Below is a comprehensive review of the different types of anti-snoring mouth guards, snoring devices, and mouthpieces and how they stop snoring. Each works in a unique manner to reduce airway resistance and increase air flow through the upper airway. While no product can guarantee that it will work for all people, there is much research demonstrating that many of these categories of snoring devices are effective for many people.
Snoring is simply the sound of resistance and turbulence in the upper airway. Contrary to popular belief, the sound of snoring does not come from the nose. Rather, snoring starts in the back of the airway. Behind the tongue, the oropharynx may become constricted during sleep.
About 50 percent of the population snores, so you are most likely very familiar with the sound of snoring. During sleep, the muscles that keep the upper airway open and patent relax. This is more prominent during REM sleep, or dream sleep, when muscles are most relaxed. As the airway gets smaller, air turbulence increases. The soft tissues in the back of the throat vibrate, which is what causes the snoring sound. Learn more about the causes of snoring here.
Sleep apnea is a sleep breathing disorder that is characterized by repetitive pauses in breathing during sleep. Pauses occur several times per hour and last for over 10 seconds. As the blood-oxygen levels decrease, the brain awakens the individual which often leads to a loud gasp or snort. Sleep apnea is associated with snoring, witnessed pauses in breathing, and excessive daytime sleepiness.
Snoring occurs because the soft tissues in the back of the throat vibrate and press against other throat anatomy, causing resistance and turbulence – the snoring sound. The anti-snoring mouth guard or night guard brings the jaw forward. This widens the back of the airway, reducing resistance and turbulence which can stop the snoring.
When choosing a snoring device, one of the most important variables is comfort. Making sure your device is comfortable is crucial because it encourages you to wear it as much as possible, leading to noticeable results. There are several types of snoring devices that work in different manners. Two of the most popular are Tongue Stabilizing Devices (TSD) and Mandibular Advancing Devices (MAD), also called JAD or jaw advancing devices.
Mandibular Advancement Devices (MADs) - This method is named after the mandible or jaw bone. It refers to the effect of moving the jaw slightly forward which results in a greater separation of the vibrating elements in the throats of snorers. This yields less turbulence and less snoring. The MADs used for treating sleep apnea are similar to many of the simple snoring devices listed here because they all move the jaw forward.
One of the most common complaints with MAD snoring devices is teeth shifting and tooth discomfort. For people with dental issues, the MAD may not be a suitable candidate.
Tongue Stabilizing Devices - (TSDs) This method takes a slightly different approach and seeks to isolate the tongue, pulling the tongue forward and creating a wider gap between the tongue and the back of the throat. This helps reduce or eliminate snoring. One of the benefits of the TSD compared to other snoring devices is that, generally, they do not cause jaw discomfort. They are less likely to cause TMJ or tooth shifting. For people who have dental issues or missing teeth, the TSD may be a more desirable option.
One of the complaints with TSDs is that people sometimes feel uncomfortable with the position of the tongue. Also, there are several reports of increased salivation (more spit in the mouth).
Snoring chin straps - These are also popular products. However, their efficacy is less established in research literature.
|Adjustable in 1 millimeter increments. Allows for full mouth breathing and custom impression of the teeth.
Use code "PatientAccess" for 10% off.
|Adjustable with included hex tool to move the lower jaw.||$69.95||View Website|
|Hinged at mandible/maxilla junction for more flexibility. Available in two sizes. No adjustment settings available.||$75.95||View Website|
|Can be custom fitted through 'boil and bite' process. Unable to be adjusted.||$69.95||View Website|
|Holds the tip of the tongue in a forward position.||$69.94||View Website|
|'One size fits all' Tongue Stabilizing Device. Can be worn with dentures.||$140.00||View Website|
|Three adjustable settings which cannot be changed after the boil-and-bite process.||$159.90||View Website|
ASA receives a financial benefit from linking to some of these snoring devices.
Most of these devices are made of thermoplastic and look similar to sports mouth guards. This rubbery-like plastic has some flexibility which helps with comfortable use on a wide array of people.
The TSDs are often ‘one size fits all.’ There are few variables with TSDs and they are ready to use out of the box.
The MAD and MAD-like devices may require extra fitting. Some MAD snoring devices can simply be placed directly in the mouth and used. Many of these MADs are now adjustable for snoring efficacy. Some of these adjustable devices require a tool for adjustment. By turning an allen wrench, the mandibular part of the mouthpiece can move forward or backward. This can allow for fine tuning of the device based on efficacy and comfort.
