Anti-Snoring Mouthpieces: Boil-and-Bite vs. Custom, and the Sleep Apnea Question

Snoring often starts or gets louder in midlife, and a partner’s elbow at 2 a.m. can send you shopping. Mouthpieces that hold the lower jaw forward are sold online and in drugstores, usually as “boil-and-bite” devices you mold at home. Here is what sleep and dental specialists recommend.

First, the sleep apnea question

Snoring can be harmless, or it can be a sign of obstructive sleep apnea, where breathing repeatedly stops or becomes shallow during sleep. The 2015 guideline from the American Academy of Sleep Medicine and the American Academy of Dental Sleep Medicine separates the two:

• For primary snoring without sleep apnea, it recommends that sleep physicians prescribe oral appliances rather than no treatment for adults who want it.¹
• For sleep apnea, oral appliances are an option for people who can’t tolerate CPAP or prefer another treatment, with follow-up sleep testing to confirm the device is working.¹

A store-bought mouthpiece can quiet the snore without fixing apnea. Our guides to why you snore and sleep apnea without snoring explain why women’s apnea is often missed.

Boil-and-bite vs. custom

	Boil-and-bite	Custom
How it’s made	Mostly prefabricated, softened and molded at home1	Made from impressions or scans of your teeth1
Adjustable	Often limited	Can be titrated (moved forward gradually)
Guideline view for apnea	Not preferred	Recommended over non-custom devices1

The guideline suggests that for sleep apnea, a qualified dentist should use a custom, adjustable appliance rather than a non-custom device.¹ It found insufficient evidence for tongue-retaining devices, which hold the tongue forward instead of the jaw.¹

Side effects to watch for

Moving the jaw forward every night can cause problems. The guideline describes jaw joint (TMJ) pain, gum irritation, sore jaw muscles and changes in how your teeth fit together, and recommends dental follow-up to catch them.¹ Jaw joint disorders were a common reason oral appliances weren’t a good fit.¹

If you have crowns, implants, dentures, loose teeth or gum disease, ask your dentist before trying any mouthpiece.

Before you buy

1. Get screened for sleep apnea if you have gasping, choking, pauses in breathing, morning headaches or daytime sleepiness.
2. Ask your dentist whether your teeth and jaw can handle a mouthpiece.
3. Stop if you get jaw pain or your bite feels different in the morning.
4. Follow up. If you use a device for apnea, a repeat sleep test can confirm it’s working.¹ Our article on oral appliance follow-up covers what to ask.

Try: “My partner says I snore loudly and sometimes stop breathing. Should I have a sleep test before trying a mouthpiece, and would a custom one be better for me?”

Did I Do That in My Sleep? includes a 14-Night Lights-Out Record and a Visit Brief. Use them to note snoring reports, waking and daytime sleepiness, and bring them to your appointment. See the book.