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Snoring mouthpieces harbor bacteria and quickly begin to smell

Anyone who has ever owned a snoring mouthpiece for even a short period of time will tell you that they can get a bit funky after wearing a few nights.

A while back we discussed cleaning specific mouthpieces using a store purchased products such as toothpaste, mouthwash, dish soap, and effervescent tablets. When it comes to cleaning, most mouth guard manufacturers offer their own guidelines which typically include these cleaning agents.

Cleaning is however only half of the battle. Using some of the above-mentioned products will often remove physical debris, leaving behind odor-causing bacteria, fungus, and viruses. These little critters are invisible to the naked eye but are still present, even after a thorough scrubbing. Since conditions inside of the mouth provide a perfect breeding ground for such critters, any colonies that were washed away during “cleaning” will quickly repopulate and within a day or two the rancid smell returns.

Until recently, I haven’t been able to find a cleaning and sterilizing product for snoring mouthpieces. The best product that I could find was effervescent tablets which kill just that bacteria and often discolor the plastic of some oral appliances.

After using Polident tablets for several years, I came across a new product called “Z CLEAN” which claims to clean and kill 99.9% of virus, fungus, and bacteria. The directions say that it can be used to “sterilize your snoring and sleep apnea devices”.  Okay, so an all-in-one product that cleans and completely sterilizes and made specifically for mouthpieces? Tell me more!

About Z Clean

Z- Clean is a product that has been developed by the oral appliance manufacturer Zyppah who has teamed up with an Orthodontic Appliance Plastics, (O.A.P.) a Hewlett, NY company that specializes in cleaning and disinfecting products for everything from aligners to dentures and mouthguards.

According to the product label, Z CLEAN is made in the USA and has been cleared by the FDA. When shopping for any such product, it’s extremely important to ensure that the product has been examined and cleared by the US Food and Drug Administration (or equivalent safety regulation agency in your country). Otherwise, you will never know if the product is safe to use for its intended purpose.

If you were to take a look at the advertisement on their website, the exact type of product that they are selling isn’t quite clear. Is it a large roll of effervescent tablets? Perhaps a canister of cleaning powder? As it turns out, it’s actually a 1.5oz bottle filled with a mint-scented gel-like foaming cleaner. The advertisement states that one bottle should last for thirty days.

The product packaging offers the following directions for use:

1. Wet the device with water
2. Spray device with Z Clean foam
3. Wait 45 seconds as foam activates
4. Brush any heavy stains with toothbrush
5. Rinse the device with water and let dry

Overall, the cleaning process seems easy and straightforward.

How much does it cost?

Zyppah is currently selling one bottle for $19.95 plus $9.95 shipping and handling, bringing the overall cost to $30. However, if you are purchasing this as an add-on item while buying the Zyppah, shipping is combined and there are no additional shipping and handling charges.

$20 for a bottle of cleaner and disinfectant? Sounds a bit expensive but does it actually work and how long does it last?  I was interested so I grabbed a bottle and put it to the test.

Product Review

Wet the device

Spray one pump and spread around entire mouthpiece with finger

Allow to sit for 45 seconds and brush with toothbrush

Rinse clean and allow to air dry

Putting Z Clean to the test

Being one who owns several snoring mouthpieces, I was curious to find out how well the Z cleaner worked. Up until this point I have always used effervescent tablets or a mild dish detergent such as Dawn to clean my oral appliances. While effervescent tablets seem to get the job done, I have always been left wondering what kind of bacteria, fungus, and virus are left behind in the cracks and crevices. Even after cleaning using the effervescent tablets, my mouthpieces still seems to have a slight odor once cleaned and dried, signaling the presence of bacterial growth.

So it was out with the old and in with the new. According to the product label, Z Clean can be used with all snoring and sleep apnea devices as well as CPAP accessories. I, however, decided to start by testing it on the Zyppah simply because this product was made specifically for this device. I later tested it on the Good Morning Snore as well as the SleepTight. All three products are distinctively different.

Upon arising in the morning I rinsed off my Zyppah, gave it a pump of Z Clean and used my finger to distribute the solution. Forty-five seconds later I used a fresh toothbrush to give it a good scrub followed by a rinse. I then allowed it to air dry until later in the evening.

As bedtime approached I grabbed the Zyppah and gave it the sniff test. Surprisingly, it still had a minty fresh smell!

In the morning there were no noticeable odors on the mouthguard so I cleaned and stored it. Once again, it remained fresh smelling after spending several hours drying.

For the next few nights, I tried Z Clean with both the GMSS as well as the SleepTight with identical results.

Because I’m not a scientist and do not own a microscope, I can not attest that this product killed 99.9% of virus, fungus, and bacteria. What I can confirm is that it keeps oral appliances smelling fresh which is an issue that I have always dealt with, until now.

How long will it last?

One bottle = 75 pumps =75 cleanings

Right about now you are probably wondering how long will a bottle last? If it lasts for several weeks then it could still be a great value.

While putting the Z Clean Clean to the test, I found that just one pump provided just enough foam to cover the surface of a mouthpiece and clean it. Since most of us will clean our mouthpiece once per day, typically in the morning, it’s safe to assume that 1 pump equals 1 day. Now, how many pumps are in this 1.5 oz bottle?

With a brand new bottle in hand, I was determined to found out the answer to this question so I pumped the bottle until empty while counting. As it turns out, one bottle produced about 75 pumps or 75 days of use.  Does this mean that it will only last for 75 number of days? Not necessarily.

Because it’s not completely necessary to sanitize daily, you can use a less expensive alternative such as Polident for most days of the week and use Z Clean every other day for a deep cleaning and to completely sanitize. If used only three times a week with one pump per cleaning, a bottle should last for up to six months. This will reduce the monthly cost while keeping your oral appliance fresh.

