Sleep apnea and other health conditions can often be alleviated through the use of oral appliances like a tongue crib. If your doctor or dentist has recommended a tongue crib, you likely have questions about what it is, how it works, what to expect and more.
What is a Tongue Crib?
A tongue crib, also sometimes called a tongue cage, is an oral medical device customized to fit your mouth. It has metal bars that go between your front teeth and push your tongue forward to prevent it from blocking your airway when you sleep or breathe.
Tongue cribs work by holding your tongue in place so it does not relax into the back of your throat. This prevents your tongue from acting as an obstruction when you breathe or snore. It changes your airway size and shape to allow better airflow.
What Conditions Can a Tongue Crib Treat?
There are several health conditions that can benefit from the use of a tongue crib:
Sleep Apnea
The most common reason for using a tongue crib is to treat obstructive sleep apnea (OSA). Sleep apnea occurs when the muscles in the back of your throat relax, causing your airway to narrow or collapse as you breathe. These blockages reduce blood oxygen levels and interrupt sleep.
By holding your tongue forward, a tongue crib can effectively treat OSA in many patients by preventing the tongue from obstructing breathing. This helps keep the airway open for more normal breathing during sleep.
Snoring
Like apnea, snoring is also caused by narrowing of the airway tissues. As air squeezes through the narrowed air passages, it vibrates the tissue to generate the loud snoring noises.
A tongue crib works to eliminate this narrowing and allow smoother airflow, significantly reducing or stopping snoring. It is an effective anti-snoring treatment and provides relief for partners.
Speech Issues
For some people with speech disorders, a tongue crib can help improve pronunciation of certain sounds like R, S, T and D. It positions the tongue properly so it can better make appropriate contact points required for clear speech.
Teeth Grinding and Clenching
Nocturnal teeth grinding (bruxism) and clenching can also be reduced through tongue crib use. It prevents the excessive tooth contacts that often stimulate these damaging oral habits. Less grinding helps prevent tooth damage, jaw pain and headaches.
Who is a Candidate for a Tongue Crib?
If you have been diagnosed with conditions like sleep apnea, snoring, speech disorders or teeth grinding, your dentist or doctor may have discussed treatment with an oral appliance like a tongue crib.
You are likely a good candidate for a tongue crib if you:
- Have mild to moderate sleep apnea
- Want to avoid CPAP machines or surgery
- Snore loudly on a regular basis
- Have tried other anti-snoring treatments unsuccessfully
- Grind or clench your teeth frequently
- Have certain speech impediments like lisps
Women may also benefit during pregnancy when weight gain and hormonal changes make sleep apnea or snoring issues worse. Custom tongue cribs provide non-invasive, medication-free relief.
How Do Tongue Cribs Work?
Tongue cribs have a simple but clever mechanism to improve conditions like sleep apnea. Custom-made to fit your mouth by taking dental impressions, a tongue crib uses metal bars to hold your tongue forward in position.
When you relax and sleep, the tongue naturally falls backward due to gravity. It rests along the soft tissue in back of the mouth and throat. For susceptible people, this starts to narrow or block the airway with each breath.
The metal framework on a tongue crib provides a stable shelf-like surface for your tongue to rest on instead. This structural barrier prevents the tongue from collapsing the air passage in the throat by holding it up and forward.
This forward adjustment of the tongue’s placement facilitates improved airflow through non-obstructed breathing. By changing the alignment of oral structures, it creates more open space for air to pass during sleep or while awake.
What Are Tongue Cribs Made Of?
Custom-fitted tongue cribs require molding and dental work specific to your mouth. An orthodontist or other specialist takes impressions of your teeth to make a replica plaster model.
On this prototype, they assemble and craft metal wires or bars in the exact shape needed. The full custom tongue crib device is then transferred accurately into your mouth using the modeled shape.
Most tongue cribs use medical-grade stainless steel for the wire framework and brackets. Quality materials ensure the device is non-toxic, durable for nightly wear and less likely to cause irritation inside the mouth.
