Who shouldn't use a snoring mouthpiece (and what to do instead)

What’s going on

A jaw-advancing mouthpiece holds your lower jaw a little forward while you sleep. As a group, these devices Strong can reduce snoring in many adults. Evidence for store-bought ones on their own is thinner. But it only works if your teeth, gums and jaw can take the pull, night after night.

Over-the-counter mouthpieces are FDA-cleared to reduce snoring in adults 18 and older. None is cleared for sleep apnea. FDA guidance lists who shouldn’t use one.

The ZQuiet Advance FDA file compares two cleared labels in detail. We call those “cleared labels” below.

The FDA warnings list tooth movement, bite changes, sore teeth or gums, jaw joint pain, blocked mouth breathing, and extra saliva. The people below are the ones most likely to run into those problems, or to be treating the wrong thing.

Who should skip an over-the-counter mouthpiece

Anyone under 18

FDA guidance lists being under 18 as a contraindication, and every cleared mouthpiece file we read is labeled for adults only. A child’s jaw and teeth are still growing. A child who snores needs a visit to the pediatrician, not a product.

See why children snore.

Anyone who might have sleep apnea

FDA guidance lists central sleep apnea and severe breathing disorders as contraindications. One cleared label also names chronic asthma, emphysema and COPD. A mouthpiece can quiet the snoring while breathing pauses go on, so you lose the warning sign.

If someone has seen you stop breathing, you wake up gasping, or you’re sleepy all day, get checked first. Start with the should I get tested? checklist.

Loose teeth or gum disease

Loose teeth and advanced gum disease are on the FDA contraindication list. Cleared labels add sore or bleeding gums, abscesses, and damaged or weakened teeth. A mouthpiece grips your teeth to move your jaw, so weak support can make things worse.

Missing teeth or dentures

A jaw-advancing mouthpiece needs enough teeth to hold on to. In a study of 100 people with sleep apnea, 34% had a reason not to use one, almost always too few teeth. Cleared labels list missing front or back teeth, dentures, and sleeping in another dental appliance.

Braces or aligners

Cleared labels list braces and other orthodontic treatment. A mouthpiece pushes on your teeth in a different direction than your treatment plan. Ask your orthodontist before you add anything.

Crowns, bridges, implants or recent dental work

Cleared labels list loose fillings or caps and a dental implant within the last three months. A mouthpiece pulls on whatever it grips, including crowns and bridges. If you have that kind of work, or had any recently, ask your dentist before you try one.

Jaw joint problems

FDA guidance warns of jaw joint pain. Cleared labels exclude a history of jaw pain or TMD, a jaw joint disorder. One lists clicking, popping or locking, and jaw pain when you chew or yawn.

In the 100-person study, an active jaw joint disorder was one of four standard reasons to rule a mouthpiece out.

A strong gag reflex

Gagging isn’t on the FDA list, but it’s a known side effect of oral appliances. An expert panel of dental sleep specialists says the first fix is thinning or trimming the appliance. Store-bought mouthpieces can’t be trimmed that way, so a bulky one may be hard to keep in.

A blocked nose, for some designs

Tongue-retaining devices hold the tongue forward instead of moving the jaw. In a study of 84 people using one, a blocked nose predicted who stopped wearing it, and the authors called it a contraindication. If your nose is often blocked, that design may not suit you.

See nasal strips vs nasal dilators.

What helps instead

If a mouthpiece is off the table, cheaper steps still help some people:

• Sleeping on your side Some, if your snoring is worse on your back.
• Less alcohol Some, especially in the hours before bed.
• Weight loss Strong, if you carry extra weight.
• Mouth and throat exercises Some, done regularly.

For more options, see how to stop snoring.

What a dentist or doctor can do

A physician can look for sleep apnea and order a sleep test. If you have apnea, a custom oral appliance Some made by a dentist trained in dental sleep medicine is one treatment option. It follows a physician’s diagnosis and order.

A dentist can also treat gum disease, fix loose work, and check whether your teeth and jaw can handle a mouthpiece later. Cleveland Clinic notes that people whose teeth can’t hold a jaw-advancing device may use a tongue-stabilizing one instead. The over-the-counter vs custom comparison explains the difference.

Are snoring mouthpieces bad for teeth?

For most adults with healthy teeth, the common problems are short-term. Sore teeth, a sore jaw and drooling often settle over a few weeks. Dry mouth can last longer. Bite changes are the one to watch: the expert panel notes side effects rise as the jaw is pushed further forward.

Stop and see a dentist if your bite feels different and doesn’t settle. The same goes for a loose or sore tooth, or a jaw that clicks or locks. See snoring mouthpiece side effects for what’s normal and what isn’t.