates the appearance of a missing or broken tooth, a stained facing which creates an appearance of an uncleaned tooth, an unnaturally-shaped facing such as a fang shaped facing, a colored facing, a facing with an artistic image, and so on. Attachment  64  may also be comprised of an anchor which retains another attachment to custom tray  56 .  
         [0126]     For a spacer for a tooth-shaped attachment  64 , it is preferred that the portion of said spacer which is to be oriented facing toward the anterior is substantially non-moldable, while the portion of the spacer which is to be oriented facing toward the gingiva or toward the opposing teeth is substantially moldable.  
         [0127]     Attachments  64 A and  64 F show fang-shaped facings which appear to be stained and uncleaned. Attachment  64 B shows a tooth replacement where a tooth is missing. Attachment  64 C shows a tooth replacement, where a portion of a tooth is missing. Attachment  64 D shows a decoration, such as a powered light source, or a jewel. Attachment  64 E shows a black facing to mimic a missing tooth space.  
         [0128]     It is preferred that a attachment  64  is located on an inner surface of custom tray  56 , between custom tray  56  and the teeth or gingiva. However, attachment  64  may be located on an outer surface of custom tray  56 , or even provided embedded within sheet  20 . It is preferred that attachment  64  has retentive features to enhance retention against the surfaces of custom tray  56 , such as undercuts, adhesives, and so on.  
         [0129]     From the description above, a number of advantages of my dental tray material and process become evident: 
        (a) Accurately adapted dental trays can be made by persons unskilled in the art     (b) Accurately adapted dental trays can be made without the use of costly specialized equipment     (c) Accurately adapted dental trays can be made in a short time     (d) Dental trays can be made to record occlusal pressures     (e) Dental trays can be intraorally molded which are accurately adapted to the form of the teeth     (f) Dental trays can be intraorally molded which have substantial retention to the teeth     (g) Dental trays can be intraorally molded which have low fluid leakage     (h) Accurately adapted dental trays made by persons unskilled in the art can retain oral attachments        
 
         [0138]     Another advantage is that accurately adapted custom dental trays can now be made by persons of the general public. In addition, they can be made rapidly and cost effectively in dental offices, or at home.  
         [0000]     Operation— FIGS. 1-13   
         [0139]     By using the dental tray material of the invention, it is now possible, surprisingly, to form an accurately conformed dental tray intraorally, without requiring costly equipment.  
         [0140]     The process offers the advantage that the dental practitioner can now produce accurately adapted dental trays in a short time, such as trays which can record occlusal pressure. The process offers a further advantage that unskilled persons can now produce accurately adapted dental trays, such as in their own homes.  
       EXAMPLE 1  
       [0141]     Implementation of the process begins with selecting an appropriately sized tray  24  from a kit provided. Non-moldable filler  26  is prepared, such as by mixing premeasured base and catalyst components of a slow-setting putty dental impression material with the fingers to form a mixed dental impression material, loading said mixed dental impression material into tray  24 , seating tray  24  with said mixed impression material onto the teeth until said mixed dental impression material is set, thereby forming a non-moldable filler  26 . Tray  24  with non-moldable filler  26  is removed from the mouth.  
         [0142]     A dental tray material provided comprises sheet  20  with indicator  54 , connector  22 , border  28 , ports  30 , and extension  32 , as shown in  FIG. 1 . Indicator  54  is comprised of a grid of embedded PTFE squares. Said dental tray material is detachably mounted over non-moldable filler  26  and tray  24 , such as by covering non-moldable filler  26  in tray  24  with sheet  20 , and stretching connector  22  around the opposite side of tray  24  to stabilize the position of sheet  20 , as shown in  FIG. 2 . Extension  32  is connected to valve  34  and vacuum  36 .  
         [0143]     Holding tray  24 , the operator immerses said dental tray material, including sheet  20 , non-moldable filler  26 , and tray  24  into water heated to approximately 70° C., or until sheet  20  becomes substantially moldable, forming a moldable sheet  20 . Tray  24 , non-moldable filler  26 , and said dental tray material with moldable sheet  20  are removed together from the heated water, and placed into a person&#39;s mouth. Non-moldable filler  26  and moldable sheet  20  are seated over the teeth by pressing firmly on tray  24  until very firm resistance is encountered. Moldable sheet  20  is now interposed between the teeth and non-moldable filler  26 . Pressure from non-moldable filler  26  molds moldable sheet  20  to fit the shapes of the teeth.  
