A snoring mouthpiece, or oral appliance, is a non-surgical device worn during sleep that works to physically adjust the position of anatomical structures in the mouth and throat. This adjustment is designed to maintain an open and clear passage for air, thereby preventing the tissue vibration that causes snoring.
Understanding Airway Obstruction
Snoring is produced when the flow of air causes the soft tissues in the upper airway to vibrate. During sleep, the muscles supporting the tongue and soft palate naturally relax, which allows these tissues to collapse partially into the airway space at the back of the throat. This narrowing of the air passage increases the velocity of the air traveling through it.
The accelerated airflow causes the relaxed tissue to flutter, creating the characteristic harsh sound of snoring. The degree of this partial obstruction dictates the intensity of the snoring sound. A snoring mouthpiece directly addresses this physiological process by preventing the backward collapse of the soft tissues, thus keeping the airway structurally open.
Classification of Snoring Mouthpieces
Snoring mouthpieces fall into two main categories, each employing a distinct mechanical strategy to stabilize the airway. The most common type is the Mandibular Advancement Device (MAD). MADs resemble a sports mouthguard but are designed to fit over both the upper and lower teeth, holding the lower jaw in a forward position.
The second category is the Tongue Retaining Device (TRD). TRDs take a different approach, focusing specifically on stabilizing the tongue rather than repositioning the entire jaw. Both types aim to increase the space in the pharyngeal airway, but they achieve this goal through different points of mechanical contact and leverage.
Physical Mechanics of Airway Stabilization
The Mandibular Advancement Device operates by mechanically altering the skeletal structure of the mouth during sleep. By holding the lower jaw (mandible) in a slightly protruded position, the device creates anatomical changes in the upper airway. This forward movement pulls the tongue base and attached soft tissues away from the back wall of the throat.
This action increases the volume of the pharyngeal area, particularly in the velopharyngeal region, a common site of obstruction. The device stabilizes the jaw and prevents the tongue and soft palate from collapsing backward, which reduces the tissue vibration that causes snoring. Many MADs are adjustable, allowing the user to incrementally increase the amount of jaw advancement to find the optimal balance between comfort and airway opening.
In contrast, the Tongue Retaining Device works by directly stabilizing the tongue without repositioning the jaw. The TRD typically consists of a plastic bulb or chamber that sits outside the front of the mouth, into which the user gently inserts the tip of the tongue.
A slight negative pressure, or suction, is created inside the device to hold the tongue in a forward position throughout the night. This prevents the tongue from falling back and obstructing the airway, which is helpful for individuals whose snoring is primarily caused by tongue base collapse. Since the TRD does not rely on the teeth or jaw for retention, it can be a suitable option for those who have few or no teeth.
Fitting, Adjustment, and Care
The effectiveness of a snoring mouthpiece is highly dependent on an accurate fit, which can be achieved through different methods. Over-the-counter devices often use the “boil-and-bite” technique, where the thermoplastic material is softened in hot water and then molded to the user’s teeth by biting down. This process creates a semi-custom impression that improves retention.
Custom-fitted oral appliances offer a more precise fit and are typically made from a dental impression taken by a professional. This custom fabrication ensures a snug fit that maximizes both comfort and therapeutic effectiveness. For MADs, adjustability is a significant factor, as many models allow the user to fine-tune the degree of mandibular protrusion in small increments to achieve the ideal airway opening.
Proper care is necessary to maintain the device’s function and longevity. Both MADs and TRDs should be cleaned daily using a soft toothbrush and mild soap or a specialized dental appliance cleaner to prevent the buildup of bacteria and plaque. Storing the mouthpiece in a protective case when not in use helps prevent damage and warping, which is important because the device’s precise shape is integral to its function in keeping the airway open.