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Mouth Devices for Snoring and Sleep Apnoea

A device worn over your teeth at night can hold your lower jaw forward and help with snoring and some sleep apnoea. Here is who it suits, how it compares with CPAP, and what to watch for.

Updated September 2026·By the OHA editorial team·8 min read·How we write
Key takeaways
  • Obstructive sleep apnoea (OSA) is when your airway narrows or closes while you sleep, so your breathing stops and starts. It needs a diagnosis from a doctor, usually with a sleep study.
  • A mandibular advancement device is worn over your teeth at night and holds your lower jaw forward to leave more space at the back of the mouth.
  • In the UK, NICE says CPAP (a machine that blows air through a mask) should be offered for moderate or severe OSA, and a custom or semi-custom mouth device considered for adults who cannot tolerate CPAP or decide not to try it.
  • Devices made and fitted by a dentist are generally preferred to shop-bought "boil and bite" devices, although NICE says the evidence on which type is best is unclear.
  • Side effects include jaw and tooth soreness, saliva changes and slow changes to your bite, so dental follow-up matters.

The NHS says snoring is very common and not usually serious. But loud snoring can be a sign of obstructive sleep apnoea (OSA), which needs treating. A mouth device, most often a mandibular advancement device (the mandible is the lower jaw), is one treatment.

What is obstructive sleep apnoea?

NICE describes OSA as a condition in which the upper airway narrows or closes during sleep when the muscles relax, causing shallow breathing (hypopnoea) or stopped breathing (apnoea).

The NHS lists gasping or choking noises, waking a lot and loud snoring, with tiredness and morning headaches during the day. Without treatment, it says sleep apnoea can lead to high blood pressure, stroke, type 2 diabetes, heart disease and accidents caused by tiredness.

Why you need a diagnosis first

Snoring and sleep apnoea are not the same thing. The American Dental Association (ADA) says snoring is not always present in OSA, and people who snore may have normal sleep study results. The NHS advises seeing a GP if you snore and also feel sleepy during the day, or your breathing stops and starts. The GP may refer you for a sleep study, usually done at home.

The test gives an apnoea–hypopnoea index (AHI): how often per hour your breathing stops or becomes shallow. The NHS grades 5 to 14 as mild, 15 to 30 as moderate and over 30 as severe.

The US Food and Drug Administration (FDA) says these devices are not for central sleep apnoea, where, as healthdirect Australia explains, the pauses come from the brain's drive to breathe rather than a blocked airway. The ADA says doctors and sleep specialists diagnose and manage OSA, and dentists who spot signs should refer patients to one.

What is a mandibular advancement device?

NICE describes it as a device worn over the upper and lower teeth that holds the lower jaw forward, increasing the space at the back of the mouth and reducing snoring and sleep apnoea. The NHS calls it a device like a gum shield. The Better Health Channel (Victoria) says it needs to be worn whenever you sleep.

It is not the same as a night guard for teeth grinding or a sports mouthguard, which protect the teeth rather than move the jaw.

Who might a device suit?

NICE says to consider a custom or semi-custom device for people with moderate or severe OSA, or mild OSA that affects their daily activities, who cannot tolerate CPAP or decline to try it. They should be 18 or over and have optimal dental and gum health. The ADA and the Better Health Channel describe devices mainly for mild to moderate OSA, and the ADA adds severe OSA when CPAP is not tolerated.

A device may not suit you if you:

  • are under 18. NICE says it may affect how the teeth develop.
  • have loose teeth, advanced gum disease or untreated tooth decay (FDA, NICE)
  • have few or no teeth. NICE says this needs experienced specialist care. See dentures.
  • have arthritis or pain in the jaw joint. A Sherwood Forest Hospitals NHS Foundation Trust leaflet says devices are not suitable for this. See jaw pain.

How does it compare with CPAP?

CPAP (continuous positive airway pressure) gently pumps air into a mask over your nose, or nose and mouth, while you sleep. The NHS says many people need one and it is free on the NHS if you do. The Better Health Channel calls CPAP the most effective treatment available, but the ADA notes many people find it hard to keep using. NICE found that in studies of moderate OSA, people rated mouth devices easier to use than CPAP and preferred them. CPAP came out slightly more cost effective, but NICE judged the difference small. It found no evidence for severe OSA and based its advice there on moderate OSA.

Dentist-made or shop-bought?

A Sherwood Forest Hospitals leaflet and NICE describe three types:

  1. Ready-made ("boil and bite"), sold online and in some pharmacies, which you soften in hot water and mould yourself. The leaflet says these are the cheapest, but may fit less well and be the least effective.
  2. Semi-custom, where you take moulds of your own teeth and post them to the maker. These cost more, and the leaflet says trials suggest they fit better.
  3. Custom, made from moulds taken by a dentist and fitted by a trained dentist. The leaflet says these should fit best and be most comfortable, but are the most expensive.

NICE says the evidence on the best type is unclear, with very little for ready-made devices. From experience, its committee judged dentist-made devices better: more durable and preferred by patients. The ADA says sleep medicine guidelines recommend a custom, adjustable device. In the US, Medicare refuses cover for ready-made devices, saying there is not enough evidence they work for OSA.

