Your constant snoring might have a deeper reason than just a tiring day at work. It can be an indication of apnea (temporary cessation of breathing) during sleep and an urgent need to get a tongue retaining device.
In this article, you will get to know about tongue retainer that can be used to address such a situation. It looks like an adult pacifier and effectively calms your sleep problems.
What This Article Is All About?
Snoring is not only about the noise you make while sleeping but your overall health. Most days, you might not even be able to wake up and start your day at all, because you feel tired and sleep-deprived.
Over the years, sleep medicine has taught us that people with snoring problems face significantly poor quality lifestyle. In Australia, this is just not acceptable!
You should never settle for substandard sleep because a good night’s sleep has no alternative. This can easily be achieved by using a tongue retaining device during the night.
Use of Oral Devices – What Is the Rationale?
In the past, surgery was the mainstay for treating sleep disorders. It was done by modifying the anatomy of the airway and increasing the airway space. However, this changed during the last decade, when the American Academy of Sleep Studies made oral devices the first line of treatment.
This was largely done due to their less invasive nature as compared to surgery and proven effectiveness, especially in mild to moderate cases. There are many oral devices available these days in Australia but the tongue retaining device is the most popular.
The main reason for snoring is the obstruction of your airway. Your airway consists of:
- Mouth (tongue, soft and hard palate)
- Pharynx or throat
The air enters your throat through nose or mouth and goes into the lungs. However, sometimes the tongue may lead to hindrance and cause snoring as well as sleep apnea.
Putting it in simple words, if your tongue falls back during sleeping, it can decrease the air passage into your throat and lungs, cutting off your oxygen supply. It is the relaxation of muscles during sleep and the effect of gravity that leads to the phenomenon of tongue fall.
Say there is a window through which air comes into the room. The blind is always tied on top of the window but due to gravity, sometimes, blind comes down. Now the air hits the blind and produces a sound. Additionally, the quantity of air coming inside the room also reduces, leading to suffocation.
Your tongue is like that blind and a tongue retaining device is a clip to hold that blind up. It keeps the airflow uninterrupted and voiceless.
How Does Tongue Retainer Work?
A tongue retainer has two main parts- the mouthpiece and lingual compartment.
# 1: Mouthpiece
The mouthpiece is designed to cover your upper and lower dental arches completely. These are made by taking the caste of your denture and supposed to fix on your teeth. This fixation is further ensured by adding support of mandibular protrusion, which covers your jaws entirely from behind as well.
The distance between these front and back protrusions is adjustable. If you feel pain or no improvement in snoring, you can get this distance altered to alleviate soreness as well as the prognosis of the disease.
There is a hole on each side of the mouthpiece. These two holes are meant to facilitate breathing through the mouth.
# 2: Lingual Compartment
The lingual portion is for holding the tongue. It is located between two dental arches, looking like a protruded balloon, and pulls your tongue inside it.
The lingual pocket generates a negative pressure due to air in the compartment and sucks the tongue forward- away from the entrance of the airway.
Material Used for Tongue Retaining Device
The tongue retaining device comes directly in contact with your oral cavity. So, it’s obvious that the material should be harmless and easy to tolerate.
Most of the retainers are made of polyvinyl material or silicone resins. Polyvinyl is a type of flexible plastic and can be customized according to the denture of the user. Both these materials are highly durable and do not irritate the skin, making the tongue retainer a vastly safe device to use.
How Effective Is the Tongue Retainer Device?
TRD is a practical solution that cages your tongue (literally) and prevents it from falling back. So, rationally speaking, it makes sense that TRD proves to be effective.
Here are the top 3 reasons tongue retainer devices are effective.
#1: It is approved by FDA
Tongue retainer has attained safety approval by the FDA, which certifies its credibility as a treatment option.
# 2: It Is Endorsed by Dental Sleep Medicine
The impact of tongue and position of the mandible on patency of airway has been a known fact in medical circles. However, in the past 25 years, studies in dental sleep medicine have emerged as a major stakeholder in this field and proven the efficacy of tongue stabilizing devices.
Dentists have started taking interest in the role of the oral cavity and its health in a better sleep cycle and quality of life. This has led to the endorsement of the tongue retaining device as an important conservative therapy to prevent obstructive sleep apnea.
# 3: It Is Backed by Research
Evidence-based medicine also points towards the efficacy and safety of TRD. One study shows that the efficacy of TRD is “quite good”. A total of 77% of the population using TRD reported a positive impact on their sleep.
A Misconception about TRD
There’s one common misconception that needs to be cleared.
Some people propagate that thick material of the retainer and its complex design (both your dentures covers and a huge tongue holder in front) can make it difficult to inhale air. This idea is entirely misplaced and neither takes into account the sophistication of its design nor human anatomy.
First, you can breathe through your nose if you don’t feel comfortable breathing through the mouth while wearing it.
Second, there are two lateral holes present in the mouthpiece solely to create ease in mouth breathing. Therefore, this claim does not stand a chance against the efficacy of oral devices.
People Who Can Benefit From Tongue Retainer Device
The tongue retainer is only beneficial for people who snore because of tongue fall.
