If you are looking for an anti snoring device, you may come across two types of oral appliances: a tongue retaining device (TRD) and a mandibular advancement device (MAD), also known as a jaw advancement device.
Both are designed to help keep the upper airway open during sleep, but they work in different ways. A TRD holds the tongue forward, while a MAD moves the lower jaw forward, which also helps reposition the tongue and surrounding airway tissues.
So, which should you consider for snoring? The answer depends on your teeth, jaw, airway, comfort preferences and whether you have been assessed for an underlying sleep disorder.
What is a tongue retaining device?
A tongue retaining device, sometimes called a tongue stabilising device, is an oral appliance designed to hold the tongue in a forward position while you sleep.
Unlike a conventional mouthpiece for snoring, a TRD does not attach to the teeth or move the jaw. Instead, it typically uses a soft chamber or bulb that holds the tip of the tongue through gentle suction.
The idea is straightforward. During sleep, the muscles of the tongue and upper airway relax. For some people, the tongue can move backwards and contribute to airway narrowing and snoring. A tongue retaining device for snoring holds the tongue forward, helping to prevent it from moving towards the back of the throat.
Research has found that tongue-retaining devices can reduce snoring and some measures of sleep-disordered breathing. However, studies comparing them directly with mandibular advancement splints have found differences in response and user preference.
What are the limitations of a tongue retainer?
A tongue retaining device (TRD) may be useful for some people, particularly when an appliance that places pressure on the teeth or moves the jaw is unsuitable.
However, it can take time to become accustomed to having the tongue held forward. Some users may experience tongue tenderness, increased salivation or difficulty maintaining the suction.
Because the appliance relies on holding the tongue forward and generally occupies the front of the mouth, nasal breathing can also be an important consideration. A blocked nose from a cold or allergies may make an appliance that relies on comfortable nasal breathing less practical.
What is a mandibular advancement device?
A mandibular advancement device, or MAD, is another type of oral appliance used for snoring. It is also commonly called a mandibular advancement splint, jaw advancement device or jaw advancing device.
Rather than holding the tongue directly, a MAD fits over the upper and lower teeth and positions the lower jaw slightly forward while you sleep.
This is where the term mandibular advancement device jaw forward comes from. “Mandibular” refers to the lower jaw, while “advancement” refers to positioning it forward.
Moving the lower jaw forward can also move the tongue and associated soft tissues forward, helping create more space in the upper airway. Mandibular advancement appliances have been studied for both snoring and mild to moderate obstructive sleep apnoea.
Tongue retainer vs jaw advancement device
The simplest way to understand the difference is:
| Tongue Retaining Device | Mandibular Advancement Device | |
| How it works | Holds the tongue forward using suction | Positions the lower jaw forward |
| Teeth required | No | Usually requires suitable teeth for retention |
| Jaw movement | Does not move the jaw | Moves or holds the lower jaw forward |
| Tongue position | Directly holds the tongue forward | Moves the jaw and indirectly helps reposition the tongue |
| Main consideration | Tongue comfort and maintaining suction | Dental, jaw and appliance comfort |
| Common terminology | TRD, tongue retainer, tongue stabilising device | MAD, mandibular advancement splint, jaw advancement device |
A direct randomised crossover study involving 27 people with obstructive sleep apnoea found that both mandibular advancement splints and tongue-stabilising devices reduced the apnea-hypopnea index. The study reported a higher response rate and better compliance with the mandibular advancement splint, and 91% of participants preferred it when given the choice.
That does not mean every person will find a MAD more comfortable or suitable. Oral appliance choice needs to take individual dental and jaw considerations into account.
Which is better for snoring, a tongue retainer or a jaw advancement device?
There is no single anti snore tongue retainer or snore mouth guard that is right for everyone.
For adults experiencing primary snoring, oral appliances such as mandibular advancement splints are an established option in Australia. The Sleep Health Foundation notes that these appliances can help reduce snoring by positioning the lower jaw forward and widening the upper airway. Oral appliances may also be considered for people with mild to moderate obstructive sleep apnoea (OSA) following appropriate assessment by a healthcare professional. Because persistent snoring can sometimes be a sign of sleep apnoea, Australians with ongoing or disruptive snoring should speak with their GP or a qualified healthcare professional about whether further assessment is appropriate.
For a person with suitable teeth and jaw health, a MAD provides a different approach from a TRD because it advances the lower jaw rather than directly holding the tongue. Research comparing the two has demonstrated benefits from both approaches, while also identifying differences in compliance and patient preference.
For someone with significant tooth loss, dentures or certain dental conditions, a tooth-retained appliance may not be appropriate. Conversely, people with existing jaw problems may need professional advice before using an appliance that advances the lower jaw.
Where does SnoreMD fit?
SnoreMD is a mandibular advancement device.
It is therefore part of the jaw advancement category rather than the tongue-retaining category. SnoreMD is designed to fit over the upper and lower teeth and use adjustable advancement to position the lower jaw forward during sleep.
This makes SnoreMD different from a tongue retaining device snoring appliance, which uses suction to hold the tongue forward.
Understanding how each appliance works can help you decide whether a mandibular advancement device is worth discussing with your healthcare or dental professional.
What should you consider when choosing between a tongue retainer and MAD?
Consider:
Your dental situation: A MAD relies on suitable teeth for retention, while a TRD does not attach to the teeth.
Your jaw health: If you experience ongoing jaw pain, clicking or other temporomandibular joint concerns, discuss jaw advancement with a qualified healthcare or dental professional.
Your comfort: A TRD and MAD feel very different in the mouth. Personal tolerance can influence whether you can use an appliance consistently.
Your breathing: Consider whether you can comfortably breathe through your nose while sleeping, particularly if you regularly experience nasal congestion.
The cause of your snoring: Snoring can have several contributing factors. An oral appliance may not address every cause of snoring.
Whether sleep apnoea is possible: Loud or persistent snoring can occur with obstructive sleep apnoea. If you have symptoms such as witnessed breathing pauses, gasping during sleep or significant daytime sleepiness, speak with a healthcare professional about appropriate assessment rather than relying on an anti snoring device alone.
Do tongue retaining devices work?
Yes, research shows that tongue retaining devices can reduce snoring and improve some measures of sleep-disordered breathing in selected people. However, they are not interchangeable with mandibular advancement devices.
The two appliances use different mechanisms, and studies comparing them have reported different levels of response, compliance and preference.
If you are comparing a tongue retainer with a jaw advancement device, the most useful question is not simply which device is “best”, but which type is appropriate for your individual circumstances and comfortable enough to use consistently.
Considering a mandibular advancement device for snoring?
If you are looking for an oral appliance to help reduce primary snoring, SnoreMD is a mandibular advancement device that works by gently positioning the lower jaw forward during sleep. Its adjustable design allows the level of advancement to be tailored to the individual.
For adults with diagnosed mild to moderate obstructive sleep apnoea, mandibular advancement devices may also be considered following appropriate assessment by a qualified healthcare professional.
Medical disclaimer: This article provides general information about snoring and oral appliances and is not intended to diagnose, treat or prevent any medical condition. Snoring can be associated with obstructive sleep apnoea and other sleep or airway conditions. If you have persistent or disruptive snoring, witnessed breathing pauses, choking or gasping during sleep, or excessive daytime sleepiness, speak with your GP or another qualified healthcare professional. If you have been diagnosed with obstructive sleep apnoea, discuss appropriate treatment options with your healthcare team before using an oral appliance.