Recommendation

Z Clean is an effective cleaner and sterilizer that solves the issue of smelly mouthpieces. While it’s a bit on the expensive side, a little bit really goes a long way. If used sparingly, a bottle will last for several weeks. In my opinion, $20 is a small price to pay for a product that cleans and sterilizes, leaving only a fresh mint scent behind. The Z Clean is by far the best oral appliance cleaning solution currently available on the market.

Here are a few pros and cons to consider:

Pros

• Only product that kills 99% of bacteria, fungus, and viruses while cleaning
• No soaking overnight cleans and sterilizes in about a minute
• Mild ph and gentle cleaning agent prevents discoloration
• Safe to use on any mouthpiece
• Can be used for other purposes such as CPAP accessories

Cons

• A bit pricey but can last up to 6 months

Oral Appliance Therapy – The CPAP Alternative

You have spent countless nights trying to become accustomed to wearing your CPAP mask and have grown tired and feel defeated. Frustration sets in and you are actually considering surgery as a solution to your sleep apnea. If this sounds familiar, you may want to take another look at your options prior to undergoing an often painful and risky surgical procedure that still do not guarantee results.

While surgical procedures such as the uvulopalatopharyngoplasty and soft palate implants (pillar procedure) are necessary in certain cases, doctors often view surgery as an aggressive approach to treating OSA. Before considering surgery, understand that there is one non-invasive solution that your doctor may not have mentioned. This solution does not require any surgery and has proven to be quite effective in treating mild to moderate sleep apnea. So what exactly are we talking about here? It’s called a dental appliance or oral appliance and it’s been in use for over three decades.

You may be wondering why you have never heard of this device. After all, it’s been available for several years and many people have found success with it. While there are several reasons why these are not as popular as CPAP machines, perhaps the most cited reason is that most doctors are not well-versed when it comes to oral appliance therapy. For years, they have been told that the CPAP is the “gold standard” when it comes to treating OSA and have accepted this as the only answer. While the CPAP along with weight loss and avoidance of sedatives is still the best and most effective treatment option, patient compliance plays a huge roll in whether or not treatment is successful.

Often times, a few simple modifications will make a huge difference when it comes to CPAP compliance. For example, adding a humidifier to your machine or trying out a different style of mask may be all that it takes to make your experience more comfortable.

But what about those who are not able to tolerate the CPAP? Those who have tried to work with their CPAP and simply can not tolerate it despite all efforts may want to speak with their doctor about oral appliance therapy.

Limitations

This type of treatment does have its limitations.

First, it’s usually only prescribed to those with mild to moderate obstructive sleep apnea who are CPAP intolerant. Those with severe OSA or central sleep apnea are very unlikely to be prescribed one of these devices.

Another limitation is its effectiveness. While oral appliances are effective, they are still not quite as effective as the tried-and-true CPAP. This is of course why in most cases the CPAP is always the first tool that physicians recommend for the treatment of OSA.

As with any other piece of equipment, dental appliances will occasionally need to be adjusted or repaired. After several months of use, they will eventually wear out and need to be replaced.

Those who have issues such as Temporomandibular Joint Dysfunction (TMJ) may not be able to use a dental appliance

After taking the above limitations into consideration you may still find yourself interested in oral appliance therapy. If so, continue reading to learn more about this treatment option.

More on dental appliances for sleep apnea

After many failed attempts with the CPAP, you have decided to further explore dental appliances. What exactly is a dental appliance, how are they used, and how much do they cost? These are a few questions that I hope to answer.

If you have ever seen an athletic mouthguard, you probably already have an idea of what a dental appliance for sleep apnea looks like.

While their appearance may be similar, they serve two entirely different purposes and should not be confused with each other.

The athletic mouthguard serves as a protective barrier between your teeth that prevents tooth injury while playing contact sports. In contrast, the dental appliance also fits between the teeth but functions as a device that holds the jaw slightly forward while asleep. It’s simply two trays – an upper and lower, that are bound together to form a mouthpiece. While there are over 80 different models to choose from, the Tap 3 Elite seems to be one of the more popular ones.

What makes this product unique and effective when it comes to treating OSA is the fact that the lower tray rests slightly in front of the upper which when worn, causes the jaw to maintain the forward position. The degree in which the advancement is set will vary from one person to another.

Why is it important to position the jaw forward? By doing so, you are pulling tight all of the muscles and tissue that surrounds the airway. This creates a clear opening for air to travel and prevents airway vibration and collapse. A restrictive airway is, of course, the cause of OSA.

Dental appliances are typically fitted and adjusted by your dentist. When choosing a dentist to create your custom appliance, be sure to find one who has extensive experience in dental sleep medicine. You will likely undergo a sleep study after receiving your new appliance to ensure that it’s working properly. Adjustments may be necessary to achieve a properly functioning device and a comfortable fit.

How much do they cost?

One of the most commonly asked questions that I hear is “How much will an oral appliance cost?” or “Will my insurance cover one?”. The short answer is somewhere around $3,000 however, this amount will vary depending on which device you choose and how much your dentist charges to fit one.

As for insurance coverage, many insurance companies cover a large portion or in some cases all of the expense associated with acquiring an oral appliance if it’s deemed to be a medical necessity.

Unfortunately, not all insurance companies operate by the same rules. What makes it even more complicated is the fact that most doctors can only give you a rough estimate of the expense because even they are uncertain of how much your insurance is willing to cover until they begin working with your insurance company. In short, your health insurance will likely foot most of the bill but be prepared to pay out up to $1,000 or more if they decide not to.

When is surgery appropriate?