More advanced anti-snoring mouth guards use a ‘boil and bite’ feature which allows for the personalization of the device. These boil and bite devices allow for custom fitting with your mouth and teeth. Usually, the devices are placed in boiling water for several seconds. After cooling the device for a few seconds, it is placed in the mouth. The user bites down on the formable piece and pushes the soft plastic against the teeth. Once the process is complete, the snore guard is customized for that user’s mouth. If the impression needs to be fixed, some of these dental devices can be refitted by simply repeating the process.
The cost of snoring devices ranges from about $30 to $150. Snoring mouthpieces that are made by dentists may cost $500 to $1000.
This depends on the type of device and how often it is used. Most snoring devices are not expected to last for more than one year. Some may last for a few years. Keep in mind that with grinding and clenching that the pieces may wear down.
Most snoring devices do not work with denture users. The MADs require teeth to be the anchor of the mouth. There needs to be something to grip the mandible so that it can be moved forward.
No, snoring devices are different from brux guards and sports mouth guards. They may look and feel the same, but they work in different ways. MAD devices do offer some protective value for people who have bruxism or teeth clenching problems. Although MADs may prevent the destruction that is caused from bruxism and teeth grinding, it is unclear if they prevent consequences of teeth clenching – like abfractions.
Some snoring treatments are offered over the counter (OTC). Snoring nose strips, and sprays (not recommended by this author) are offered without a doctor’s order. However, many of the MADs offered in the U.S. do require a physician order as they are listed as FDA Class II devices.
For some snoring devices, you do need a doctor’s prescription. Because many of these devices are regulated by the US FDA, they are considered treatment devices. There is concern that many individuals that have more severe health issues (like obstructive sleep apnea) may be undiagnosed, or misdiagnosed, and have complications as a result of no clinician intervention. In general, it is recommended that you speak with your physician and dentist about using these devices before you use them.
Expensive snoring devices can often be adjusted and customized which is why you pay more for them. Additionally, many of the newer and more expensive devices avoid latex materials and plastics that contain BPA. Latex can be problematic for people allergic to the material and BPA is currently being studied because of the consequences of absorption into the body. Most high-quality food containers and medical devices avoid latex and BPA because of these possible risks.
Some snoring devices have an FDA indication for treatment of mild obstructive sleep apnea. Unless ordered in conjunction with physician care, you should not use a simple snoring device for the treatment of sleep apnea.
One of the risks of using a simple snoring device for the treatment of sleep apnea is that the device will not adequately treat all of the respiratory issues during sleep. Essentially, the user risks being under-treated. There is an increased risk of heart attack, stroke, deadly heart rhythms, and accidents from daytime sleepiness in patients with untreated obstructive sleep apnea.
Generally oral devices are not used for the treatment of central sleep apnea.
As mentioned above, it is good practice to talk to your doctor and dentist before starting any treatment. Having good dental care and following dental hygiene is important in maintaining oral health. Once you have the device, you should follow up with your doctor and dentist. If you have pain or discomfort, this is something that should be discussed. If you have persistent snoring, pauses in breathing, witnessed apneas or gasps, or excessive daytime sleepiness, you may need to be evaluated for sleep apnea.
One of the most important things is to keep your snoring device away from animals that like to chew things. Dogs are well known for using snore mouthpieces for chew toys. Keep your device in a protective container away from pets.
There are special cleaning fluids that can be purchased to clean your device. Simply using water with a gentle toothbrush will keep particles off of the device and help to prevent fungus and bacteria from growing on the device.
Using an anti-snoring mouth guard does not guarantee that snoring will stop. Although these options work for many, they do not work for all. Additionally, what might work in Year 1 may not work in Year 2. If you find yourself continuing to snore with the device, go through this checklist of possible problems.
Similar to most interventions in the medical field, there are risks and potential complications with dental sleep and snoring treatments.
With most snoring devices that move the jaw forward by anchoring the teeth, there is a risk that the teeth will shift from their original position. Because of the traction that is placed on the teeth for 8 hours each night, there is a tendency for the teeth to follow the direction of the stress. This can cause teeth and bite alignment issues. The mandible and maxilla often feel misaligned in the morning. This is often most noticeable upon waking. When trying to eat breakfast, the teeth might not feel like they fit together like they did several hours prior. This often improves as the days continue.
There isn’t one specific snoring device that is perfect for everyone. There are advantages and disadvantages to many of these devices because they all are so different. Often, trying one for comfort and efficacy is required to determine which anti-snoring mouthpiece is best for you. Read more about anti-snoring mouth guards, snoring devices, and mouth pieces in this blog post.
© 2020 American Sleep Association.