Snoring is the sound produced by the vibration of soft tissues in the upper airway during sleep. The noise occurs when the muscles relax during the deepest stages of sleep, allowing the tongue and soft palate to partially collapse and narrow the passage. Oral appliances, often called snoring mouthguards, offer a non-surgical method for managing this issue by physically altering the position of the mouth’s structures. These devices are generally intended for simple, habitual snoring, although they are also used for mild to moderate obstructive sleep apnea (OSA).
How Snoring Mouthguards Reposition the Airway
Snoring mouthguards function by keeping the upper airway open and preventing the soft tissues from vibrating or collapsing during inhalation. The most widely used type is the Mandibular Advancement Device (MAD), which resembles a sports mouthguard but consists of two trays for the upper and lower teeth. These trays connect in a way that gently pushes the lower jaw forward by a few millimeters. This forward repositioning of the mandible pulls the tongue and the soft palate tissues away from the back wall of the throat.
This action effectively increases the diameter of the airway, allowing air to pass through more freely and reducing the turbulence that causes the snoring sound. Many professional MADs include an adjustment mechanism that permits the user or dentist to incrementally advance the lower jaw to find the optimal position for maximum effectiveness. A second, less common type of device is the Tongue Retaining Device (TRD), which uses a small suction bulb to hold the tongue forward. The TRD secures the tongue in a protruded position, which prevents it from falling back and obstructing the airway.
Comparing Custom-Fitted and Over-the-Counter Devices
The primary distinction between available snoring mouthguards lies in their fit, precision, and cost. Custom-fitted oral appliances are fabricated by a dentist following an impression of the patient’s teeth and jaw structure. This process ensures a precise fit, which maximizes comfort and promotes long-term compliance. Custom devices are typically made from durable acrylic or resin materials and are often fully adjustable to allow for fine-tuning of the jaw advancement.
In contrast, over-the-counter (OTC) options, commonly known as “boil-and-bite” devices, offer a one-size-fits-most approach with limited customization. These devices are made of thermoplastic material that softens in hot water, allowing the user to create a basic impression of their teeth. While significantly more affordable, these devices are less precise, often bulkier, and lack the adjustability needed for optimal therapeutic positioning.
Evidence of Effectiveness and Who Benefits Most
Oral appliances have demonstrated effectiveness in significantly reducing or eliminating simple, primary snoring. For individuals whose main issue is the noise of snoring, a mouthguard is often a highly successful solution. The effectiveness is directly related to the device’s ability to maintain an open airway.
These devices are also a recognized treatment option for patients diagnosed with mild to moderate Obstructive Sleep Apnea (OSA). Success is measured by a reduction in the Apnea-Hypopnea Index (AHI), which tracks the number of breathing interruptions per hour of sleep. Oral appliances often reduce the AHI by 50% or more in suitable patients, improving sleep quality and reducing daytime drowsiness.
They are particularly useful for individuals who cannot tolerate continuous positive airway pressure (CPAP) therapy, the standard treatment for severe OSA. Best candidates are those whose snoring is positional, meaning it is worse when sleeping on the back, and those who have a mild to moderate AHI score.
Addressing Discomfort and Safety Concerns
While generally considered safe, the use of a snoring mouthguard can lead to temporary side effects as the mouth and jaw adjust to the new positioning. The most common complaint is temporary jaw discomfort or soreness in the temporomandibular joint (TMJ) and surrounding muscles, especially during the initial weeks of use. This discomfort typically subsides as the muscles adapt to the nightly forward positioning of the lower jaw.
Other adverse effects include excessive salivation or a sensation of dry mouth, as well as temporary changes in the alignment of the bite upon waking. This morning malocclusion usually resolves within a few minutes, though long-term use can sometimes lead to minor, permanent changes in tooth position. Individuals with active gum disease, loose teeth, or pre-existing severe TMJ disorders should consult a dentist or sleep specialist before use. Regular follow-up appointments are recommended to monitor for any lasting dental or jaw-related changes.