Most doctors will tell you that invasive surgery should be last on your list when it comes to treating OSA. Depending on the type of surgery that you are considering, the recovery period could last for several days to several weeks or even months. Even after undergoing surgery, some patients still have issues with sleep apnea.

For these reasons, the CPAP or oral appliance (along with weight loss if necessary) are the ideal treatment choice. There are however some instances where surgery is necessary such those who have very large tonsils or airway obstructions. It’s always recommended that you speak with your doctor concerning the best treatment options for your particular situation.

Several years ago when I first looked into buying an anti-snoring mouthguard, I remember wondering exactly what it would feel like to wear one of these devices. Some of the products that were available appeared large in size and intimidating. I simply couldn’t imagine the idea of falling asleep with such a monstrous piece of plastic in my mouth. Fortunately, I was able to overcome this fear and order my first mouthpiece.

My experience with the one-piece mouthguard

The first product that I had tried was a simple one-piece boil and bite device with two medium size breather holes at the front. When it arrived, it appeared to be about the size that I had envisioned based on the online photos. Before starting the fitting process, I placed it into my mouth to get a feel for its actual size. As I expected, it was pretty bulky and left about a half inch of space between my upper and lower teeth. At this point, I began to question whether or not I would be able to tolerate such a gargantuan piece of plastic stuffed inside of my oral cavity.

Nonetheless, I continued forward with the fitting process by heating a few cups of water on the stove until it began to boil. After submerging the mouthpiece into the hot water for several seconds, it emerged from the water as translucent and very pliable. I allowed it to cool for a couple seconds and then placed it into my mouth, bit down firmly, and slightly pushed out on my jaw. As I was biting down, I could feel my teeth slowly sinking into the hot molten plastic. This position was held for several seconds as I worked the plastic around the outer edges of my teeth with my finger and inner edges with my tongue.

Once the fitting process was complete, I noticed a reduction in the gap between my upper and lower teeth as well as a much better fit. Instead of half of an inch of space, there was only about 1/4″. While the fit was much closer after going through the fitting process, it was still noticeable inside of my mouth.

From here I gave it a try, to see if it actually worked. The first night was rather awkward. I woke up in the morning next to a large pile of drool and felt a bit of soreness in my jaw. While I was not exactly thrilled with my first night experience, I was pleasantly surprised when my wife told me that I did not snore one bit throughout the night. This confirmation provided a glimmer of hope that I may have found a snoring solution that actually works. After contacting the manufacturer’s customer support, I learned that drooling and soreness are typical side effects that usually disappear after a few days.

Moving on, I used my mouthguard for the next four nights with continued success. The drooling stopped after the second night and morning soreness was completely eliminated after the fourth night.

While it did take a few days to become accustomed to wearing it, doing so was well worth the effort and I were thrilled with the results. It felt great to wake up in the morning refreshed and ready to tackle another day.

Encouraged by my success, I set out to find a product that was more compact and just as effective as the simple one-piece device.

Finding a more compact solution

The “zQuiet”

After testing out several different one-piece mouthguards, (all featured similar designs) I decided to venture into testing out a few products that were engineered differently. The first product that I tried out was the zQuiet followed by the GMSS. In comparison to the standard boil and bite units that I had previously tried, each was completely unique.

The zQuiet featured a thin upper and lower tray that is hinged together at the rear of the mouth near the molars. I found this product to be particularly interesting because it could be used straight out of the box and appeared to have a much lower profile, meaning that I should be able to close my mouth so that it rests in more of a natural state.

Upon arrival, I gave the zQuiet a quick rinse under warm water and put it to the test. There was a noticeable difference in thickness. The feel was a bit more natural and less bulky. Due to the inability to custom mold, the fit was a bit looser in comparison to the standard mouthpieces that I have tried. While it was noticeably more comfortable in comparison, I had still experienced a couple days of drooling along with a few days of soreness. As with the other mouthpieces that I have tried, this disappeared after a few days. I was soon left with a more comfortable and compact device that still effectively controlled my snoring.

Soon after, I had tested out a completely different product called the Good Morning Snore Solution or GMSS. Instead of placing between the teeth, this device attached to the tip of the tongue using suction.

Trying the GMSS for the first time was fairly odd. It resembles a pacifier and holds your tongue forward, just passed your front teeth. Imagine about 1/2″ of your tongue sticking out. The sensation is a bit strange but like the other products that I have tried, it was easy to become accustomed to after a few days of use. The tip of your tongue will become tender the first few nights that you use it. This product was also incredibly effective and comfortable after a few days.

How noticeable are they?

After several different trials with various products, I must say that each takes a few days to adjust. After passing the adjustment period, wearing a snoring mouthguard is comfortable and fairly easy to tolerate. While I still prefer a more compact version of this product, such as the zQuiet, I always eventually became accustomed to wearing any product that I have tried.

So, how noticeable are they? No matter what product you choose, each one will be noticeable for a few days until you become accustomed to wearing one. After the initial break-in period, it becomes much easier. There will be a period where it feels unnatural, cumbersome, and you will probably drool a little. Hang in there and you will be well on your way to a comfortable, snore-free night.

A common question asked by those who are interested in a Mandibular Advancement Device is “Will my insurance cover one and how much will I have to pay?”. There are actually several different factors that will determine if and how much your health insurance will cover.

Determining insurance coverage

Dental appliances for Obstructive Sleep Apnea

Before getting too far ahead, it’s important to understand that in most cases, health insurance companies are not going to cover an appliance that is used for the sole purpose of controlling snoring.

That being said, most health insurance companies will cover a portion (about half) or in some cases all of the cost of an oral appliance if it has been determined to be a “medical necessity“.  Appliances that are custom made by the dentist for the purpose of controlling obstructive sleep apnea are considered a medical necessity and are often covered by private insurance as well as Medicare, Medicaid, and obamacare when certain conditions are met.

