Recently we evaluated the SnoreRx device which is an over-the-counter oral appliance for the treatment of snoring.
Snoring is the sound caused by a narrowed nasal and/or oral airway during sleep. Potential airway narrowing may occur in the nose and includes a deviated septum, enlarged soft tissue (turbinates), polyps, and/or sinus congestion.
Narrowing in the oral airway may come from one or both places and include: 1) the back of the throat including a narrowed pharynx, an elongated soft palate, enlarged tonsils, and enlarged uvula and/or 2) the tongue falling into the airway from a small lower jaw, a bad bite, an enlarged tongue, or a crowded and smallmouth.
As the air has to pass through a smaller, more narrow space, it rushes at a faster rate and vibrates the tissues, resulting in the familiar and often annoying snoring sound.
SnoreRx works best for snoring caused by tongue blockages by moving the lower jaw slightly forward to maintain an open airway during sleep. In my opinion, the SnoreRx closely resembles a custom-made oral appliance due to several features:
The process to fit the SnoreRx was easy to follow with the clear and concise directions. To mold the appliance to the teeth, there is a handle included to avoid burns when placing the device in the boiling water.
When placing the device in the mouth, the patient should bite down as hard as possible and suction the air and water to mold the material to the teeth. If needed, this step may be repeated in case of poor retention or not seating the tray all the way.
The handle is easily removed and the device may then be calibrated to move the lower jaw forward. It is best to start with a small and comfortable increase of 1mm to avoid jaw pain. After 3-5 nights at each setting, the device can be adjusted as often as needed, up to 6mm of movement until the snoring is reduced.
The SnoreRx website has good education, explanations, and support. The patients I utilized for this device reported ease of preparing the appliance for use, comfort while wearing, and decreased snoring. Potential side effects include tooth or gum soreness, excessive salivation or dry mouth, tooth movement or changes in bite, and temporomandibular (jaw joint) issues. If you experience jaw pain, headaches, facial pain, jaw noises, or jaw locking, use of the device should be discontinued. If the symptoms do not resolve, we recommend you see a dentist trained in TMJ Dysfunction.
When comparing this device to a custom-made oral appliance, the overall size is bulkier due to the outer shell being approximately 2mm thick then containing the inner moldable copolymer. This may lead to the lips remaining open during sleep and mouth breathing or dry mouth.
The dental literature suggests that the soft mouthguard material, such as the inner lining of the SnoreRx, may induce tooth clenching. If you find that you are waking with clenched teeth, facial pain, or headaches along the temples, you should discontinue use and seek an examination by your dentist if the symptoms persist.
Overall, the SnoreRx is an ideal appliance to use for snoring, as a stepping stone prior to trying a more long-term custom-made oral device, or as a temporary device while awaiting a more definitive treatment method.
To raise awareness of potentially serious health implications, readers should be aware that snoring is a sign of sleep apnea, which is a complete cessation of breathing for ten seconds or more. Sleep apnea is often undiagnosed and untreated. It is a serious health condition associated with:
If you or your loved one wakes gasping or has been told of stopped breathing during sleep, or has been diagnosed with sleep apnea via an overnight sleep study, treatment should be sought by a sleep physician or a dentist trained in sleep-disordered breathing rather than using an over-the-counter snoring device.
Treatment methods include a CPAP (Continuous positive air pressure) machine, surgery, weight loss, oropharyngeal exercises, and custom-made oral appliances.
SnoreRx is fabulous BUT don't forget that we've also done a list of the best mouthpieces to stop snoring.
What is bruxism? Bruxism is a condition where one grinds, gnashes, or clenches their teeth. This may be done during waking hours presented as clenching and during sleep by unconsciously clenching or grinding the teeth.
Bruxism may be caused by stress and anxiety, however, it can also be caused by a sleep disorder, such as sleep apnea, when occurring during sleep. Persons with an abnormal bite, missing, or crooked teeth may be at risk for bruxism due to the facial discrepancies also causing a small airway. Tooth clenching is also a normal reaction to pain in the body.
