What You Should Know Before Buying a Snoring Mouthpiece
You only snore while you sleep on your back (i.e., your are a tongue snorer)? Then a snoring mouthpiece is definitively a good snoring aid for you. Choosing the right one among the many, however, isn’t quite that simple. There are so many devices on the market that it is pretty difficult to buy the one that is best for you. On top of that, snoring mouthpieces are sold under many different names (mandibular advancement devices, snore guards, snoring mouth guards and so forth) which all mean the same thing! We can help you find the best snoring mouthpiece for you.
In Brief: How Snoring Mouthpieces work
Snoring can have several reasons. If it is caused by your tongue dropping back into the throat, a snoring mouthpiece is usually the appropriate aid. It puts the lower jaw into light tension and pulls it forward. With that, the tongue muscles and the tissue in the lower jaw area are also put under tension and can no longer sink to the back of the throat. The airways remain clear and the snoring sound is not heard.
A Snoring Mouthpiece is Different from A Mouth Guard for Mouth Snoring
The snoring mouthpiece, also called mandibular advancement device, is the most common type of mouthpiece. It prevents the rear part of your tongue (also: tongue base) from falling back into the throat while you sleep in a supine position. Otherwise, the tongue would obstruct or even block the airways. A mandibular advancement device therefore helps alleviate tongue snoring. It puts the muscles of the lower jaw under slight tension and gently pushes them forward. As the tongue muscles are attached to the lower jaw, the base of the tongue is also put under tension and moved forward. The tongue base is quite unable to relax and to slip back. The breathing air can flow in and out freely.
Dentists refer to the advancement of the mandible as “protrusion”, that’s why they are also called “protrusion splints”. The snoring mouthpieces are not only used in dentistry for anti-snoring therapy, but also for treating of so-called “retrognathia” or “retrognathism” (also: receding chin or overbite). Here, the patient’s lower jaw sits too far back and has to be artificially moved forward. Protrusion splints must have a firm fit because they must continuously maintain the tension of the mandible. The splints are therefore attached to the teeth rows in the upper and lower jaws for fixation. Protrusion splints are very common devices and there are many manufacturers.
Mouth Guard (for Mouth Snoring)
Mouth guard (for mouth snoring) – also called „mouth shield“ or “oral vestibular plate” – has a very different effect than a snoring mouthpiece: it prevents breathing through the mouth while sleeping. This prevents the soft tissue in the back of the mouth and throat from vibrating – this is called mouth snoring. The mouth guard, therefore, is an excellent device against mouth snoring.
Its shape reminds of a boxer’s mouthguard. But unlike the bulky mouthpiece, which is known from various sports, the mouth guard has a very slim design. It is very comfortable to wear – it won’t bother you during sleep. The mouthpiece is large enough to prevent it from being accidentally swallowed while sleeping (no risk of choking!).
The mouthpiece is inserted into the oral cavity between the lips and teeth. It is not firmly anchored to the teeth, but loosely surrounds the row of teeth of the upper jaw. The lower jaw is freely movable.
The mouthpiece prevents nightly mouth breathing and its unpleasant consequences: bad breath, dry mucous membranes, caries and mouth snoring. At the same time, it supports natural nasal breathing which helps the human body to regenerate better and faster.
An anti-snoring brace, on the other hand, is a bow-shaped stainless steel loop (coated with silicone). It is pushed backwards through the mouth opening into the palate area and puts the palatal arch under slight tension. The anti-snore brace is used for mouth snoring or when you snore in any position with the mouth closed (so-called “retrovelar snoring”).
Anti-snoring braces are, on the other hand, not used for tongue snoring. They have a completely different field of application than snoring mouthpieces (this does not apply to the special form RonchAP; these braces can also be used for tongue snoring).
The snoring mouthpiece needs to have a good hold on the upper and lower jaw so that it can move the lower jaw forward. For that purpose the snoring mouthpiece is anchored to the row of teeth. An anti-snoring mouthpiece actually consists of two parts; namely one for the teeth of the upper jaw and one for the teeth of the lower jaw. Both parts are then bonded together. Depending on the type of snoring mouthpiece used, it can be a permanent and fixed bonding or – with the help of bands or screws – a flexible connection design. This difference leads to a distinction between monobloc and bibloc snoring mouthpieces.
They are made of one piece, which means that the parts for the upper and lower jaw are bonded or melded together. Due to their simple design, they are very easy to use and to wear. Especially snorers who try out a snoring mouthpiece for the first time appreciate the straightforward handling of this type of mouthpiece. Moreover, monobloc snoring mouthpieces are much cheaper than the technically more advanced bibloc mouthpieces.
One big disadvantage of monobloc mouthpieces is their lack of flexibility. Once the mouthpiece has been fitted to the teeth, the degree of mandibular advancement – i. e., how far the lower jaw is moved forward – can no longer be calibrated. The upper and lower part of the mouthpiece are finally and firmly bound together. For most snorers this will not be a problem, but in some cases the mandibular advancement has to be readjusted (tightened) after a few months: The lower jaw has become “accustomed” to the mandibular advancement and becomes slack.