         [0144]     Valve  28  is opened, permitting undesirable air and fluids to be forcefully suctioned from between moldable sheet  20  and the teeth and gingiva, and in through border  28  and extension  32 , drawing moldable sheet  20  further into the detailed spaces about the teeth and gingiva.  
         [0145]     Moldable sheet  20  is permitted to cool sufficiently to become non-moldable, thereby forming a molded sheet  20 . Tray  24  with non-moldable filler  26  and said dental tray material with molded sheet  20  are removed from the mouth, as shown in  FIG. 3 . Extension  30  is disconnected from valve  28 . Connector  22  is cut with shears. Molded sheet  20  is pulled free from non-moldable filler  26 . Molded sheet  20  of said dental tray material is trimmed with shears to form a completed custom dental tray, custom tray  56 , as shown in  FIG. 11 .  
         [0146]     Custom tray  56  is inserted into a patient&#39;s mouth. The dental arches are occluded forcefully, such that occlusal contact points of the teeth apply pressure to custom tray  56 . Indicator  54  PTFE is compressed by the occlusal contact points, thereby rendering the indicator  54  PTFE substantially translucent at the location of the occlusal contact points. The translucent PTFE areas are visually distinguishable from the surrounding opaque PTFE, and can therefore serve as translucent recordings, records  58 . As such, the occlusal contact points are visually recorded as records  58  in custom tray  56 .  
         [0147]     Records  58  may be used to quantify parafunctional pressures to help patients recognize the associated risks. In addition, the data may be useful for assessing occlusal discrepancies, or may be useful for assessment of parafunctional jaw movements during sleep  
       EXAMPLE 2  
       [0148]     Implementation of the process begins with selecting an appropriately sized tray  24  from a kit, wherein tray  24  has the following connected elements thereon: sheet  20  with indicators  54 , border  28 , ports  30 , extension  32 , filler  28 , pad  40 , and socket  42 , as shown in  FIG. 5 . Indicators  54  are connected to socket  42  by circuits  60 .  
         [0149]     Extension  32  is connected to valve  34  on a vacuum  36  that is provided. Tray  24 , with said connected elements, is immersed into water heated to approximately 70° C., or until sheet  20  becomes substantially moldable, forming a moldable sheet  20 .  
         [0150]     Tray  24  and moldable sheet  20  with said connected elements are removed from the heated water, and placed into a person&#39;s mouth. Tray  24  with said moldable sheet  20  is forcefully seated over the teeth by pressing firmly on tray  24  until very firm resistance is encountered. Moldable sheet  20  is now interposed between the teeth and moldable filler  38 .  
         [0151]     The opposing arch of teeth are forcefully clenched down onto pad  40 , to provide seating pressure of tray  24  against moldable filler  38 , moldable sheet  20  and the teeth. Additional seating pressure is created by finger pressure against rest  46  areas. Substantial seating pressure against tray  24  is transferred to moldable filler  38 , and thence to moldable sheet  20 , causing moldable sheet  20  to become molded to the shapes of the teeth.  
         [0152]     The seating pressure tends to cause border  28  to be pressed against the vestibular mucosa. As such, border  28  acts as a cushion between the rigid walls of tray  24  and the sensitive mucosa, and border  28  tends to form a somewhat airtight seal. Valve  34  is opened, and the negative pressure vacuum in vacuum  36  forcefully suctions undesirable air and fluids from between moldable sheet  20  and the teeth and gingiva, and forcefully drawing moldable sheet  20  further into the detailed spaces about the teeth and gingiva.  
         [0153]     Moldable sheet  20  is permitted to cool sufficiently to become non-moldable, thereby forming a molded sheet  20 . Tray  24  with molded sheet  20  and connected elements are removed from the mouth. Molded sheet  20  is cut free from tray  24 , such as by cutting with shears or a blade about the entire perimeter of molded sheet  20 . Residual moldable filler  38  is cleaned from the surfaces of molded sheet  20 . Molded sheet  20  is trimmed with shears to form a completed custom dental tray, custom tray  56 .  