Some people may be unaware of grinding their teeth, especially during sleep. However, others may wake with a dull, constant headache, sore teeth, and/or sore jaw which are common signs of bruxism. Also, people may be told they have bruxism by their bed partner who hears the grinding at night.
In some cases, chronic teeth grinding can result in fracturing, loosening, or loss of teeth requiring dental restorations such as root canals, crowns, bridges, implants, partial or complete dentures. Not only can bruxism damage teeth, but it can also affect the jaw joints that attach the lower jaw to the head, know as TMJ (Temporomandibular joint). Symptoms of TMJ Dysfunction may include: headaches, face and/or jaw pain, jaw joint noises such as clicking, popping, grating, jaw locking, limited mouth opening, neck pain, ear pain, and pressure, dizziness, vertigo, and hearing changes, to name a few.
If you suspect you may be grinding your teeth, it is recommended to have some type of mouth guard or oral appliance to protect the teeth. You may talk to your dentist about a custom-made device or try an over-the-counter mouthguard.
If while wearing any mouthguard, whether over the counter or custom made, symptoms become worse such as increased or new pains, there are some mechanisms that may occur and cautions to be aware of. For instance, the mouthguard may change where the lower jaw normal lines up and has the potential to lead to jaw popping or clicking, jaw pain, or bite changes. If this occurs, use of the mouthguard should be discontinued.
If the tooth grinding is related to sleep breathing such as sleep apnea, there is a chance that a single arch mouth guard could make the symptoms worse. If you find that you grind your teeth more with the appliance or feel like you are choking during the night, it could be causing the lower jaw and/ or tongue to move back toward the throat and make the airway more crowded. Use of the mouthguard should be discontinued and you should seek an opinion with a sleep physician or dentist trained in sleep breathing disorders.
There are several options for over-the-counter mouthguards for tooth grinding and clenching and we evaluated the reasonably priced Bruxor® Dental Guard, available online. Bruxor® Dental Guard is intended to protect teeth and reduce the damage caused by bruxing, or nighttime teeth grinding, and to prevent the noise associated with bruxing and grinding.
One product description found on Amazon for Bruxor® Dental Guard is as follows: “Bruxor acts as a protective layer between your top and bottom teeth by absorbing the tension caused by night time grinding and clenching. This dispersion of force wears down your night guard rather than your enamel. It's slim and lightweight is comfortable to wear and allows you talk and breathe through your mouth.”
The FDA approved device is nicely packaged and comes with instructions, two mouthguards, a fitting tray, and a protective case. The easy to follow and pictorial instructions for the Bruxor® Dental Guard recommend molding to the upper teeth. However, due to the size of the mouthguard, it may have to be fitted to the lower teeth for some patients with wide upper arches.
It was noted that during the molding process there is some excess boil and bite material which squeezes out over the appliance and could irritate the lips, cheeks, or tongue. Although the instructions do not state, the material is soft enough that it may be trimmed with a sterilized cuticle or other small sharp scissors if rubbing occurs on the mouth tissues.
The design of the appliance is lightweight, which helps with retention and staying in all night to protect the teeth. The guard is also BPA and latex free for sensitive and allergic people.
Wearing a mouthguard for bruxism may not completely eradicate symptoms however it is great at protecting the teeth. In addition to a dental guard, people who are stressed should seek counseling or try to make positive changes to relieve the stress. For patients who clench from chronic pain, they should try to address the root causes and be sure to exercise and eat right.
Overall, the Bruxor mouthguard is a great product for the price, has easy to follow instructions, and is lightweight and comfortable. With any mouthguard, if symptoms do not improve or worsen, use should be discontinued.
