Snoring mouthpiece jaw pain: causes, fixes and when to stop

What’s going on

A jaw-advancing mouthpiece holds your lower jaw forward for hours each night. The chewing muscles and the jaw joints in front of your ears take that strain. FDA guidance lists pain or soreness in the jaw joint among the side effects makers must warn about.

Some soreness is common early on. In a 2009 trial, 59% of people using a jaw device reported jaw discomfort. It was mostly mild and faded within about 30 minutes of taking the device out.

An expert panel of dental sleep specialists splits jaw pain into two kinds:

• Passing morning pain: discomfort when you take the mouthpiece out, gone during the day on its own or with exercises.
• Persistent pain: pain that lasts or worsens through the day, lasts more than a few weeks, or gets in the way of daily life.

The first is usually something you can manage. The second means stop and see a dentist.

Common causes

• Too far forward. The panel notes side effects can rise from about half your maximum forward reach. Sore chewing muscles were more common at 50% and 75% of that reach than at 25%.
• Too fast. Jaw muscle soreness is more common while you’re still adjusting forward.
• Uneven sides. On mouthpieces with a separate adjuster on each side, uneven settings can pull your jaw off center.
• A poor fit. A mouthpiece that rocks or sits off center makes your jaw work to hold it.
• Clenching or grinding. Grinding can cause jaw and tooth pain by itself. Toothache.com explains jaw and tooth pain from grinding.
• Jaw trouble you already had. Mouthpiece labels list jaw joint problems as a reason not to use one.

What helps

Most of these steps come from the expert panel’s first-line advice for jaw pain. That advice was written for dentist-fitted appliances. The same ideas apply at home, but a dentist should see anything that doesn’t settle.

1. Back off one step. Go back to the last setting that didn’t hurt. You can move forward again later, more slowly.
2. Slow down. Wait longer between steps, and give each setting a week or more.
3. Center it. If your mouthpiece adjusts on each side, set both sides the same.
4. Wait a little. Mild morning soreness often eases over the first few weeks as your jaw gets used to the position.
5. Use simple comfort measures. NIDCR’s first steps for jaw muscle and joint pain include soft foods, heat or cold, and over-the-counter pain relievers. It also suggests cutting down on clenching and gum chewing.
6. Take a short break. If the pain is bad enough to disturb your sleep, stop for a few nights. When you restart, go back a step.

Morning jaw exercises

The panel describes two kinds of exercise. One is moving your jaw against gentle resistance, such as your hand, up and down and side to side. The other is gently stretching your jaw’s range of movement with your fingers.

There’s some trial evidence behind this. In a small trial of 29 people with jaw joint problems using a mouthpiece for sleep apnea, jaw exercises reduced pain. Those people also wore their mouthpiece more than the comparison group.

Ask a dentist to show you how to do them. Stop any exercise that makes the pain sharper.

Morning bite guides

A morning occlusal guide is a small device you bite into after taking the mouthpiece out. It helps guide your jaw back to its usual position. The panel lists it as a first-line option for sore jaw muscles and for bite changes.

It’s made by a dentist, chairside or by a lab. Store-bought mouthpieces don’t come with one.

Who shouldn’t use a store-bought mouthpiece

Skip one if you’re under 18, might have sleep apnea, or have loose teeth, gum disease, dentures, braces or aligners. The same goes for jaw joint problems, and for recent implants, crowns or other major dental work. The full list, and why, is in who shouldn’t use an over-the-counter mouthpiece.

When to stop and see a dentist

Take the mouthpiece out and see a dentist if you notice:

• Your jaw locks, catches, or won’t open or close fully.
• Clicking, popping or grating in the jaw joint that hurts.
• Pain that lasts through the day, or for more than a few weeks.
• Pain that spreads to your face or neck.
• Your bite still feels changed hours after you take the mouthpiece out.
• A tooth that hurts to bite on or feels loose.

NIDCR lists locking, limited movement, painful clicking and a change in how the teeth fit together as possible signs of a jaw joint disorder.

What a dentist or doctor can do

A dentist can examine your jaw muscles and joints and check how your bite has changed. They can tell you whether to keep going, and whether a different design would suit you better.

A 2019 review found that people who already had jaw joint trouble generally didn’t get worse with a jaw device for sleep apnea. Those studies were of people treated for sleep apnea. Store-bought labels still list jaw problems as a reason to skip one, so see a dentist before you try.

If your jaw can’t take a mouthpiece, a tongue-retaining device Weak holds the tongue forward without moving the jaw. Its evidence is weaker, and it needs a clear nose. See jaw mouthpiece vs tongue-retaining device.

If you’re still snoring or tired in the day, see a physician about a sleep test. The teeth grinding and snoring page covers how grinding and snoring connect.