Anti-snoring solutions first entered the marketplace in the early 1990s, which led to their being advertised in the media. Since that time, the anti-snoring niche market became heavily competitive. These days, there are over 100 different devices on the market, all geared toward alleviating the distress of snoring. Before examining the mouthpieces, some history is in order.
History of mouthguards
Snoring mouthguards evolved from the obvious necessity of protecting the mouth from the damage caused by high impact sports. The first mouthpiece was invented in 1890 by a London dentist named Woolf Krause for the express purpose of protecting boxers from lip lacerations.
These early devices were known as “gum shields” and were effective in preventing fighters from splitting their lips. After almost 70 years of no significant change to mouthguards, a Canadian pediatric dentist named Arthur Wood developed the “teeth guard” which was the precursor of the modern day mouthguard. Since then, mouthguards have been developed for just about every major sport, from water polo and weightlifting to field hockey and football.
In more recent times, dentists started to improve on the device that athletes had been long using, and began to build and prescribe them for snoring and sleep apnea. In the early 1990s, anti-snoring products began to appear on the market, which in turn led to them being marketed in the media. Of the multitude of different appliances that exist, they can generally be broken down into two categories.
Two types of mouthpieces
Click to enlarge
Oral devices are the most common solutions. They come in two distinct styles. The Mandibular Advancement Device (MAD) and the Tongue Stabilizing Device (TSD).
The MAD is a jaw retaining mouthpiece, similar to a sports style mouthguard. MAD’s are designed to move the jaw forward, widening the airway while the user sleeps. Once properly fitted, the MAD repositions the lower jaw forward ever so slightly. The result is that the tongue can no longer drop backward, naturally creating a wider passageway in the throat. The MAD is easy to fit, proven safe, and quite effective. Note that this variety cannot be used by denture wearers, and needs to be replaced several times a year.
The TSD takes up much less room in the mouth. Furthermore, although uncommon, some do complain that the jaw holding variety causes facial pain and promotes an under or over bite. With the tongue holding variety, these problems are alleviated.
Note that, although both devices focus on eliminating or reducing snoring, and are not geared toward serious apnea related conditions, they have been shown to be efficient in reducing the number of apnea-hypopnea episodes (IAH), as well as increasing the oxygen saturation level in the blood and reducing microarousals.
Both mouthpieces can be purchased over the counter for $50 to $100. Note that these products can also be prescribed by a dentist, however, without insurance the cost can run upwards of $1500. This does not factor in the necessary doctor visits for checkups and adjustments. While some insurance plans will cover the expense, many do not, despite the proven studies and results.
How MAD’s Work
How MAD Works (Click to enlarge)
The MAD uses leverage to hold the mandible (lower jaw) in a forward sitting position, forcing the collapsible part of the airway to remain open while the user sleeps. Although snoring can be a result of any of a number of causes, including sinus issues, obesity, obstructed nasal passages, an overbite and more, the main issue tends to arise due to a blockage in the airways. Indeed, blocked airways are one of the most common causes of snoring and sleep apnea.
The MAD maintains the mouth position necessary for snoring prevention by creating a tight fit around the teeth and gums on both the upper and lower jaw. For the lower teeth to fit into the snug compartment, the lower jaw position must be brought forward from an entirely relaxed position, widening the back of the throat, and freeing the wearer from snoring.
Air holes are often built in between the upper and lower teeth anchors of the MAD, allowing for resistance-free breathing. For users who breathe through their mouths while they sleep, this is an integral component of the device.
Depending on the product, some report having issues with sensitive gums, sore teeth, general discomfort or difficulty with the unit falling out during sleep. In general, fit and comfort vary widely from product to product.
Note that it can take up to 6 months to acclimate oneself to the appliance, making persistence vital. However, although observance rates vary from one study to another, generally 75% of patients continue to use the device after one year of MAD treatment.