What are the side effects?

A Queen Victoria Hospital NHS Foundation Trust leaflet and the FDA list:

  • tender face muscles, jaw joints, gums or teeth
  • a change in your bite, or teeth that move or feel slightly loose
  • too much or too little saliva
  • snoring or apnoea symptoms that do not go away

The ADA links long-term use with gradual changes in how the teeth meet. It says a device can be adjusted to help you avoid mouth breathing, which can cause a dry mouth.

What follow-up should you expect?

The sources give different timings. NICE says to review the fit and your symptoms at 3 months, then as needed, checking side effects and your bite. It says devices need replacing at regular intervals. The US National Heart, Lung, and Blood Institute (NHLBI) says you may need to see your dentist after 6 months, then yearly. The ADA says dentists should check the device at least once a year, and a doctor should repeat sleep testing to confirm it works, especially if symptoms return.

Keep up dental check-ups: the Queen Victoria Hospital leaflet says you need healthy teeth and gums for a device.

Availability and cost

  • UK: NICE says NHS provision of dental services that make these devices is limited. The Queen Victoria Hospital leaflet says snoring alone, without diagnosed sleep apnoea, is not eligible for NHS treatment, and its waiting list is likely to be a few months. Not all dentists make custom devices, the Sherwood Forest leaflet says, but yours should be able to refer you. See dental costs and help.
  • Australia: healthdirect and the Better Health Channel describe the device as fitted by a dentist but do not give costs. Ask your dentist what the fee includes.
  • US: Medicare covers a custom device for OSA only if set conditions are met, including a qualifying sleep test, an order from a treating practitioner, and supply by a licensed dentist.
Sleepiness and driving
  • UK: GOV.UK says you must tell the DVLA if you have confirmed moderate or severe OSA with excessive sleepiness, or another sleep condition, including suspected mild OSA, that has caused excessive sleepiness for at least 3 months. Do not drive until the sleepiness is under control and you are following treatment.
  • Australia: the national Austroads standards say a person with sleep apnoea plus moderate to severe daytime sleepiness, frequent sleepiness while driving, or a crash caused by sleepiness is not fit to hold an unconditional licence. A conditional licence may be possible if treatment is followed and working.
  • US: NHLBI advises not driving if you feel tired or sleepy.
When to see a doctor or dentist
  • You snore and feel very tired during the day, or someone has seen your breathing stop and start while you sleep: see a GP before buying a device (NHS).
  • Contact the dentist or clinic that supplied your device if jaw pain, bite changes or saliva problems do not settle, as the Queen Victoria Hospital leaflet advises.
  • See your doctor if snoring, gasping or daytime sleepiness comes back while you use a device (ADA).

Frequently asked questions

Can I just buy an anti-snoring mouthpiece?

NICE says there is very little evidence for ready-made devices in sleep apnoea. If you have signs of sleep apnoea, see a GP first.

Will a mouth device cure my sleep apnoea?

It treats the problem while you wear it, so the ADA and the Better Health Channel say to wear it every time you sleep. NICE says treatment may be reviewed if sleep apnoea may have gone, for example after major weight loss.

Can children use these devices?

No. NICE says they are not suitable for under-18s. healthdirect says sleep apnoea in children is usually caused by large tonsils or adenoids. See mouth breathing and children's teeth.

Sources

  1. Sleep apnoea, NHS, accessed September 2026
  2. Snoring, NHS, accessed September 2026
  3. Obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s (NG202): recommendations, NICE, accessed September 2026
  4. NG202: rationale and impact, NICE, accessed September 2026
  5. NG202: terms used in this guideline, NICE, accessed September 2026
  6. Mandibular advancement device (MAD), Sherwood Forest Hospitals NHS Foundation Trust, accessed September 2026
  7. Mandibular advancement appliances for snoring and obstructive sleep apnoea, Queen Victoria Hospital NHS Foundation Trust, accessed September 2026
  8. Excessive sleepiness and driving, GOV.UK (DVLA), accessed September 2026
  9. Obstructive sleep apnoea, healthdirect Australia, accessed September 2026
  10. Sleep apnoea, Better Health Channel (Victoria), accessed September 2026
  11. Assessing Fitness to Drive: sleep disorders, medical standards for licensing, Austroads, accessed September 2026
  12. Sleep apnea: living with, NIH National Heart, Lung, and Blood Institute, accessed September 2026
  13. Sleep apnea (obstructive), American Dental Association, accessed September 2026
  14. The role of dentistry in the treatment of sleep related breathing disorders, American Dental Association policy, accessed September 2026
  15. Intraoral devices for snoring and/or obstructive sleep apnea: class II special controls guidance, US Food and Drug Administration, accessed September 2026
  16. Oral appliances for obstructive sleep apnea (L33611), Centers for Medicare and Medicaid Services, accessed September 2026

This article is general information about oral health. It is not a diagnosis or a substitute for advice from a dentist or doctor who knows your situation. If you have pain, swelling, bleeding that does not settle, or a problem that is getting worse, see a dental professional. In an emergency, contact your local emergency service.

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