In addition, a monobloc mouthpiece offers no room for manoeuvre. All three possible directions of movement (up/down, left/right and forwards/backwards) are blocked. With biblock mouthpieces, only the forward / backward direction of movement is blocked. In particular the blocking of lateral movements by monobloc mouthpieces is problematic: it can lead to temporomandibular joint complaints.
Bibloc mouthpieces consist of two parts that are connected via flexible joints, elastic bands, plastic bands or also by metallic screw connections . These connections can be unfixed and re-adjusted over and over again.
The advantage of bibloc mouthpieces is their flexibility. The space between the top and bottom part ( = range of motion upwards / downwards) and the extent of mandibular advancement ( = range of motion forth / back) can be individually calibrated. With that, each user can find and maintain exactly the jaw alignment that promises the most effective relief for his individual snoring complaints. Furthermore, all bibloc mouthpieces allow for lateral movement, which means that even if the mouthpieces are put in, you are still able to fully move your lower jaw to the left and to the right. This provides for a relaxed jaw, even if the device is worn over long periods of time.
At the beginning, it may take some time to get used to wearing bibloc mouthpieces. They need to have a rather tight fit and develop traction to move the lower jaw forward. This can lead to muscle aches in the jaw area. This discomfort usually fades away after a few weeks. By the way: Clenching your teeth 3-4 times in the morning helps against any feeling of tooth sensitivity after wearing a snoring mouthpiece.
Given these “start-up difficulties” with bibloc mouthpieces, some dentists recommend a step-by-step approach. The patient should at first try a budget-priced monobloc device. Once he got used to wearing the device and it is clear that, all in all, he can cope well with the snoring mouthpiece, he may consider switching to a more high-quality bibloc snoring mouthpiece.
Examples of bibloc mouthpieces are the SomnoFit, SomnoFit-S, SomnoGuard AP, SomnoGuard SP and nearly all custom-made snoring mouthpieces made by dentists.
How to Fit a Snoring Mouthpiece – Boil ‘n Bite vs. Custom-Made
For a great fit, the snoring mouthpiece has to fitted to your teeth by making an impression of them. There are two ways to do that.
Boil n’Bite devices
With the boil ‘n bite method, the customer does the fitting at home. He receives the mouthpiece in form of a thermoformable blank. Don’t worry: you will find detailed instructions for each model.
The boil n’ bite method usually works as follows: You warm up the snoring mouthpiece in a hot water bath until the material becomes malleable (“waxy”). Then put the splint in the mouth, bite hard and wait a few seconds until the material hardens. This gives you an impression of your own teeth and guarantees that the mouthpiece fits. Afterwards you rinse the mouthpiece with cold water and it is ready for use. When necessary, the fitting process can be repeated several times.
An extra hint:
Those who feel not confident enough to fit the snoring mouthpiece on their own, may ask their dentist to do the fitting for them. Many dentists are happy to provide this service. It is best to consult with your dentist before buying if he were willing to do the fitting and what costs would be incurred.
The benefits of the boil ‘n bite method are clear: An individually fitted mouthpiece is much more comfortable than a non-fitted model. Compared to a custom-made solution, the boil n’ bite mouthpiece has the great advantage that it can be fitted again, should the dentition or the tooth postion change. At the same time, boil n’ bite mouthpieces are the much cheaper alternative.
The material of thermoformable mouthpieces only has a limited lifespan, though. Depending on the manufacturer, it ranges from 18 to 24 months. The soft synthetics of such mouthpieces wear out more easily than the solid material of mouthpieces which are custom-made by dentists. In addition, a custom-made mouthpiece can match more precisely your tooth profile than a boil n’ bite mouthpiece.
Examples of thermoformable snoring mouthpieces include SnorBan, SomnoGuard 3, SomnoFit and SomnoFit-S. Among the mouth guards (for mouth snoring), somnipax shield is thermoformable, for instance.
Dental Splints / Made-to-Measure Splints
In contrast, individually manufactured splints – sometimes also called “dental splints” – are not fitted by the customer, but are individually designed by the dentist or dental technician based on the user’s dentiture. For that purpose the doctor takes an impression of your teeth and has a dental plaster made from them.
Dental splints are characterized by a very precise fit. Moreover, dental splints can be better adapted to various particularities of the jaw position. This has a positive impact on the effectiveness of the splint and its wearing comfort. Apart from that, the degree of protrusion can be set very precisely with a dental splint.
The disadvantage of a dental splint is its very high price and its lack of flexibility. Once the splint has been made, it cannot be re-fitted afterwards through thermoforming. If the position of your teeth changed, a new splint would be due. In some cases users of dental splints also claim that due to their very precise fit, the splints would adhere too tightly to the teeth. This may affect the wearing comfort.
Pull vs. Pressure – Differences in Function
All mandibular advancement devices follow the same principle: They try to prevent the tongue base from falling back into the throat, thus avoiding vibrations of the slackened tongue tissue. There are two different ways to put the tongue base under slight tension: Either the mandibular advancement device works with traction or it uses pressure.