How TSD’s work
The TSD is a non-invasive, ready-to-use mouthpiece that applies suction to the tip of the tongue, preventing it from slipping to the back of the throat while the user sleeps. When falling asleep, the muscles in the body begin to relax, and this includes the tongue. At this point, gravity may pull the tongue backward toward the throat. If this occurs, the soft tissue will begin vibrating as air is forced through the constricted passageway as it heads to the lungs, generating a snoring sound. However, when the tongue is held in place, air can flow freely to the back of the throat and on to the lungs, without encountering any kind of obstruction that produces noise.
It is not uncommon for those who recently purchased a TSD to either not create enough suction or to place too much suction on the tongue. Too little suction prevents the tongue from remaining in place for the duration of wearer’s sleep. Alternatively, too much suction can cause the tongue to become numb due to a lack of blood flow.
Another common occurrence that new users may experience is an increase in drooling during sleep. However, this generally decreases significantly with time.
Note that it is recommended to acclimate the tongue to the device for small periods of time while watching television, cleaning the house, etc. This will allow the user to become accustomed to the sensation of having the appliance attached to the tongue, and allowing for an easier transition when falling asleep.
Do “As seen on TV” mouthguards prevent snoring?
Yes. Scientific studies have demonstrated marked improvements among study participants, indicating that snoring mouthguards are effective.
Snoring is the result of some different causes, and there does not exist a one-size-fits-all remedy. The MAD is specially designed to expand the back of the throat by stretching the muscles in the jaw. The TSD is intended to prevent the tongue from falling to the back of the mouth.
MAD Snoring mouthguards are effective for well over 50% of the snoring population, and most of the “as seen on TV” snoring mouthguards are MAD based. However, the MAD may prove ineffective for users with tongue issues or for sufferers of allergies and blocked sinuses.
This is also true for users who experience nasal polyps, or if intolerant to a device inserted in the mouth. Also, for users without teeth in places where the appliance needs to anchor, it is likely that this device will prove ineffective.
A simple and useful test to determine the effectiveness of an “As Seen on TV” mouthpiece
- Tilt the head back slightly and imitate the sound of snoring.
- While engaged, pivot the lower jaw forward and make sure that the mouth remains mostly closed. Maintain a position that ensures that the back of the throat remains open.
- Continue imitating the sound of snoring.
If the snoring becomes diminished or completely eliminated, a mouthguard may prove very effective. If the sound is reduced but not entirely eliminated, it may still be worth pursuing. However, all potential users should first consult with their doctor. Even without health concerns, where the feeling is that snoring is merely annoying, it may still be indicative of a more serious issue, such as Obstructive Sleep Apnea.
Top reasons why people return their snoring devices
- Improper use; did not follow instructions
- Source of snoring sound not coming from back of throat
- Sinus snoring
- Nasal obstructions such as polyps
- Device intolerance
- Denture wearers
- Users with extremely sensitive gums
- Mouth shape unconducive to device use
- Abnormal airway anatomy
- Abnormal jaw anatomy
- Excessive buildup of flesh or fat around the airway
- Overbite, a size-reduced lower jaw and more
Before purchasing a mouthpiece off of a media advertisement or online, it is important to ensure that money back guarantee is offered. The money back guarantee will prevent a monetary loss in case the device proves ineffective.
As it is against the law and accepted health standards to resell any product that has been inserted into the user’s mouth, there is no reason to worry that the device will be resold once it is returned to the seller.
About prescription devices
Before selecting any kind of mouthpiece, it is critical to verify that the snoring is not a result of sleep apnea. Sleep apnea is a potentially dangerous sleep disorder in which breathing repeatedly stops and starts. Those who snore loudly and who feel tired even after a full night’s rest, may be experiencing sleep apnea.
For those with sleep apnea, a dentist or doctor may recommend a specially fitted appliance. In certain extreme cases of sleep apnea, a CPAP machine may be prescribed. This machine is used to pressurize air down the wearers airway via a facemask. Once sleep apnea has been ruled out, it is safe to move forward with the purchase of a mouthpiece.
Prescription devices may also be required in cases where dental issues are preventing the successful use of a MAD. Here, a dentist will utilize a dental impression kit. With these products, one receives a mouth tray and some clay from the manufacturer. After biting into the clay, it is sent to the laboratory where the device is custom made to fit the user’s mouth.