A Detailed Look Into Tongue Retaining Device

Tongue Retaining Device

What are Tongue Retaining Devices?

Tongue retaining devices (TRDs) are dental appliances used to help position the tongue forward in the mouth during sleep. They are sometimes recommended for people who have obstructive sleep apnea (OSA) or snoring issues caused by the tongue falling back in the mouth and obstructing the airway. TRDs work by holding the tongue slightly protruded from the mouth, opening up the airway.

How do they work?

Tongue Retaining Device work in a similar way to other oral appliances used to treat sleep disordered breathing like mandibular advancement devices (MADs). They function by physically altering the patient's airway anatomy during sleep. When awake, muscles in the tongue and soft palate help keep the airway open. But during sleep, these muscles relax which can cause the tongue and soft palate tissues to collapse and obstruct breathing.

TRDs work to prevent this collapse by holding the tongue protruded and out of the way of the airway. The most common design is made of soft, flexible plastic that wraps around the sides and underside of the tongue. Straps or elastic bands hold it firmly in place throughout the night. This new tongue position helps keep the airway clear and open for unobstructed breathing.

Assessing Candidacy for a TRD

Not everyone is a good candidate for a TRD. Dentists and sleep physicians must carefully evaluate each patient's specific sleep disordered breathing symptoms and oral anatomy before recommending a TRD. In general, the best candidates tend to be:

- Patients with mild to moderate OSA or snoring caused primarily by the tongue falling back during sleep. TRDs work best when this is the main obstruction site.

- Those who cannot tolerate CPAP therapy or prefer an oral appliance over it. TRDs provide an alternative non-surgical treatment option.

- Individuals whose tongue is of average size or smaller. A very large tongue may not be fully controlled by current TRD designs.

- Good dental health with few missing or diseased teeth is ideal for a custom-fitted oral device to work properly.

Rules out include very severe OSA, obesity, pregnancy, and macroglossia - an abnormally large tongue. In such cases, other treatments may have greater success at sufficiently resolving breathing issues.

Advantages of TRDs

When fitted and used correctly, TRDs can provide several potential benefits compared to other sleep apnea therapies:

- Non-invasive and comfortable - No tubes, masks or surgery are required which some patients find less irritating than other options.

- Portable - Unlike CPAP, TRDs do not use any bulky equipment so sleepers can easily use them when traveling.

- Low cost - On average, TRDs have similar or lower initial and ongoing costs compared to CPAP machines and maintenance.

- Quick effect - Most notice reduced snoring and improved breathing soon after the first night's use. Some experience relief of OSA symptoms within just a few weeks.

- Oral habituation - Wearing a TRD trains the tongue to maintain a healthier sleep position naturally over time in many cases.

- Treatment for coexisting snoring - TRDs directly address snoring caused by the tongue, which CPAP does not treat on its own.

Drawbacks of Tongue Retaining Devices

However, like any sleep apnea therapy, TRDs also present some potential disadvantages:

- Complaints of tongue soreness - The pressure on the tongue from a TRD can cause temporary discomfort for some users as they adjust.

- Dry mouth - Holding the tongue forward may contribute to drying of the mouth during sleep. Bi-level oral devices are designed to be less drying.

- Improper fit issues - TRDs require precise custom fitting by a dentist or sleep doctor to work effectively. An ill-fitting device could exacerbate apnea or cause pain.

- Inability to fully resolve OSA - More severe cases may only see partial reductions in apnea events and may still need CPAP or other adjunctive therapies.

- Limited long-term compliance data - Long-term adherence rates with TRDs have not been as well-studied as CPAP. Devices frequently need refitting as dentition changes over years of use.

So in summary, TRDs offer a comfortable, low-cost alternative treatment for mild-moderate sleep apnea, especially in those who cannot tolerate CPAP. However, their effectiveness depends highly on the individual's specific symptoms and correct fitting of the device by a trained professional.

Other Considerations with Tongue Retaining Devices

It is always best to consult with a board-certified sleep physician when considering treatment with a TRD. Here are some other factors to keep in mind:

- Initial polysomnogram - A sleep study is needed before and sometimes after starting a TRD to establish a OSA diagnosis, severity, and measure therapy effectiveness objectively.

- Dental examination - A dentist should evaluate dental health, jaw alignment, bite, and tongue size and shape before any oral appliance therapy.

- TRD fitting - Having a qualified dentist custom-make and fit the TRD specifically based on dental impressions and measurements helps ensure proper function and comfort.

- Follow-up visits - Sleep physicians recommend periodic re-evaluations, especially in the first few months of TRD use, to monitor adherence, side effects, and run further sleep tests if needed.

- Combination therapies - TRDs are sometimes combined with other options like weight loss counseling, positional therapy, or CPAP for mild residual events to maximize OSA resolution.

- Alternatives for failure - Options like upper airway surgery should be discussed in advance for patients who fail or cannot adapt to wearing a TRD long-term.

Overall, TRDs represent a valuable non-surgical option for managing tongue-related sleep disordered breathing issues when used appropriately under medical guidance on suitable patients. Adherence to proper protocol helps optimize outcomes with this oral device therapy.

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Ravina Pandya, Content Writer, has a strong foothold in the market research industry. She specializes in writing well-researched articles from different industries, including food and beverages, information and technology, healthcare, chemical and materials, etc. (https://www.linkedin.com/in/ravina-pandya-1a3984191)