BPA Latex FreeAnother important criterion while selecting an oral appliance is finding out the material of construction. Remember, this device will be in your mouth every night for the next several months. Therefore, understanding the comfort, safety and durability of the material are important considerations.
Most oral appliances are made out of dental plastic material. Some devices, such as aveoTSD, are made from medical grade silicone. One might look to see how hard the material feels—a softer, flexible material will place less pressure on the dental structures and prevent soreness, as compared with a rigid material. Moreover, it is essential to check to see that these devices are free of bisphenol A (BPA) and latex. A clear indication should be provided by the manufacturer regarding BPA and latex content.
Moreover, I prefer to check the manufacturer’s label for other statements regarding discoloration and hygienic features of devices. These devices should be non-permeable to oral fluids, thereby preventing microbial growth over continued use.
Custom-made vs. Non-customized MAD
As pointed out earlier, MADs can be either custom-made or store-bought. The custom-made devices, such as Thornton Adjustable Positioner (TAP 3), are usually obtained through consultation with a dentist. The dentist will take one’s dental impression, and send it to the manufacturer for a fitted mouthpiece. A custom-made device may provide better mouthpiece retention over non-custom devices. However, be advised that customized MADs are expensive options that can go into $1000-$2000 price range. In addition, one has to take into account the cost of dentist visitations. Any adjustments that have to be done after delivery of the device will be charged extra. If a customized MAD is considered, one must first find out how much insurance coverage can be expected. A custom-fitted MAD has a life-expectancy of a few years. It will provide features to adjust the jaw position, for example, in increments of millimeters.
You will be relieved to learn that there are several brands of non-custom MADs that offer comparable effectiveness as the custom devices. The store-bought mouthpieces generally come in moldable designs with adjustability features. Most non-custom MADs are made up of thermoplastic material and offer boil-and-bite customization. A user can place the MAD in boiling water for a few minutes, slightly cool it off, and then bite down on it for a customized fit. The device is then placed in cold water, which helps retain the bite shape. Unlike the older models of MADs, the recent designs have significantly eliminated the soreness and side effects experienced with use. Moreover, given the effectiveness of MADs as demonstrated through clinical studies, a store-bought variety is a reliable and economical option for primary snoring cases.
Breathing HoleAn important consideration is the availability of breathing holes with MADs, which support mouth breathing during sleep. For those of you who are mouth breathers, a safe option is to obtain a MAD with breathing holes or hinged jaws for movement (such as, ZQuiet). Not only is this relevant for chronic mouth breathers, people who have blocked nasal passages from allergies, cold, etc. will be safe and comfortable using a device that allows mouth breathing. The small size of these holes allows enough air passage for breathing, but may produce a whistling sound.
Some examples of mouthpieces with breathing holes are Ripsnore, SleepPro Standard and Snore Eliminator. As mentioned earlier, ZQuiet is a MAD with a hinged jaw that allows for normal jaw movement during sleep. Therefore, ZQuiet supports mouth breathing without the necessity for breathing holes.
MADs that do not feature breathing holes, encourage the healthy way of breathing, that is, through one’s nose. These may be ideal for people who usually sleep with their mouths closed.
FDA ApprovedOral anti-snoring appliances are recognized as medical devices that require FDA clearance before they can be legally marketed within the US. If you reside in another country, please check to confirm if the oral appliance has been cleared by your residing health authority. Some devices, such as Good Morning Snore Solution, have been cleared by several international health authorities, including FDA, Health Canada, EEC, and TGA Australia. FDA approval indicates that the medical device has undergone thorough testing to ensure its safety and efficacy. As with any other medical device, strict adherence to the manufacturer’s instructions is essential for the continued smooth performance of the device.
Clinically ProvenBefore purchasing a device over the internet or in the store, you may like to know whether it can really do the job. A good way to find out is to look for clinical studies that have tested the device for efficacy. A lot of clinical studies have already been conducted to compare different models of oral mouthpieces for snoring and even sleep apnea remedy. Mandibular advancement devices (MAD) have been proven to be efficacious for primary snoring and mild-to-moderate obstructive sleep apnea. Tongue stabilizing devices (TSD) are demonstrated to be efficacious for snoring with or without apnea, and may be considered as a second-line option for individuals who have a hard time adjusting to Continuous Positive Airway Pressure (CPAP) therapy.
Check the manufacturer’s information to see what types of clinical studies have been done on the particular oral device you are interested in. It will help you make the right choice with confidence.
Convenience is a foremost concern while choosing the right anti-snoring aid. A product may be effective in controlling snoring, but if it is too uncomfortable to sleep in, people tend to discontinue the use. Two factors that may greatly affect comfort of use are the material and design of the device. Oral appliances that are made from soft flexible plastic material will produce a more positive mouth feel. In addition, one may find the simpler designs more appealing, as compared with some of the bulkier devices. The simpler designs are comfortable to wear to sleep and offer easy cleaning for regular use.
ConvinienceOne should carefully consider the adjustable features that anti-snoring devices provide. For example, for MADs the ability to reposition the jaw forward or backward through adjustment of screws can yield comfort to the user. It has been my personal experience that when it comes to convenience a small adjustment can often create a big difference.
Some of the MADs I have tested out were the boil-and-bite technology, and I could contour the thermoplastic material to my unique dental shape. However, I have encountered situations where I required two attempts at boil-and-bite to get the shape just right. Again, this was a workable solution because most devices can support a few (sometimes as much as 5) remolding attempts.
Another factor that greatly influences customer satisfaction is the absence of significant side effects from wearing oral appliances. For examples, the earlier models of MADs caused jaw soreness, facial pain, increased salivation and overbite with prolonged use. However, the sleeker designs and flexible materials have led to reduced side effects in MADs.