Which insurance is responsible for covering this expense? Despite the fact that these devices fit inside of the mouth, they are covered under your health insurance, not dental insurance because they are used to treat a medical condition such as sleep apnea.

Unfortunately, with so many insurance companies out there, it’s impossible to make a blanket statement concerning all insurance coverage. Since the insurance companies do not publish the amount that they will cover, not even your doctor can give you an exact out of pocket amount until several weeks after getting the insurance process rolling.

The entire process can take up to six weeks to complete and even then, you will only be given an estimate and not an exact amount. During this time period, you will be working with an insurance billing expert who will submit your information to the insurance company.

An affidavit of intolerance to CPAP explaining why you are unable to use a CPAP to control your sleep apnea as well as a copy of your sleep study is often submitted to your insurance company for review. From here, your insurance will determine the amount that they are willing to pay.

How about a rough estimate?

As a general rule, it’s a good idea not to depend on your insurance company to cover 100% of the cost of your oral appliance. Although better insurance companies will pick up all of the costs associated with obtaining an oral appliance, others will only cover about half.

The cost will also depend upon the brand of oral appliance that you choose. There are well over a hundred manufacturers, some are more expensive than others. Expenses typically include the initial consultation followed by a mouthpiece fitting and then follow up visits for adjustments. Oral appliances alone cost somewhere around $2,000 plus your doctors fees. Overall, you should expect the total cost to add up to somewhere in the ballpark of $3,000 on the low end. As mentioned, it is likely that your insurance will cover around half or more so you should anticipate an out of pocket expense of somewhere around $1,500. If they pick up more than half the cost, consider it a bonus. You will, of course, want to plan to pay the higher amount and not expect your insurance to pick up the entire cost.

Mouthguards for snoring

What if you are interested in obtaining a dental appliance for the sole purpose of controlling snoring that is not related to OSA?

Unfortunately, for those who have simple benign snoring that does not involve sleep apnea, most insurance companies are not willing to pay out in such cases.  If this is the case, you may be left wondering what options are available aside from paying the full $3,000 plus.

While the bad news is, as mentioned, your insurance will likely not cover the expense of an oral appliance, the good news is that there are several do-it-yourself products that can be purchased online that will help to stop the sound of snoring. These DIY products look and function very similarly to professionally fitted oral appliances yet sell for $60-$80 and can be fitted at home in as little as 5 minutes using a pot of hot water.

What started with one manufacturer in the early 1990’s has grown into a much larger industry with several manufacturers who offer their own version of the at-home mouthguard style dental appliance. Take a look at the comparison chart on the homepage to get an idea of what’s available and the overall cost that you should expect to pay.

Concluding thoughts

In recent years, there has been quite a bit of confusion regarding oral appliance therapy and insurance coverage. Unfortunately, many people have been led to believe that oral appliances are expensive and most insurance companies do not cover them. While this may have been true in years past, this no longer seems to be the case.

If you have been diagnosed with OSA and would like to try an oral appliance, your best option is to work with a dentist who is familiar with fitting oral appliances and has a billing team that understands the insurance process. Doing so will be a tremendous help when it comes to getting your insurance company to pay for your dental appliance.

Since individual circumstances vary, there is no single resource online that will show the exact amount that your insurance company will cover. The only way to determine the amount that you can expect to pay is to visit your dentist. Even after your initial visit, you will likely not have an exact amount until several weeks later when the insurance process starts to go through.

If you have not been diagnosed with sleep apnea (and have spoken with your doctor and are certain that your snoring is not related to OSA), you may want to consider the less expensive alternative which is a plastic DIY mouthguard that often sells for a very reasonable price.

How safe are snoring mouthpieces?

According to the American Academy of Dental Sleep Medicine, about 24% of women and 40% of men have a snoring problem. Currently (as of 2015) the population in the United States is approximately 319 million. Assuming that half of the population are men and half women, that’s 38 million snoring women and 64 million snoring men or a combined snoring population of 102 million.  In other words, A LOT of people snore.

Snoring has become so common that living with a snoring partner is often accepted as a part of life and jokingly dismissed. Unfortunately, living with a snorer can actually lead to serious relationship issues as sleeping together in the same room can eventually become a problem.

Those who have to deal with a snoring partner usually end up searching for a solution and quickly become overwhelmed with all of the available products from nasal strips, throat sprays, herbal remedies, nasal dilators, mouthpieces, rings, as well as a number of other snoring solutions.  In fact, there are more than 300 snoring products currently registered with the US patent and trademark office.

As a snorer, I have tried several of the mentioned products and above all, have found the Mandibular Advancement Device (MAD), or mouthpiece to be the most effective. For most who are trying to decide upon a solution, product safety always seems to be a concern. That being said, let’s examine some of the safety concerns that one may have when it comes to using one of these devices.

Before getting started, here’s a brief explanation of how these devices work.

In a nutshell, a traditional a MAD resembles an athletic mouthguard and is placed into the mouth at night before going to bed. The device fits around your teeth and holds the lower jaw forward. Doing so opens a restricted airway which is the most common area where snoring occurs. A more in-depth explanation of how these devices work can be found here.

Those who have an interest in treating a snoring problem with such a product usually question the safety of a snoring mouthpiece.

For about three decades now, mouthpieces have been used to treat snoring and in some cases, mild to moderate OSA. They have been issued by dentists for a number of years and when used as prescribed and under the right circumstances, these are generally considered to be safe.

As with any other medical device, there is always an exception when it comes to safe use. Below are a few potential safety issues that you may want to consider.