         [0154]     Custom tray  56  is inserted into a patient&#39;s mouth during a test session, such as during sleep, or during an analysis of occlusion. The dental arches are occluded forcefully, such that occlusal contact points of the teeth apply pressure to custom tray  56 . The pressure sensitive ink of indicators  54  is compressed by the occlusal contact points, thereby causing electrical signals to be generated by said ink. Said electrical signals are conducted by circuits  60  to socket  42 , where said electrical signals are recorded in a removable data collection chip. If signal amplification is necessary for signals to be recordable in said chip, then a power source and amplifier would also be provided. Said chip is capable of recording data regarding location, duration, amplitude and timing of occlusal pressure.  
         [0155]     After the test session is complete, said chip is removed from socket  42 , and connected to a standard computer input port, either directly, or using an adaptor. Data contained in said chip is copied from said chip into the computer, where it may be saved or transmitted to a remote computer for analysis. Such data may be used to quantify parafunctional pressures to help patients recognize the associated risks. In addition, the data may be useful for assessing occlusal discrepancies, or may be useful for assessment of parafunctional jaw movements during sleep  
       EXAMPLE 3  
       [0156]     Implementation of the process begins with selecting an appropriately sized tray  24  from a kit provided, wherein tray  24  has the following elements thereon: filler  28 , skin  44 , and pad  40 , as shown in  FIG. 6 .  
         [0157]     An ingestible spacer for an attachment  64 , wherein the shape of said spacer is similar to attachment  64 , is adhered to the surface of a tooth or gingiva using a temporary adhesive paste. Said spacer has retentive undercut features to enhance retention to custom tray  56 .  
         [0158]     A dental tray material, comprising sheet  20 , connector  22 , border  28 , ports  30 , and extension  32 , is detachably mounted over skin  44  and tray  24  by covering skin  44  on tray  24  with sheet  20 , and stretching connector  22  around the opposite side of tray  24  to stabilize the position of sheet  20 . Extension  32  is connected to valve  34  and vacuum  36 .  
         [0159]     Tray  24  with said dental tray material is immersed into water heated to approximately 70° C., or until sheet  20  becomes substantially moldable, forming a moldable sheet  20 .  
         [0160]     Tray  24  with said dental tray material with a moldable sheet  20  is removed from the heated water, and placed into a person&#39;s mouth. Tray  24  with said moldable sheet  20  is forcefully seated over the teeth by pressing firmly on tray  24  until very firm resistance is encountered. Moldable sheet  20  is now interposed between the teeth and skin  44 .  
         [0161]     The opposing arch of teeth is forcefully clenched down onto pad  40 , to provide seating pressure of tray  24  against moldable filler  38  and skin  44 , and skin  44  against moldable sheet  20 , and moldable sheet  20  against the teeth. Additional seating pressure is created by finger pressure against rest  46  areas. The seating pressure against moldable sheet  20  causes moldable sheet  20  to become molded to the shapes of the teeth.  
         [0162]     The seating pressure tends to cause border  28  to be pressed against the vestibular mucosa. As such, border  28  acts as a cushion between the rigid walls of tray  24  and the sensitive mucosa, and border  28  tends to form a somewhat airtight seal. Valve  34  is opened, and the negative pressure vacuum in vacuum  36  forcefully suctions undesirable air and fluids from between moldable sheet  20  and the teeth and gingiva, and forcefully drawing moldable sheet  20  further into the detailed spaces about the teeth and gingiva. Said spacer for attachment  64  reserves a space for attachment  64  about the teeth or gingiva, forming a reserved space having retentive undercut features.  
         [0163]     Moldable sheet  20  is permitted to cool sufficiently to become non-moldable, thereby forming a molded sheet  20 . Tray  24 , said dental tray material with molded sheet  20 , and said spacer are removed from the mouth. Molded sheet  20  is cut free from tray  24 , such as by cutting with shears or a blade about the perimeter of molded sheet  20 . Molded sheet  20  is trimmed with shears to form a completed custom dental tray, custom tray  56 .  
