Thank you for viewing. Oral Immune Training Device: Littre Meter I purchased this at a dental clinic and opened the box, but I never used it and have kept it in storage. I would be happy to pass it on to someone who needs it (*^^*) Also, [Only the small mouthpiece is included‼️]. The instruction manual is also included. ✴︎Since this is also listed elsewhere, priority will be given to the first person to purchase it. This device is used to train the muscles around the mouth and display the results numerically. It's for children undergoing orthodontic treatment and for those who are concerned about the decline of the muscles around their mouth. There is also an instruction manual with usage instructions.