Sleep apnea

One of the greatest safety concerns when it comes to using a mouthpiece to prevent snoring is whether or not there is a presence of what is known as sleep apnea. Sleep apnea occurs when there is a momentary pause in breathing while asleep that can often last for several seconds. It just so happens that snoring may be a sign of sleep apnea.

Sleep apnea may lead to a number of other health issues such as high blood pressure, heart disease, and stroke.

How do you know if you have sleep apnea? The only way to know whether or not your snoring is related to OSA is to visit your doctor where he or she will help you to determine if further testing is required. Those with known sleep apnea should seek professional medical assistance to treat this condition. This page contains a questionnaire that can help your doctor determine the probability that sleep apnea is present.

While a MAD can be used to treat OSA, this should only be attempted while under the supervision of a doctor. You should not use a MAD if you suspect that your snoring is a symptom of sleep apnea.

Loose/ missing teeth

For the sake of safety, those with loose or a number of missing teeth should not use a mouthpiece to prevent snoring. Two trays, an upper and lower, fit snugly around the teeth and use leverage points to hold the jaw in the forward position. Since a strong set of teeth are needed for proper functioning, such devices should not be used if you are experiencing any such dental issues.

More recently, the Tongue Stabilizing Device (TSD) has been recognized as an effective means to treat snoring. Products such as the GMSS may be a good alternative for those with loose/missing teeth or dentures. Be sure to check with the manufacturer concerning your individual condition before use.

Jaw issues

For those who have jaw issues such as Temporomandibular Joint Dysfunction (TMJ), a jaw that pops, locks, or dislocates or any other problems with their jaw should not use a mouthpiece for snoring. Doing so is not safe and can cause further issues.

A mouthpiece will hold your jaw forward and stretch the muscles in the surrounding area. If an underlying problem currently exists, the use of such products could irritate or worsen the condition.

Food and Drug Administration Involvement

Choosing a product that has been cleared by the Food and Drug Administration (United States) is an important safety consideration that should be examined prior to using a mouthpiece. The FDA examines the safety of such medical devices and issues clearance prior to the product being sold.

Between dentist prescribed products and internet sold DIY mouthguards, there are several dozens to choose from. Unfortunately, there are some manufacturers who did not go through the proper channels to obtain FDA clearance. Simply put, non-FDA cleared products may not be safe and should be avoided altogether. Check here to see if the product that you are interested in has been cleared.

Overall thoughts on safety

When it comes to safety, be sure to review the above safety considerations before deciding to use any such product to stop your snoring.

It’s a good idea to consult with your doctor who can address any additional concerns that you may have as well as help you determine if sleep apnea may be a possibility. If you have loose or missing teeth or issues with your jaw, such devices may not be a good fit for you.

As always, be sure to use a product that has been cleared by the FDA as these are going to be your safest bet.

Follow all of the manufacturer’s instructions and use only as directed.

Speak with your doctor about oral appliances and take a look at some of these DIY products which can be ordered online at a fraction of the cost of professionally fitted devices.

Tell me about dental appliances

One of the latest snoring treatment options to appear on the market is the dental appliance, better known as a snoring mouthpiece. While the technology behind this device dates back to the 1980’s when it was issued exclusively by dentists, it wasn’t until recent years that several manufacturers started to produce an at home do it yourself version of the device.

Today, there are over three dozen companies that are producing such OTC dental appliances and the number of new entrances to the market continues to grow each year.

So what’s all the buzz about? Do these things really work?

These are two questions that I asked myself a few years back when I was in search of a snoring solution. You can read more about my story here.

To answer the first question, the reason behind the explosion of interest in recent years is because the action of the DIY dental appliances closely mimics those that were once only available from a dentist. The cost of a custom fitted mouthguard is upward to $3,500 and many insurance companies are not willing to foot the bill. Meanwhile, the at home versions are available for $100 or less with several models to choose from.

As you may have guessed, the answer to the second question is “yes” they are quite effective as I have found out by trying several products and sharing my experience testing each and writing several product reviews.

There are of course some advantages and disadvantages of using a dental appliance to treat snoring.

DIY dental appliance advantages

• Inexpensive – As previously mentioned, the cost of most products are around $100, in many cases much less. The cost of professionally fitted custom devices is between $1,500-$3,500, often with little to no insurance reimbursement when used for the purpose of controlling snoring.  It’s easy to see that pro-fitted appliance cost 15x-35x more than a DIY.
• Proven effective – Throughout the past three decades, multiple studies have been conducted examining the effectiveness of these appliances. Each study concluded that such products are an effective way to control snoring to some degree. Here is one study if you are interested. Several other studies have been conducted by universities as well as private studies from product manufacturers.
• Safe – When you choose an appliance that is FDA cleared, follow the instructions, and use only as intended, they are safe to use. Keep in mind, these DIY products should only be used to treat snoring and should not be used to treat obstructive sleep apnea without first consulting with your doctor. Such appliances are often used to treat OSA but this should only be attempted under the supervision of your doctor.
• Simple to use – There’s nothing complicated about it, it’s a mouthpiece. After creating the custom fit, simply pop it in your mouth at bedtime and remove it in the morning. You will have to disinfect it daily to prevent the buildup of bacteria and germs.
• Long life – Depending on the brand, many devices can last for as long as two years. If you do not grind your teeth while sleeping and use good cleaning and storage practices, it may last even longer.

Disadvantages

• Doesn’t work for everyone – One of the biggest disadvantages of using a dental appliance to control snoring is the fact that they are not 100% effective. Most manufacturers claim a satisfaction rate of over 90% while several clinical studies suggest a much lower rate of effectiveness that is 85% or less. Based on my personal experience along with feedback from friends and family who I introduced the dental appliance to (as well as several readers of this blog), they are quite effective and have helped many including my wife and me.

