Snoring is the harsh sound produced by the vibration of soft tissues in the upper airway during sleep. This vibration occurs when the air passage narrows, causing turbulent airflow that makes the soft palate, uvula, and pharyngeal walls flutter. Oral appliances, commonly referred to as snoring mouthpieces, are a widely used, non-surgical method to address this issue. These devices are designed to maintain an open, unobstructed airway, which in turn reduces the sound and frequency of snoring. For many seeking a simpler solution than continuous positive airway pressure (CPAP) therapy, these mouthpieces offer a portable and effective option for managing mild to moderate snoring.
The Two Main Types of Anti-Snoring Mouthpieces
Anti-snoring mouthpieces fall into two distinct types, each using a different mechanical strategy to widen the airway. The most common are Mandibular Advancement Devices (MADs), which resemble athletic mouthguards. These devices fit over the upper and lower teeth and hold the lower jaw (mandible) in a slightly forward position during sleep. By advancing the jaw, the MAD prevents the soft tissues and the base of the tongue from collapsing backward into the throat.
The second type is the Tongue Retaining Device (TRD), sometimes called a Tongue Stabilizing Device. Unlike MADs, the TRD does not attach to the teeth or directly manipulate the jaw position. Instead, this appliance features a small compartment that uses gentle suction to hold the tip of the tongue forward. TRDs are often used by individuals with dental issues, such as missing teeth, that prevent the secure placement of a MAD. Both types function to create more space in the back of the throat, but they achieve this goal through different points of anchor and pressure.
How Mouthpieces Physically Stop Snoring
Snoring is caused by the relaxation of muscles in the throat and tongue during sleep, allowing soft tissues to partially collapse and narrow the airway. When air rushes through this constricted space, it causes the surrounding tissue to vibrate, generating the snoring sound.
Anti-snoring mouthpieces mechanically solve this problem by physically increasing the dimension of the posterior airway space. MADs work because the tongue is connected to the lower jaw; pulling the jaw forward also pulls the tongue base forward, effectively clearing the airway. TRDs achieve a similar result by directly securing the tongue in a forward position, preventing it from falling back. By stabilizing and advancing these soft structures, both devices reduce the airway obstruction, allowing air to flow more smoothly and quietly.
Understanding Clinical Effectiveness
Clinical studies have established that oral appliances are an effective treatment, particularly for primary snoring and mild to moderate Obstructive Sleep Apnea (OSA). For simple, non-apneic snoring, success rates are high, with many users reporting a significant reduction in intensity and frequency. These devices often achieve a noticeable improvement, with a 50% to 70% reduction in snoring events or loudness reported by users.
Simple snoring must be distinguished from OSA, which involves repeated pauses in breathing. For mild to moderate OSA, MADs are a recognized alternative to CPAP therapy. They reduce the Apnea-Hypopnea Index (AHI)—a measure of apnea severity—though they are less effective at eliminating all respiratory events compared to CPAP. The success of a mouthpiece depends heavily on the specific cause of the snoring and the patient’s individual anatomy.
Practical Considerations and Potential Drawbacks
Users must weigh the choice between a custom-fitted device and a generic over-the-counter (OTC) option. Custom oral appliances are fabricated by a dentist from precise impressions, offering a superior, more comfortable fit that maximizes long-term compliance and efficacy. OTC devices, often using a “boil-and-bite” method, are less expensive and more accessible, but an uneven fit can reduce effectiveness.
Common side effects are minor and diminish as the user adjusts to the appliance. These can include temporary jaw soreness, tooth discomfort, and increased salivation or dry mouth upon waking. More serious, long-term use of poorly fitted devices can lead to changes in bite alignment or discomfort in the temporomandibular joint (TMJ). Therefore, users should seek professional guidance to ensure proper fitting and to monitor for any adverse dental or jaw effects.