Snoring is the common sound resulting from the vibration of soft tissues in the throat as air passes through a partially obstructed airway during sleep. This noise often indicates an issue related to the oral and pharyngeal structures. Dentists are increasingly recognized for their ability to address primary snoring due to their expertise in the anatomy of the mouth, jaw, and associated airway components. They play a significant role in treating patients whose snoring originates from structural issues within the upper airway.
Anatomical Causes of Snoring
The vibrations that create the sound of snoring are linked to the relaxation of muscles in the throat and mouth during sleep. When a person sleeps, the muscle tone supporting the soft palate and the uvula decreases, causing these tissues to become floppy. Air forced past these relaxed structures makes them flutter, which creates the characteristic rattling sound.
A significant mechanical factor is the tongue falling backward toward the throat, which narrows the breathing space. This movement reduces the cross-sectional area of the airway, increasing air velocity and tissue vibration. The structure of the lower jaw, or mandible, also plays a part. A naturally receding or misaligned jaw position can predispose an individual to a narrower airway, making obstruction and subsequent snoring more likely.
Custom Oral Appliance Therapy
The primary treatment a dentist provides for snoring is custom oral appliance therapy, using precision-fitted devices worn only during sleep. These appliances are fabricated from detailed impressions of a patient’s teeth, unlike generic mouthguards. Customization ensures a secure fit, maximizes comfort, and allows the dentist to make controlled, incremental adjustments.
The most common type is the Mandibular Advancement Device (MAD), which holds the lower jaw and tongue gently forward. This forward positioning tightens the muscles and tissues of the upper airway. It prevents the tongue and soft palate from collapsing backward, physically maintaining an open airway and reducing the tissue vibration that causes snoring.
Another option is the Tongue Retaining Device (TRD), which uses gentle suction to hold the tongue in a forward position. TRDs are useful for patients who are not suitable candidates for MADs due to jaw joint issues or a disproportionately large tongue. Both custom appliances increase the size and stability of the airway, resulting in quieter and less obstructed breathing.
The Critical Distinction: Snoring Versus Sleep Apnea
It is important to recognize that loud, frequent snoring can be a symptom of a serious medical condition called Obstructive Sleep Apnea (OSA). Primary snoring is primarily a noise issue, while OSA is a medical disorder characterized by repeated pauses in breathing due to a complete or partial collapse of the airway. These interruptions can last for several seconds and occur numerous times each hour, leading to fragmented sleep and potential long-term health complications like hypertension.
A dentist is qualified to treat primary snoring using oral appliances, but they cannot legally or medically diagnose Obstructive Sleep Apnea. The diagnosis of OSA must be made by a medical doctor, typically a sleep specialist, following an overnight sleep study called a polysomnography. This test quantifies the frequency and severity of breathing interruptions to confirm the condition.
The dentist’s role in OSA treatment is highly collaborative with the medical team. After a sleep specialist confirms the diagnosis, a custom oral appliance may be prescribed as a first-line treatment for mild to moderate OSA or for patients who cannot tolerate a Continuous Positive Airway Pressure (CPAP) machine. Dentists are the only healthcare providers with the expertise to fabricate and manage these custom oral appliances.