• Soreness/ discomfort – If this is your first time using a mouthpiece, you will likely wake up with a sore jaw. This soreness is caused by the jaw being held in the forward position for several hours as you sleep. Fortunately, with continued use, any soreness tends to dissipate within the first 2-5 days as your jaw becomes accustomed to being stretched. Think of it as that sore feeling the day after visiting the gym after a long hiatus.

• Difficulty fitting – While all of my experiences fitting my dental appliances have been positive without any major issues, those who are not familiar with these devices may find the fitting process to be challenging. The key to getting a great fit with any product, regardless of manufacturer, is to carefully read the instructions before starting and work quickly. Most appliances are dipped in hot water for just a few seconds and then immediately placed into the mouth. A bath in hot water for too long or a delay in placing it into your mouth will cause fitting issues.

Is it worth it?

After reading over the advantages and disadvantages, you may be asking yourself “Is it worth it?”.

While this snoring solution is not for everyone, it’s worth giving a try because of all of the low risk offers that exist.

Luckily, the industry is fairly competitive and all of the major manufacturers include a no/ low-risk trial just to get you to try their product.  While the details of each manufacturer differ slightly, most can be tested out for 30-45 days by paying only the shipping charges upfront which is typically between $8-$15.

Usually, the process works something like this:

1. Order the product and pay the costs associated with shipping and handling
2. Test it out for the specified period of time (usually 4-6 weeks). You will know whether or not it works within the first week
3. Keep the dental appliance if you are satisfied and your card will be billed for the remainder of the balance after the end of the trial date
4. If not satisfied, you can send it back to the manufacturer and your card will not be billed.

Each manufacturer will, of course, vary so be sure to check with them before committing to a purchase.

I’ve had personally eliminated my snoring and receive daily emails from people who have thanked me for introducing them to these devices and saving their relationships. If you have a snoring problem, I would highly recommend giving one of these products a try.

If you need help deciding on which appliance to go with, take a look at my recommended products.

The Continuous Positive Airway Pressure (CPAP) machine is considered the “gold standard” when it comes to treating Obstructive Sleep Apnea (OSA). Those who have been prescribed a CPAP machine often describe the experience as uncomfortable, irritating, and cumbersome. Some patients complain of issues keeping their mask securely fastened to their face, a dry stuffy nose, dry throat, and skin irritation.

So what options are available for those who can not tolerate a CPAP? Before moving into alternative treatment options, you may want to first consider the following.

Before giving up…

Check a secure fit

Before exploring CPAP alternatives, it’s a good idea to try to work with your current CPAP set up. Ensure that the mask fits securely and comfortably on to your face. Most masks can be adjusted for a more secure fit. Check the manufacturer’s instructions that were provided with your machine for proper fitting directions. Your doctor can also help you make adjustments if necessary.

Try a different style of mask

It’s possible that the mask that came with your machine may not be a good fit for you. Several different mask styles are available including the nasal, full face, nasal pillow, nasal prong, hybrid, oral and total face mask so you may want to try out a different type of mask before giving up.

For example, if you find that a full face mask is too irritating or you are feeling claustrophobic, you may want to consider trying out a nasal pillow style mask. Several different styles and sizes are available in a price range that is between $40 and $200. Most insurance providers will provide coverage for select masks.

If you are having difficulty keeping the mask secured to your face, try using the adjustment straps to create a closer fit. Avoid over tightening as this can cause further irritation.

Try a CPAP humidifier

Nasal, mouth, and throat dryness are also another common issues that CPAP users often experience when using a machine for the first time. If dryness and irritation is an issue, you may want to consider switching to a machine that has a humidifier. This lubricates your nasal passages and helps to prevent them from drying out.

Most newer CPAP machines come with a heated moisture adding a feature that can be adjusted to a level of humidity that makes your experience a more comfortable one. If you have an older machine, you may be able to add a heated humidifier to the air stream.

Alternatives to the CPAP for those who can’t tolerate

If you are having difficulty tolerating a CPAP machine after testing out different masks, making adjustments, and adding moisture, you may want to speak with your doctor about testing a Mandibular Advancement Device (MAD) or Tongue Stabilizing Device (also known as a Tongue Retaining Device or TRD). Both have been proven to treat mild to moderate obstructive sleep apnea and are also an effective way to treat snoring.

As mentioned, there are basically two different styles of mouthpiece available, the MAD and the TSD.

Most who have made the switch to a mouthpiece agree that they are less invasive and easier to use. Best of all, you don’t have to carry around a large machine, tubes, and a mask. In addition, no electricity is necessary.

MADs and TSDs that are available by prescription only and can be very expensive because they are usually custom made. The cost of these can exceed $2,500 and are usually fitted by a dentist. Popular brands include Somnowell, Somnofit, SomnoDent, OASYS, Thornton Adjustable Positioner (TAP), AveoTSD as well as several others.

The good news is, less expensive self-fitted options are available. Below are two types that you may want to consider.

Self-fitted MADs

A less expensive alternative to a dentist fitted mouthpiece is the self-fitted MADs which are available from a number of different manufacturers at a fraction of the cost of a professionally fitted product. These self-fitted devices usually cost between $50 to $100 and can be incredibly effective.

Internet ordered MADs are typically made from a thermoplastic material which is heated at home in hot water before being placed inside of your mouth as you bite down and move the lower jaw forward. Your teeth sink down into the soft thermoplastic material and this position is held for a few seconds until the plastic cools. The mouthguard is then removed and placed in cold water to set the shape.

When properly used, these devices hold the jaw forward, which widens the airway and prevents snoring as well as mild to moderate sleep apnea.

