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Mouth Guards for Sleep Apnea: Pros & Cons

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A sleep apnea mouth guard is an alternative to sleep study prescribed continuous positive airway pressure (CPAP) therapy that many find uncomfortable for daily use.

The challenge is identifying the right mouth guard with a proper fit for treating sleep apnea symptoms. Some mouth guards can improve sleep and reduce snoring caused by obstructive sleep apnea (OSA).

Do mouth guards work for sleep apnea?

Mouth guards can work for upper airway sleep apnea symptoms if the type is OSA, the most common type of sleep disorder.

Central sleep apnea (CSA) is more complicated. The rare condition is caused by failed signaling from the brain. Often, underlying medical conditions are also at play with CSA.

How much does a sleep apnea mouth guard cost? A simple sleep apnea mouth guard can cost under $100, but it won’t do much for your sleep apnea. Customized solutions may cost in the thousands but are more effective in treating symptoms.

Your insurance may cover some, none, or all of a dental solution to your sleep apnea. Your dentist’s office will contact your insurance provider on your behalf and address coverage options with you.

There are several types of anti-snoring mouth guards out there. Some of these treatment options are more effective than others when it comes to sleep apnea, and some aren’t suitable for sleep apnea at all.

Note: If your sleep apnea is caused by a condition like tongue-tie or other underlying conditions, your physician, sleep specialist, or dentist’s office will develop a treatment plan to address those issues first.

  • Over-the-counter mouth guards: These simple mouth guards are more suitable for treating bruxism, or teeth clenching, and teeth grinding. A sports mouthguard is for specialized sports use and is meant to protect your teeth and soft tissues in your mouth.
  • Oral splint: An oral or occlusal splint works by protecting the mouth from bad habits while you sleep, including teeth grinding. It is not an effective treatment for sleep apnea.
  • Mandibular advancement device (MAD): MADs work by temporarily moving the lower jaw forward to improve airway space. The concern is that a MAD fails to address the underlying causes of sleep apnea and is not a permanent solution.
  • Tongue-retaining device (TRD): A TRD works by holding your tongue forward to prevent snoring and sleep apnea symptoms caused by a large tongue. While it’s easier for some to tolerate than a CPAP machine, it also does not address the root causes of sleep apnea.

A daytime-nighttime appliance, or DNA appliance, is often lumped into the same category as mouth guards, but it goes beyond most devices to address the underlying cause of OSA.

This FDA-approved dental appliance is a non-surgical way to widen your dental arches gradually. It works by giving your tongue room in your mouth, a common reason why your airflow is blocked as you sleep.

Mouthpiece Benefits

The benefits of a mouth guard may vary depending on the type of device you choose for regular use. An approach for treating severe sleep apnea may look different than addressing mouth breathing.

Generally, the benefits are more significant with a customized solution. That may mean an impression of your teeth and periodic checkups by your dentist to maintain a good fit.

Let’s explore some of the benefits of custom mouth guards.

  • They are a CPAP alternative. CPAP machines are very effective in addressing OSA symptoms, but they can be noisy and uncomfortable for both the wearer and their sleep partner. This may reduce regular use over time and make them less effective.
  • They are removable. Mouth guards are not meant for permanent use. If you need a daytime appliance, you will still be able to remove that device when you eat and clean your teeth. Most are dedicated to nighttime use.
  • They can straighten your teeth. Some mouth guards work similarly as a retainer. Custom-fit mouth guards from your dentist’s office may help improve your smile and straighten crooked teeth over time.
  • They may relieve temporomandibular joint (TMJ) disorder symptoms. Mouth guards can act as a cushion for TMJ-related clenching and relieve some of the related jaw pressure. TMJ disorder sufferers with more mild symptoms may start with a soft mouth guard.
  • They protect against teeth grinding. Mouth guards are often the first response for teeth grinding. While they won’t prevent you from the action itself, your teeth will get some protection from the additional buffer.

Problems

Most mouth guards are not considered a permanent solution to sleep apnea. They are temporary measures that often treat bruxism rather than sleep apnea.

Mouth guards can also come with some problems, especially if you’re not under the care of a dentist and purchase over-the-counter solutions.

  • Discomfort and jaw pain: A poor fit or new device can lead to jaw soreness and discomfort, making it less likely you will wear that mouth guard regularly.
  • Gum irritation: A loose fit can also irritate your gums. This side effect is more common with hard mouth guards that are less flexible inside your mouth. Irritation can put you at risk of infection.
  • Dry mouth: An ill-fitting mouth guard can cause more mouth breathing throughout the night and result in dry mouth and cracked lips.
  • Excessive salivation: On the other end of the spectrum, a mouth guard can engage your saliva glands in such a way that you begin producing excess saliva. This can lead to drooling overnight.
  • Tooth movement: An improved smile can be a positive with some mouth guards. If you’re not sure of the cause of your sleep apnea, though, changing your tooth structure may not improve your symptoms.

In fact, it may make things worse.

Can mouth guards worsen sleep apnea? An ill-fitting mouth guard can worsen sleep apnea if it ends up obstructing your airway rather than improving it. 

That’s why it’s so important to see your dentist for any dental devices. They can ensure a custom fit and provide follow-up care to adjust your oral device as needed or recommend a more suitable device for you.

Mouth Guards vs CPAP vs DNA Appliance

Most mouth guards and sleep apnea treatments like a CPAP machine treat the symptoms of sleep apnea rather than the underlying causes of the condition. It’s understandable why.

Sleep apnea can cause everything from daytime sleepiness to hypoxemia, where oxygen levels in the blood are severely reduced. It can increase your risk of high blood pressure and heart disease over time.

It can make sleep anxiety-producing, reducing quality sleep over time even further.

A DNA appliance is a permanent solution for many OSA sufferers by addressing one of the leading causes of sleep apnea — giving more room for your tongue to occupy your mouth — it’s doing more than treating your symptoms. This oral appliance therapy is a permanent solution.

If you’re ready to cure your sleep apnea, book an appointment today at our Manhattan or East Hampton offices. Our teams specialize in a whole-body approach to not only dentistry but your overall health.

Sources

  1. Otsugu, M., Suehiro, Y., Hanaoka, I., Okawa, R., & Nakano, K. (2021). Oral management with mouth guards during the mixed dentition period: A case report. Dental traumatology : official publication of International Association for Dental Traumatology, 37(3), 531–536. Abstract: https://pubmed.ncbi.nlm.nih.gov/33369093/
  2. Lazard, D. S., Blumen, M., Lévy, P., Chauvin, P., Fragny, D., Buchet, I., & Chabolle, F. (2009). The tongue-retaining device: efficacy and side effects in obstructive sleep apnea syndrome. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 5(5), 431–438. Abstract: https://pubmed.ncbi.nlm.nih.gov/19961027/
  3. Sutherland, K., Vanderveken, O. M., Tsuda, H., Marklund, M., Gagnadoux, F., Kushida, C. A., & Cistulli, P. A. (2014). Oral appliance treatment for obstructive sleep apnea: an update. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 10(2), 215–227. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899326/
  4. De Meyer, M., Vanderveken, O. M., De Weerdt, S., Marks, L., Cárcamo, B. A., Chavez, A. M., Matamoros, F. A., & Jacquet, W. (2021). Use of mandibular advancement devices for the treatment of primary snoring with or without obstructive sleep apnea (OSA): A systematic review. Sleep medicine reviews, 56, 101407. Abstract: https://pubmed.ncbi.nlm.nih.gov/33326914/

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