Snoring is a common disruption affecting millions, often causing annoyance for partners and concern for the snorer’s rest. This noisy breathing is caused by restricted airflow, which makes the soft tissues in the throat vibrate. Oral appliances, commonly called anti-snoring mouthguards, are a widespread, non-invasive method to address this problem. These devices physically adjust the anatomy of the mouth and throat to maintain an open airway while sleeping.
The Cause of Snoring and the Role of Oral Appliances
The distinct sound of snoring occurs when the muscles in the throat and mouth relax during sleep. This relaxation allows the soft palate, uvula, and tongue base to partially collapse into the airway. As air passes through this narrowed space, it causes these soft tissues to vibrate, producing the characteristic rattling sound.
Oral appliances work by mechanically altering the position of the lower jaw and tongue to counteract this muscular relaxation. By physically holding these structures in a forward position, the devices increase the cross-sectional area of the airway. This adjustment stiffens the soft tissues, allowing air to move more freely and preventing the vibrations that cause snoring.
Types of Devices and How They Work
The two main categories of anti-snoring mouthguards achieve the goal of opening the airway using different mechanical approaches. The most common type is the Mandibular Advancement Device (MAD). These devices fit over both the upper and lower teeth, similar to a sports mouthguard, and are connected by hinges or bands.
The MAD works by gently pushing the lower jaw (mandible) slightly forward from its resting position. This movement tightens the soft tissue at the back of the throat and pulls the base of the tongue away from the airway. MADs are frequently adjustable, allowing a dentist to fine-tune the amount of jaw advancement for effectiveness and comfort. While custom-fitted, dentist-prescribed MADs are the most effective, some over-the-counter “boil-and-bite” versions are available.
A second type is the Tongue Stabilizing Device (TSD), also known as a Tongue Retaining Device. Unlike MADs, TSDs do not engage the teeth or jaw, making them a potential option for people with insufficient teeth or specific dental issues. This device consists of a preformed bulb that sits outside the lips, and the tip of the tongue is placed into it.
The TSD uses gentle suction to hold the tongue in a forward position, preventing it from falling back into the throat and causing an obstruction. TSDs are less widely used than MADs, but their distinct mechanism primarily focuses on tongue-based snoring.
Effectiveness and Usage Considerations
For people who experience simple, non-apneic snoring, oral appliances are generally successful at reducing or eliminating the noise. Their ability to physically maintain an open airway translates to high success rates in treating primary snoring. Patients often report a significant decrease in the intensity and frequency of their snoring when using a custom-fitted device.
Compliance is a significant factor in long-term effectiveness. Initial side effects are common, including temporary discomfort in the jaw joints or teeth, or increased salivation or a dry mouth. These minor issues usually lessen over the first few weeks of regular use as the mouth adapts.
Proper fit and maintenance are important for performance and longevity. Custom-fitted appliances from a dentist are preferred because they ensure a precise, comfortable, and effective fit. The devices require daily cleaning with a toothbrush and mild soap or denture cleaner to prevent bacteria buildup. With good care, most appliances can last several years before needing replacement.
When to See a Doctor (Snoring vs. Sleep Apnea)
While a mouthguard is effective for simple snoring, it is important to distinguish it from Obstructive Sleep Apnea (OSA). OSA is characterized by repeated episodes where the airway completely or partially collapses, causing breathing to stop and start throughout the night. This condition interrupts the flow of oxygen and can have serious long-term health consequences, including an increased risk of heart disease and stroke.
Signs that snoring may be more than a nuisance include gasping, choking, or silent pauses in breathing observed by a partner. Excessive daytime sleepiness, morning headaches, and difficulty concentrating are also indicators that require a medical evaluation. A doctor will typically recommend a sleep study to diagnose the severity of any underlying sleep disorder.
Oral appliances are generally recommended for people with simple snoring or those diagnosed with mild to moderate OSA. They should never be used to treat severe OSA without the direct supervision of a healthcare professional. The first step for anyone with symptoms beyond simple snoring is to consult a sleep specialist or a dentist specializing in sleep medicine, who can determine the appropriate device and ensure safe treatment.