The downside to such self-fitted product is that they typically only last for 1-2 years, depending on how well they are cared for. In comparison, a professionally fitted device can last for more than two years.

One-size-fits-all TSD

An alternative to the self-fitted MAD is the one-size-fits-all TSD. There are currently two manufacturers who make a TSD – Good Morning Snore Solution (GMSS) and the AveoTSD. The AveoTSD can only be purchased from your dentist while the GMSS can be purchased online without the need to submit a prescription.

Instead of fitting it inside of the mouth along the teeth, the TSD actually attaches to the tip of your tongue, using suction and holds the tongue and associated muscles forward which has the same effect as the MADs. The advantage of this product is that it’s less invasive and works right out of the box.

Non-prescription products such as the GMSS can only be purchased online and cost around $100.  These tend to last for a year or more before needing a replacement.

A final note on switching from CPAP to a mouthpiece

Several people have already made the switch from a CPAP to a mouthpiece. Does this mean that you should also make the switch? This is a question that absolutely needs to be discussed with your doctor before making a decision. There are several factors that should be considered such as the severity of your apnea as well as the type of apnea. Changing the type of treatment without first consulting with your doctor can be dangerous to your health so please be sure to discuss this option with your doctor prior to making any changes to your current treatment.

While speaking with your doctor, ask about professionally fitted products as well as the less expensive internet ordered self-fitted alternatives. You can find plenty of in-depth information on self-fitted mouthpieces including several product reviews on the website that you are on right now.

Considerations before buying a Snoring Mouthpiece on Amazon

With over 200 million items offered for sale from 35 different departments, it’s no wonder why Amazon.com is the worlds largest e-commerce company with over $74 billion in annual sales.

The large selection of items that are available at competitive pricing can be a bit overwhelming. Where else can you find everything from the latest electronic gadgets to snoring mouthpieces, all shipped to your doorstep in as little as one hour in some cities? Wait a second, did you say that you can buy a snoring mouthpiece on Amazon? Yes, there are a handful of such products that are being sold for as little as $10. Some of the more popular names include Rest Assured, Eliminator Pro, Sparkling White Smiles, Serenity Sleep, Happy Sleep, Shock Doctor, Sound to Sleep, as well as dozens of other generic products.

At this price point, what’s not to like? When you look beneath the surface, you will begin to discover that many of the discounted products that are being sold on Amazon have some potential issues. The following are a few points that you may want to consider before buying a mouthpiece on Amazon.

Product regulation

One of the biggest considerations that one should look into before purchasing a mouthguard from Amazon is whether or not the product being sold is being regulated. What exactly do I mean by “regulated”?

Many buyers are under the impression that if Amazon sells a product, it must have been examined and determined to be safe. At least this was my understanding whenever I first started using Amazon many years ago and didn’t fully understand how the company operates.

The reality is, any person can have an item mass produced overseas and then sent to an Amazon fulfillment center (warehouse) where it’s stored and then shipped to the consumer with very few if any questions asked. This practice has become increasingly popular in recent years.

So what does this mean? In the case of a mouthpiece, the piece of plastic that you are placing into your mouth every night to prevent snoring could have been manufactured in unsanitary conditions and might contain BPA or other harmful toxins due to inexpensive plastic materials that are sometimes used in production. Unfortunately, hundreds of such products are sent out to consumers every day without them fully understanding the risks.

In the United States, the Food and Drug Administration (FDA) regulates the sale of snoring mouthpieces (Mandibular Advancement Devices). Other countries such as Australia, Canada, and the UK have similar regulatory agencies that oversee the sales of such products.

Technically speaking, in the US, MADs are considered a class II medical device and should be sold by prescription only. The manufacturer must prove that their product is “substantially equivalent” to another product that has already been cleared by the FDA. They must submit the necessary paperwork showing that their product is safe to use and disclose the type of materials used in production. All of this must occur before the product becomes “FDA cleared” and can be sold legally in the US.

A seller’s packaging might even show the FDA symbol, however, don’t take their word for it. I’ve come across several sellers who claim that their product has been cleared by the FDA when in fact they haven’t. Before purchasing any product, always search the FDA database to ensure that it has actually been approved. Without clearance, there is no telling if the product is safe to use.

Protection against misuse

When you purchase directly from a reputable company, you will notice that you are asked a series of questions prior to being able to complete your order. Example of such questions include:

• Do you have headaches that often occur or Temporomandibular Joint Disorders (TMJ)?
• Does your jaw pop?
• Have you ever been told that you stop breathing while asleep?
• Do you often wake up tired in the morning?

These questionnaires are designed to help prevent people who have a more serious medical condition such as TMJ or sleep apnea from buying their product. In order to proceed with an order, the answers to your questions must meet the manufacturer’s criteria. Doing so, the manufacturer makes a reasonably safe assumption that their product is a good fit for you.

No such safety questionnaire is present when purchasing on Amazon. The issue here is that an undiagnosed underlying issue such as obstructive sleep apnea or TMJ may be present which may require the attention of a medical professional prior to using such a product. Regardless of the presence of a questionnaire, you should always first speak with your doctor about your concerns before using such a product.

Clinical research

Many reputable manufacturers who go through the effort of having their product cleared by the FDA also often have clinical studies to back up their claims. These studies cost tens of thousands of dollars and are almost never conducted by those who sell cheaply made products at discounted prices.

While conducting clinical research on a product is not a requirement when it comes to selling, it’s an extra step that reassures you that the product has been tested and is safe and effective.

Final thoughts

When deciding where to purchase your antisnoring device, safety should always be your number one concern. If you were to browse through the mouthguard selection on Amazon, you will notice several that are being sold without approval from a regulatory agency. This brings into question concerns about the safety of manufacturing processes.

