Tongue retaining device vs jaw mouthpiece: which suits you?

What’s going on

Snoring often starts when the tongue and soft tissue sag back during sleep and narrow the airway. Both devices try to bring the base of the tongue forward. They just grab different things.

• A jaw-advancing mouthpiece fits over your upper and lower teeth and holds your lower jaw slightly forward. Your tongue is attached to the jaw, so it comes forward too.
• A tongue-retaining device (also called a tongue-stabilizing device) doesn’t touch your teeth much. Cleveland Clinic describes a suction bulb that holds your tongue forward, with the tip of the device outside your lips.

Store-bought versions of both are FDA-cleared only to reduce snoring in adults 18 and older. None is cleared for sleep apnea.

How they compare

Evidence

A jaw-advancing mouthpiece Strong has the stronger evidence. The AASM and AADSM guideline recommends oral appliances over no treatment for snoring without sleep apnea.

For tongue-retaining devices Weak, that guideline found too little evidence to assess them for sleep apnea. Research on them is small.

• Head to head: a 2009 trial had 27 people with sleep apnea try both types, under clinic care. Both lowered breathing pauses by a similar amount on a sleep study. People reported more snoring improvement with the jaw device.
• Store-bought tongue device: a small 2008 crossover trial compared a suction tongue device with the same device without suction. Only the suction version cut the snoring index. The authors called for larger studies.

These studies were done in people with diagnosed sleep apnea, under medical care. They don’t mean either device should be used for untested apnea.

Comfort and sticking with it

This is where the two split most. In the 2009 trial, 91% of people preferred the jaw device. With the tongue device, 86% took it out in their sleep without meaning to, against 9% with the jaw device.

The side effects differed too:

• Jaw device: jaw discomfort (59%) and dry mouth (50%). The authors describe these as mostly mild and short-lived.
• Tongue device: extra saliva (86%), dry mouth (59%) and sore soft tissue (50%). Some also found swallowing harder.

About two in three stopped using the tongue device within three weeks. A device only helps on the nights you can keep it in.

Your nose

With a tongue device in place, you need to breathe through your nose. In a long-term French study, a blocked nose predicted that people would stop using their tongue device. The authors treated nasal blockage as a reason not to use one.

A jaw mouthpiece can also make mouth breathing harder. FDA guidance lists that as a warning for these devices. Either way, a clear nose matters; see nasal strips vs nasal dilators.

Which one suits you

A jaw mouthpiece, if

• You have healthy natural teeth, with no loose teeth or gum disease.
• Your jaw joint doesn’t hurt, click or lock.
• You don’t wear dentures or braces.

Start at the smallest setting and move forward slowly. See how to adjust a snoring mouthpiece.

A tongue-retaining device, if

• Your teeth can’t hold a mouthpiece. Cleveland Clinic gives teeth that aren’t strong enough as an example. The Good Morning Snore Solution’s maker points to dentures and few teeth.
• You have jaw joint trouble and a dentist agrees a jaw device isn’t right for you.
• You breathe easily through your nose all night.

Expect an adjustment period with drooling and sore soft tissue. Give it a couple of weeks, and stop if your tongue or gums stay sore.

Neither, if

• You’re under 18.
• You might have sleep apnea: loud snoring with gasping, pauses in breathing, or daytime sleepiness.
• You’ve had recent implants or major dental work.

What not to do

• Don’t use either to manage suspected sleep apnea on your own. Store-bought versions are cleared for snoring only. Loud snoring with gasping or pauses in breathing needs a physician first.
• Don’t wear a tongue device with a stuffy nose. If a cold or allergies block your nose, leave it out that night.
• Don’t force a jaw mouthpiece onto weak teeth. The FDA lists loose teeth and advanced gum disease as reasons not to use one.
• Don’t push a jaw mouthpiece further to make up for poor results. Move forward in small steps, and stop if your jaw or bite stays sore.
• Don’t judge either one after a single night. Both take time to get used to. Give it about two weeks unless something hurts.

What a dentist or doctor can do

A physician decides whether you need a sleep test. If you do have sleep apnea, the guideline suggests a custom, adjustable appliance from a qualified dentist over store-bought devices.

A dentist trained in dental sleep medicine can also tell you whether your teeth and gums can take a jaw mouthpiece. If you wear dentures, ask your dentist about options that work with them. The dentures and snoring page covers more.

For all store-bought options side by side, see anti-snoring mouthpieces compared.