Some versions also use acrylic plastic bases or connectors between the wire bars for stability and reduced discomfort. Newer designs may also incorporate gentle vibration motors to keep the airway more actively open.
What Does The Tongue Crib Procedure Involve?
Getting fitted with a custom tongue crib takes 2-3 dental visits to complete the process comfortably:
- First visit: Molds are taken of your upper and lower teeth to create plaster models. Measurements ensure proper size and shape.
- Second visit: The custom tongue crib framework is tested and adjusted in your mouth to optimize the fit and function. Minor adhesive bands to teeth may also be added to secure it’s place.
- Final visit: Once aligned in the optimal position to move your tongue forward adequately, the tongue crib is permanently cemented into place on your teeth. Specific wearing instructions are provided.
Tongue crib placement is pain-free, with no drilling or alteration to tooth surfaces. Some people experience a short adjustment period as the tongue gets used to being repositioned forward between the crib’s metal bars.
How is Tongue Position Monitored and Managed?
One of the adjustments tongue crib wearers need to get accustomed to is the changed position of their tongue. It now rests touching the metal frame regularly.
Your doctor will monitor any speech changes and ability to keep the tongue properly positioned forward during follow-up visits after you begin wearing the appliance full-time.
Minor adjustments can be made by slightly bending the crib wires to re-position the tongue if needed. As you become consistent wearing the appliance at night, keeping your tongue resting forward should become second nature.
During the day if the tongue crib is not worn, remember to actively keep your tongue placed forward as much as possible. This trains the muscles to maintain better alignment on their own over time.
What is the Ideal Tongue Crib Position?
Proper tongue crib positioning is critical for enabling opened airflow and results. Your orthodontist or sleep professional will use several criteria to optimize it’s placement:
- Between front 6 teeth – Spanning the visible upper and lower teeth distributes pressure evenly and allows total tongue control.
- 1/2 inch behind teeth – This placement clears the sensitive gum line to avoid irritation while still adequately holding the tongue forward.
- 45-degree wire angle – The forward-angled framework allows the tongue to rest more naturally with it’s new positioning.
- 2-3 mm space between wires – Adequate spacing between the upper and lower framework bars gives needed tongue clearance while preventing it from slipping backward.
As you wear it, the tongue crib should feel snug without impinging movement or causing discomfort from rubbing or pressure points within the mouth.
How Should a Tongue Crib Fit? What Does it Feel Like?
When properly fitted by an experienced dentist or orthodontist, wearing a custom tongue crib soon begins to feel relatively natural and normal.
It fits closely around the contours of your teeth, keeping it stable and fixed in position inside the mouth. The slim metal bars allow you to close your lips and jaws completely to swallow, speak, drink, etc, with minimal intrusion.
The tongue generally has the most noticeable sensation when first adjusting to resting on the shelf-like crib structure. Any feelings of gagging or impediments to tongue movement diminish within days or weeks of consistent day and night usage.
As it begins to feel like a standard fixture in your mouth, you should not notice it except for a general awareness of your tongue being maintained in a more forward resting posture. This desired positioning enables improved breathing capacity.
What is the Break-in Period for a New Tongue Crib?
When beginning to wear any type of oral appliance like a tongue crib, allow 1-4 weeks for an initial break-in adjustment phase. Each person adapts on their own timeline based on factors like:
- Current oral condition and health
- Level of sleep issues or other problems being treated
- Daily wear time consistency
- Level of motivation to tolerate minor discomforts initially
- General patience and willingness to adjust oral habits
Be diligently consistent about wearing your prescribed tongue crib hours during this period. Continuous day and night usage allows your tongue, jaw and brain to acclimate most quickly to the changed environment.
Stay in touch with your treating dentist during the break-in phase for check-ins. Be open about any problems or ongoing discomforts so adjustments can be made as needed for compatible comfort and effectiveness.
What Does it Feel Like to Talk with a Tongue Crib?
One of the key sensory changes when you begin wearing a new tongue crib all day is how it feels to talk. Adjusting speech to the changed tongue positioning takes patience and practice.
At first, it may seem awkward having your tongue constantly resting on the shelf-like crib structure instead of floating freely. Words can feel slightly mumbled or slurred behind your teeth.