If you or someone you know suffers from snoring or sleep apnea, treatment will improve overall health. It is well known that certain medical conditions such as high blood pressure, heart disease, depression, anxiety, headache, Type 2 diabetes, weight gain, adult asthma, and acid reflux are associated with sleep apnea. Non-medical associations include the risk of increased car accidents and relationship issues.
Treatment options include a Positive Air Pressure (PAP) machine, oral appliances, nasal or throat surgery, tongue reduction surgery, and weight loss. This article will focus on CPAP and Oral Appliance therapy.
A CPAP machine is a Continuous Positive Airway Pressure machine and is the most commonly used treatment for Obstructive Sleep Apnea (OSA), but many people are unclear about what exactly this machine does. A CPAP machine provides patients with a constant flow of pressurized air at a setting specific to the needs of the patient to splint the airway open to eliminate collapsing tissues that cause sleep apnea.
A CPAP machine is composed of three main parts: the motor, the hose, and the mask. The motor is a small compressor that draws in air and pressurizes it to deliver the correct air pressure to the obstruction in the airway. A motor means the machine must be very loud, right? In reality, the CPAP motors are very quiet, and often people find the soft noise to be soothing while falling asleep. The next part of the CPAP, the hose, is the transport apparatus that delivers the newly pressurized air from the motor to the mask. Once the air reaches the mask, the patient can breathe it in and through the obstructed airway. Masks come in a variety of shapes and sizes to ensure comfort since every person’s face is designed a little differently. While CPAP machines are the most common treatment for sleep apnea, many patients find they cannot tolerate the machine. Often patients complain of dry mouth, nasal irritation, acne breakouts, and allergy-like symptoms.
Each person is unique and may experience different effects of treatment. There are two main types of people with sleep apnea: overweight persons who generally do well with a CPAP machine and are encouraged to lose weight, and normal body weight persons with facial deficiencies such as an overbite, crowded or missing teeth, or a lower jaw set back. The latter may be candidates for other types of treatments, including oral appliances.
A custom-made oral appliance helps to position the lower jaw forward, increasing the size of the upper airway during sleep, and in turn reducing air resistance. Boil and bite molded products such as SnoreRx and Zyppah also position the lower jaw forward. Reducing this resistance helps prevent snoring and treat sleep apnea. These appliances fit like an athletic mouth guard or an orthodontic retainer. Many people find that oral appliances have numerous advantages, including being comfortable, portable, easy to wear and care for, and quiet.
So, how does a patient know if a custom-made oral appliance will work for him or her? According to the American Academy of Sleep Medicine, oral appliance therapy should be the first line of treatment for snoring and mild to moderate OSA. There are more than 100 oral appliances approved by the FDA, so a dentist’s expertise is needed to obtain the correct appliance for a patient’s given conditions. The process to obtain an appliance can be simple, involving only a few visits to the dentist. It is recommended to seek a dentist with additional training in oral appliances.
At the first visit with the dentist, a clinical evaluation will be given, including an oral exam and often x-rays. If an oral appliance seems to be the best course of treatment, physical or digital impressions will be taken to create models of the patient’s teeth. These models will be utilized in a dental lab to create the custom-made appliance. After the appliance is built, the dentist will then fit and adjust the appliance with the patient to ensure comfort and efficiency. Follow-up visits to the dentist are required throughout the treatment process to ensure the continued effectiveness of the appliance. A sleep study with the oral appliance is also recommended to check the appliance efficacy.
Many people that undergo oral appliance therapy find that their symptoms and overall quality of life improve. Often people sleep better throughout the night and have more energy and attentiveness during the day. Some side effects are common and include tooth discomfort, jaw and muscle discomfort, tooth movement, and bite changes. However, most patients find these negative side effects minor compared to the positive changes they experience.
Since snoring can be a nuisance and a sign of potential sleep apnea, and sleep apnea can be life-threatening, speak first to your physician or dentist about treatment options to improve your health, and possibly your bed partner’s health as well!