         [0164]     Said spacer for attachment  64  is removed from said reserved space in custom tray  56 , such as by working said spacer free from retentive undercut features. An adhesive is placed into custom tray  56 , to enhance retention of attachment  64 . Attachment  64  is inserted into said reserved space in custom tray  56 , and engaged into said retentive undercut features, as shown in  FIG. 13 . Custom tray  56  is placed over the teeth with attachment  64  retained in the desired location. Tray  24  with skin  44  containing moldable filler  38  may be reused.  
       EXAMPLE 4  
       [0165]     Implementation of the process begins with selecting from a kit providing an appropriately sized custom dental tray material comprising sheet  20 , border  28 , ports  30 , extension  32 , frame  50 , and handle  52 , as shown in  FIG. 9 . Vacuum  36  is removed from the kit, and valve  34  is connected to extension  32 .  
         [0166]     The dental tray material is immersed in water heated to approximately 75° C., or until sheet  20  becomes substantially moldable. Said dental tray material with moldable sheet  20  is removed from the heated water, and inserted into a person&#39;s mouth. Holding handle  52 , the operator seats border  28  fully into the mucosal vestibule about the dental arch, facilitated by the rigidity of frame  50 . Moldable sheet  20  is thereby stretched over the teeth.  
         [0167]     The teeth are gently occluded onto the dental tray material, to begin molding the occlusal surface of the dental tray material. Valve  34  is opened, and negative pressure vacuum from vacuum  36  forcefully suctions air and fluids from between moldable sheet  20  and the teeth and gingiva, and forcefully draws moldable sheet  20  into the detailed spaces about the teeth and gingiva. Moldable sheet  20  is thereby molded to fit the shapes of the teeth. Moldable sheet  20  is permitted to cool, and become non-moldable, forming a molded dental tray material with a molded sheet  20 .  
         [0168]     Said dental tray material with molded sheet  20  is removed from the mouth. Extension  32  is disconnected from valve  34 . Molded sheet  20  is trimmed with shears to form a completed custom dental tray, custom tray  56 .  
         [0169]     An amount of medicament is placed into custom tray  56 , and placed into the mouth for a desired time period, after which custom tray  56  is removed from the mouth.  
         [0000]     Summary, Ramifications and Scope  
         [0170]     Accordingly, the reader will see that the dental tray material of this invention permits formation of accurately adapted custom dental trays to be formed intraorally in a short amount of time, and without the need for costly equipment. Furthermore, the dental tray material and process has the additional advantages in that it permits formation of accurate trays which can record occlusal pressures.  
         [0171]     Although the description above contains many specificities, these should not be construed as limiting the scope of the invention and process, but as merely providing illustrations of some of the presently preferred embodiments of this invention.  
         [0172]     For example, a dental practitioner may elect to utilize a custom dental tray material and process of the invention to eliminate having to form models of the teeth, despite having a custom tray vacuum former.  
         [0173]     As a second example, a dental practitioner not having a custom tray vacuum former may elect to use a custom dental tray material and process of the invention, but substitute using models of the teeth instead of the patient&#39;s teeth as a template for molding sheet  20 .  
         [0174]     As a third example, a dental practitioner may elect to use the process partially, such as by connecting extension  32  to the office vacuum system, rather than utilize vacuum  36 .  
         [0175]     As a fourth example, an oral suction orifice may be connected to border  28  to permit the user to utilize forceful inhalation of air to create negative air pressure within border  28 .  
         [0176]     As a fifth example, skin  44  with moldable filler  38  may be used as a custom tray with or without the use of sheet  20  or tray  24 , such as when a medicament is interposed between skin  44  and a person&#39;s teeth, and moldable filler  38  is heated to accelerate the rate of activity of said medicament.  
         [0177]     As a sixth example, a dental practitioner may use a vacuum former and models of teeth to form a custom tray  56  capable of indicating and recording occlusal pressures from sheet  20  with indicators  54 , circuits  60  and chip  62 .  
         [0178]     Thus the scope of the invention should be determined by the appended claims and their legal equivalents, rather than by the examples given.