However, tongue falling is not the only reason for airway obstruction. It may be due to:
- Macroglossia (bulky tongue)
- Elongated soft palate
- Enlarged tonsils
- Poor positioning or anatomy of mandible
- Soft tissue abnormalities
Since tongue retainer works on the principle of positioning tongue, it cannot help people with obstructive sleep apnea due to these conditions. If you have one of these problems, you should consult your doctor for appropriate surgical management.
Pros of Tongue Retaining Device
A few qualities set tongue retainers apart from many treatment options available.
- It is superior to surgical treatment
Although surgery is still the treatment of choice for some structural abnormalities that lead to snoring, tongue retaining has come as a lifesaver.
- It is conservative and less invasive than a surgery
- It is cost-effective
- It does not involve wound healing so, appropriate for diabetics
- It is personalized according to denture
If you like products that are customized especially for you, opt for a tongue retainer device.
It is specifically designed according to the oral structure of individuals and has a personal touch to it. Moreover, you hardly face fitting problems; hence, there are lesser chances of injuries to gingival tissue.
- The fitting is adjustable
The mandibular protrusion distance is adjustable and can be fitted according to your comfort and severity of the disease. If the results are not promising, you can reduce the distance to get more out of your device. Conversely, if your jaws feel tender, you can loosen it up slightly to make it more comfortable.
Cons of Using Tongue retaining Device
- It causes soreness
One of the biggest reasons many people often discontinue using tongue retainers is the discomfort due to the sensation of a foreign body. Not everyone is a fan of a plastic object being tucked into his mouth. Since you have to wear it the whole night, your tongue gets sore due to being sucked in a bulb for hours.
The negative pressure also causes pain in the tongue because its suction effect is a bit too potent for some people.
- It leads to dry mouth
TRD also causes dryness of mouth and it is mostly attributed to ineffective lip seal while wearing the retainer.
Some studies recommend that decreasing the vertical thickness of the device can help manage this problem. Another way to prevent this is to encourage nasal breathing because breathing from mouth certainly aggravates it.
- It causes excessive salivation
You should be mindful of possible drooling before choosing this option. Hyper-salivation is also attributed to the inability to seal the lips effectively. It is often tolerable and you get used to it in a few days.
However, in severe cases, experts recommend adding an oral shield with the device to reduce the seepage of saliva.
- It may lead to dental changes
The prolonged use of tongue retainer devices can lead to changes in dental structures. It may alter the angulation and positioning of maxillary as well as mandibular incisors. However, the chances are negligible and only documented in long-term usage.
Contraindications of Tongue Retaining Device
You cannot expect a treatment to work for everyone equally. Each person has a different reason for his snoring problem.
Some conditions in which TRD does not work are enlisted below:
#1: An Incomplete Denture
Tongue retainers need support to get fixed and that support is provided by teeth in your oral cavity. Since dental arches need to be retained, those who have incomplete denture cannot use these devices.
Australia has excellent dental health standards but old age people are often prone to this condition.
A study shows that if your dental arches have less than 10 teeth per arch, TRD is contraindicated.
# 2: Nasal Obstructions
While using TRD, you rely mostly on nose breathing. Mouth breathing is possible through lateral holes but you cannot always count on it to be enough. Hence, tongue retaining device is relatively contraindicated in Grade 1 nasal obstruction and forbidden for Grade 2 nasal obstruction.
Nasal obstruction involves conditions like deviated septum and nasal polyps etc. You are advised to consult your ENT doctor about the use of tongue retainer if you have one of these problems.
# 3: Oral Diseases
If your oral cavity is in poor health, you should not use a retaining device. It can aggravate conditions like oral thrush and gingivitis (inflammation of gums), causing severe pain.
# 4: Age More Than 60 Years
Old age people cannot tolerate TRD because their oral tissue is often in poor health and cannot withstand negative pressure.
The research also shows that protrusion distance of 7mm or less in retainer shows no efficacy in people older than 60 years. A larger protrusion distance may work but the effectiveness is not well-documented.
The Cost and Availability in Australia
The price of tongue retainers varies depending upon the brand and the place of purchase. It may cost you as low as $30 because it is largely a cost-effective product.
It is also readily available in Australia so, availability is a non-issue.
You should invest in a reasonably priced yet durable tongue retainer though. It is meant to stay in your mouth all night long; hence, poor quality or ill-fitted retainer can cause more damage than good. An ideal retainer is the one that has been designed according to your denture. It might cost you slightly more amount than usual but the quality will be guaranteed.
What Other Options Do you Have?
Apart from Tongue retainers, you can choose CPAP or mandibular advancement devices.
It is worth mentioning that CPAP is considered the first line treatment for sleep apnea. It creates a positive pressure in the airway and keeps it spacious and intact. TRD comes as a second preference but considering the size, invasive nature and poor aesthetics of CPAP, people prefer tongue retaining devices.
You can also opt for a mandibular advancement device (MAD) as it is considered superior to TRDs in terms of efficacy. However, the tongue retaining device is easier to use as compared to MAD.
The Final Verdict
It is a fact that snoring can compromise your well-being but there are viable treatment options at your disposal. Although CPAP and MAD have some superior features, the tongue retaining device has its own set of benefits.
There is also sufficient scientific evidence that the tongue retainer device helps people with sleep troubles. In the end, the choice lies with you but you cannot deny the fact that tongue retaining devices have promising results.