Mandibular Advancement Using Pull-Effect
The connectiong pieces of a mandibular advancement device which uses the pull effect typically consist of elastic strips or plastic spacers. They keep the the mandible under light ongoing tension but still allow (to a certain extent) for flexibility in the jaw’s motions (lateral movement and “open or close”). Mandibular advancement devices that use the pull-effect typically have a greater wearing comfort due to their flexibility and are generally better accepted by patients than those which work with pressure.
Examples of mandibular advancement devices that work with the pull-effect are Snorflex, SomnoGuard SP or SomnoFit and SomnoFit-S.
Mandibular Advancement Using Pressure
Mandibular advancement devices that work with pressure move the lower jaw forward by using a tight screw- or plug connection. The mandibular advancement is fixed. This means that when using such a mandibular advancement device the wearer can no longer move the lower jaw. The moment the mandible is pushed forward, the tongue’s tissue automatically becomes tense. In addition to bibloc splints that are screwed or plugged together, also monobloc splints are using the pressure effect to move the lower jaw forward.
Snoring mouthpieces and tooth gaps
A snoring mouthpiece builds up artificial tension in the jaw, because the lower jaw is permanently under slight tension. This tension is transmitted to the teeth (i.e., the teeth of the upper jaw and the mandible) and they have to bear it. If you still have all teeth, this generally shouldn’t pose a problem, because the pressure is distributed among all teeth. This is certainly true for snoring mouthpieces which cover the entire dental arch. However, you should avoid mouthpieces that strain the incisors and canines disproportionately (for instance because the mouthpiece arch doesn’t cover the back teeth).
Missing individual teeth do not present a problem when using a snoring mouthpiece. However, if several teeth are missing per dental arch, you should consult your dentist before purchasing a snoring mouthpiece. Only he or she can determine whether your dentition provides sufficient support for a snoring mouthpiece and whether your remaining teeth can withstand the pressure load without any problems.
If there are only four teeth (or less) on each side of a dental arch, then in any case a snoring mouthpiece therapy should be ruled out. The pressure of the snoring mouthpiece is distributed among too few teeth which could negatively affect their stability. However, there is still great help for affected tongue snorers. They could use positional therapy devices that help to avoid sleeping on the back. This stops tongue snoring.
Snoring mouthpieces and prostheses / implants
If you are a wearer of a removable denture or oral prosthesis, you generally cannot use a snoring mouthpiece. In this case, the snoring mouthpiece cannot be anchored to a sufficiently stable base.
As an alternative to snoring mouthipeces, positional therapy might be a great option for you.
Fixed implants or bridges on the other hand don’t necessarily prevent the use of a snoring mouthpiece. Nevertheless, even in this case you should consult your dentist first before you buy a snoring mouthpiece.
Snoring Mouthpieces and Strong Overbite
If you have a strong overbite, the standard advancement of snoring mouthpieces may not be sufficient enough in your case ( = the bands may be too short). One mouthpiece (SomnoFit), however, caters to patients with a strong overbite. Its strips can be reconnected in a way that they fit comfortably even with a strong overbite. Further information and details can be found in the snoring mouthpiece’s product sheet.
Snoring Mouthpieces and Bruxism (Teeth Grinding)
Teeth grinding – also called bruxism – is defined as the process of constantly and unconsciously pressing or grinding the upper and lower jaw together. The dental splint therapy is the most effective method against teeth grinding, since it prevents the tooth surface from rubbing against each other. A snoring mouthpiece can also be quite effective in such a case, as it prevents the teeth from touching each other. The mouthpiece serves as a sort of protective barrier between the upper and lower jaw.
Strong teeth grinders have to be careful, though: It is not uncommon that a snoring mouthpiece can be bitten through over time! Under such exceptional strain, a snoring mouthpiece usually won’t reach its typical life span of 18 to 24 months.
Good Oral Hygiene – Essential!
Once you have chosen a certain snoring mouthpiece, there is one important point to consider when wearing it:
If you wear the mouthpiece every day – which is recommended for a lasting therapeutic success– you should also maintain a good oral hygiene. Small nutrient particles and leftover food that remain in the oral cavity at night, due to inattentive tooth brushing, make for a welcome feast for oral flora bacteria. When they’re also pressed against the teeth by the splint, then caries bacteria find excellent conditions to propagate. This can eventually damage the tooth and lead to tooth decay.
Snoring mouthpieces should be cleaned daily after use and stored cool and dry. For daily cleaning there are cleansing gels, rinses, cleaning brushes and special tabs that can be purchased. For cleaning your snoring mouthpiece, please do not use off-the-shelf tabs for dentures or dental prostheses. They are too aggressive to the snoring mouthpiece’s surface and would drastically reduce the lifespan of the device. The same is true for toothpaste: Its abrasives would harm the mouthpiece’s surface over time.
Cleaning Your Snoring Mouthpiece – A Special Tip!
To clean your anti-snore mouth guard, you can also use an unconventional solution. Dilute an off-the-shelf mouth rinse (such as Listerine) with water at a ratio of 1:3. Now clean the mouthpiece with the help of a tooth brush while it’s in the solution. Immediately afterwards, please rinse the splint thoroughly with clear, cold water and let it dry. Done!