Snoring occurs when airflow through the nose and mouth is physically obstructed during sleep, causing soft tissues in the throat to vibrate. These vibrations can range from a soft purr to a loud noise. A dental appliance, often called a night guard, is a common, non-invasive method used to manage airway resistance. This custom-fitted or moldable device adjusts the position of the jaw or tongue during sleep. The goal is to open the collapsed airway and reduce or eliminate the disruptive noise.
How Oral Appliances Stop Snoring
The primary cause of snoring is the natural relaxation of soft tissues in the throat and the tongue base during the deeper stages of sleep. When these structures relax, they partially collapse backward, narrowing the airway and accelerating the air passing through it. This increased speed causes the loose tissues, particularly the soft palate and uvula, to flutter and vibrate, producing the characteristic sound of snoring.
The most widely used night guard is the Mandibular Advancement Device (MAD), which shifts the lower jaw slightly forward. Advancing the jaw simultaneously pulls the attached soft tissues, including the tongue and soft palate muscles, forward and tightens them. This mechanical action prevents the collapse of soft tissues at the back of the throat, creating a wider, unobstructed passage for air. The device is custom-designed to hold the jaw in this forward position throughout the night. An alternative involves Tongue Retaining Devices (TRDs), which use a small suction bulb to hold the tongue forward directly, preventing it from falling back.
When Snoring Requires Medical Intervention
It is important to distinguish between simple (primary) snoring and Obstructive Sleep Apnea (OSA), as they represent different health risks. Primary snoring is generally a noise nuisance caused by tissue vibration, but it does not involve significant pauses in breathing. In contrast, OSA is a medical condition where the airway becomes completely or nearly blocked for short periods. This causes repeated cessations of breath and drops in blood oxygen levels.
While oral appliances treat simple snoring and are sometimes recommended for mild to moderate OSA, they are not a substitute for a medical diagnosis. If snoring is consistently loud, or if a bed partner observes gasping, choking, or snorting sounds, a consultation with a physician or sleep specialist is necessary. These symptoms, especially when combined with excessive daytime sleepiness or morning headaches, suggest moderate to severe OSA. For these serious cases, the standard of care often involves a continuous positive airway pressure (CPAP) machine. An oral appliance may be considered only as a secondary option or for those unable to tolerate CPAP therapy.
Selecting the Right Anti-Snoring Device
Consumers choose between two main categories of oral appliances: over-the-counter (OTC) options and custom-fitted devices from a dental professional. OTC night guards, often using a “boil-and-bite” technique, allow for a semi-custom fit at a lower cost. However, these devices may offer a less precise fit and are not always adjustable. This lack of precision can compromise comfort and reduce their effectiveness in maintaining an open airway.
Custom-fitted devices, typically Mandibular Advancement Devices, are fabricated from detailed impressions of the patient’s teeth and jaw structure. This precise fitting ensures maximum comfort and allows the dentist to calibrate the exact degree of lower jaw advancement needed. While more expensive, the custom fit is associated with better compliance and long-term effectiveness in treating both snoring and mild to moderate OSA. Patients using either appliance may experience temporary adjustment issues, such as hypersalivation or mild jaw soreness, which usually resolve within a few weeks.