Considering that you are placing this product into your mouth for at least 8 hours every night, it’s a good idea to go with a manufacturer that has been checked out by the FDA (or similar agency) and has a solid reputation. Choosing anything else could put your health at risk.

Personally, I buy a lot of products from Amazon and find shopping online to be convenient and inexpensive. However, when it comes to snoring mouthpieces, (or any other home medical devices) I tend to scrutinize any item that is listed for sale. If you are interested in trying an Amazon mouthpiece, I would suggest that you are able to answer “yes” to the following three questions before making your decision.

1. Has the product been cleared by the FDA?
2. Is the product made from safe materials that are free of BPA and other toxins?
3. Does it come from a reputable seller who can be contacted via phone, email and physical address?

Which product should I go with?

I can’t stress enough that it’s best to go with a device that is produced by an established company that has the proper FDA clearance.

I created this table with over 25 different mouthpiece reviews, several that I have tried personally. Some products were excellent while others were lackluster.  I have also made a page with my recommended products, all of which I have personally tried and verified their credentials.

Your experience buying an Amazon snoring mouthguard?

If you have tried a snoring mouthguard from Amazon that you are satisfied with and meets the above-mentioned criteria, I would like to hear from you. Please leave a comment in the box below.

Do women really snore?

“Women don’t snore!”

Throughout the years, this common belief has been accepted as factual information by most people. If you live with a female partner who keeps you awake throughout the night, you already know that nothing could be further from the truth.  Perhaps you are the guilty party and have come here to find more information and a solution. Either way, we are here to set the record straight and offer some practical solutions for women who deal with a snoring problem.

It’s a fact. According to the National Sleep Foundation, snoring is an issue that affects both men and women. However, at a younger age, most experts agree that men are twice as likely to snore in comparison to women. After menopause, the number of women snorers eventually becomes equivalent to the number of men who snore.

Certain factors such as being overweight, alcohol or drug use, and sleeping position can all influence whether or not we snore. There are a number of other issues that can be a contributing factor to snoring such as the anatomy of the jaw and airway and nasal or sinus issues. In some cases, snoring may be a sign of a more serious issue such as sleep apnea. For these reasons, it’s a good idea to check with your physician before attempting to treat a snoring problem.

Snoring mouthpieces for women

There are several natural remedies that may help with a snoring problem. Here are a few ideas that you may want to consider before moving forward with other solutions. For example, if you are overweight, losing as little as 10lbs might be all that it takes to eliminate your snoring.

After exploring these suggestions, you may be interested in testing a mouthpiece before moving forward with a more aggressive approach such as surgery. A mandibular advancement device, better known as a snoring mouthpiece, is a practical and inexpensive solution that can be used to prevent snoring.

There are two types of products available. The first type is a dentist fitted custom device. There are various brands including the Tap 3, Somnowell, Somnodent, Herbst, Narval CC, Silent Nite SL as well as several others. While these are an ideal snoring solution, they are only available through your dentist and often cost several thousands of dollars. Depending on medical insurance coverage, most people are left paying several hundred dollars out of pocket.

A less expensive and readily available solution that has become quite popular in recent years is the DYI mouthpiece. These are often made from a thermoplastic material and are custom fitted at home using a pot of boiled water. There are dozens of manufacturers who produce these devices including names such as zQuiet, GMSS, Vitalsleep, SnoreDoc, SleepTight, Zyppah, as well as several others. On average, these products range in price from around $60 to $100 and are typically only available for purchase online.

Are these DIY products really gender specific?

One question that snorers often ask is whether or not DYI devices are gender specific. In general, with a bit of heating and modification, most products will accommodate a wide range of mouth sizes and shapes for both men and women.

There are of course some exceptions. Women usually have a mouth structure that is smaller in comparison to that of men’s. If you are a woman and your mouth is substantially smaller in size, you may want to consider going with a product that is labeled as “small” or “for women”. Unfortunately at the time of this writing, there are very few manufacturers who offer this option.

While there are literally dozens of products available, I’ve only found three that will assist women snorers with smaller mouths – The GMSS, VitalSleep, and Snoremeds. All three are effective and can be purchased online without having to visit a dentist.

Three largely different solutions

GMSS– If you are a woman snorer with a small mouth, you might want to consider a less traditional product to treat your snoring. The GMSS will accommodate nearly every mouth size because it’s worn on the tip of the tongue instead of between the teeth. This product, created by a Canadian dentist, holds the tongue forward which prevents the sound of snoring. It costs around $100 and is quite effective. You can read my review here.

Vitalsleep– The VitalSleep is available in both regular and small sizes. It has micro adjustment screws on which allows the lower tray to be adjusted out several millimeters. The VitalSleep sells for around $60 and can be purchased at a discount if you order two. I tested this product and wrote a complete review.

SnoreMeds– Last on the list is the SnoreMeds. This product is a boil and bite mouthpiece with two breather holes. It’s also available in both regular and small sizes and is as simple and effective as they come. This is perhaps my most favored no-frills product because it’s very inexpensive. The value pack which contains 4 devices can be purchased for around $70 or about $18 each.  Read the full review here.

Other available options

It’s important to mention that while these three products are marketed and sold as “women’s” mouthpieces, this can be somewhat misleading. For the average woman, most standard or regular size mouthguards will work just fine. The smaller size should only be used if you are finding that standard size devices do not fit properly or are uncomfortable.

A much larger selection of reviewed products is available here.  Pay close attention whether or not the company offers a money back guarantee. In the event that they do not fit, you can return it for a refund and purchase one of the smaller devices mentioned above.

There are a lot of great options when it comes to DIY anti-snoring products. For most, just about any standard size device will work. For others, the smaller mentioned devices may be ideal.