larger face mask to rule out reduced contact with the cheeks—is an interesting one. We would like to see a demonstration of the effectiveness of this proposed technique in reducing air leaks. Why not share our interest in this topic by conducting a multicenter trial? We also thank Roth for his comments. Based on his experience, he reports that, in some patients, lower lip face mask placement with the cephalad end of the mask on the eyes may cause ocular damage. Roth recommends using the head straps to improve contact between the mask and cheeks. In our own experience, we have found that the head straps themselves may promote ocular damage and, therefore, should be used with caution. Also, we are convinced that the problem of air leak at the cheeks is best solved by moving the contact points rather than increasing pressure. However, as airway obstruction contributes to air leak, we fully agree with Roth that the use of an oral airway is one of the keys to improving face mask ventilation in edentulous patients. Why not conduct a formal comparison among headstrap–adjusted face masks, larger face masks, and lower lip positioning of masks in edentulous patients?
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