Work to actively place your tongue tip on the ridge behind your top front teeth when talking, similar to normal speech. You essentially talk by moving the middle and back of your tongue up and down toward the palate rather than just the tip.
With consistent practice talking this way, speech soon becomes second nature again. Vowel sounds tend to need the most adjustments, while consonants are usually easier to articulate around the foreign fixture.
Does a Tongue Crib Affect Eating or Swallowing?
The bars of a properly fitted tongue crib are quite thin, with adequate space around them for food and saliva/liquid passage during meals. Most people experience only minimal impact to eating or swallowing once accustomed to the appliance.
Until the tongue gets conditioned to it’s new forward resting posture, larger bites of food or swallows of liquid can feel awkward passing over your tongue. Chew thoroughly and intentionally place your tongue tip to the roof of your mouth while you swallow to direct the food around the crib framework.
Be vigilant the first days and weeks about cleaning your tongue crib thoroughly after meals and before bed to prevent residue buildup. Don’t allow stuck particles to excessively impede space needed for swallowing efficiency around the metal bars.
Do You Have to Use Special Cleaning Tools?
Keeping oral appliances clean is essential for health and effective functioning in the moist environment of your mouth. For cleaning around and under the framework of your custom tongue crib, using certain specialized tools can help.
Interdental brushes come in slim handled sets with tiny brush heads to penetrate narrow spaces. These are excellent for scrubbing up close around each tongue crib wire to dislodge clinging debris.
A pointed plastic irrigator tip lets you direct an angled stream of water or mouthwash into nooks of oral devices. For tongue cribs, aim streams vigorously along the inner and outer surface of the metal bars and connectors.
Your dentist may also recommend an ultrasonic cleaning bath system allowed by some tongue crib manufacturers. The energized water agitation can refresh appliance surfaces and hidden surfaces from residue buildup.
Is There Soreness or Discomfort After Getting a Tongue Crib?
As your tongue and mouth tissues adjust to an unfamiliar fixture like a tongue crib, some mild tenderness, rubbing or pressure is common initially. Especially the first days and weeks, be attentive to any spots causing noticeable discomfort or irritation.
Use Orthodontic wax inside your mouth to temporarily cushion any rough metal edges rubbing the gums or sides of the tongue. You can also gently bite down on gauze for pressure points along the top or bottom bars.
Always inform your treating dentist about any ongoing irritation or sore areas so adjustments can be made. The crib wires may need slight bending to prevent tissue impingement while still maintaining adequate tongue control for open airflow.
Can You Remove a Tongue Crib When Needed?
Ideally, the goal with oral appliances like a tongue crib is consistent 24-hour usage – day and night. This trains your muscles fastest to the new orientation needed for keeping the airway actively open. Removing it frequently undermines results.
However, most tongue cribs are designed as removable devices if necessary for important functions like public speaking or playing sports with mouthguards. Some musicians or singers also take them out for performances then replace afterward.
Have your dentist show you proper placement and removal techniques to avoid damaging the wires. Limit removable periods to less than 1 hour at most. Then discipline yourself to immediately place it back into position for open breathing.
Does Insurance Cover Tongue Crib Treatment Costs?
Because a tongue crib is prescribed to treat specific diagnosed health conditions, many medical and dental insurance plans cover part or all of the costs. Check your insurance details to understand benefits for oral appliances.
Exact coverage varies greatly by insurer and region. But as tongue crib therapy gains support from more physicians for sleep apnea and related problems, more insurance companies now allow this as reimbursable treatment.
Submit the dental codes your doctor uses for tongue crib creation so claims are categorized properly in your policy for consideration. Appeal denials when needed if tongue crib therapy is deemed medically necessary for your documented health needs.
What Results Can You Expect From Using a Tongue Crib?
The level and pace of improvement from a tongue crib depends on your specific health issues being addressed and wearing consistency. But most see benefits in:
- Sleep apnea relief – Preventing the tongue from dropping into the airway prevents night breathing interruptions, low oxygen drops and sleep disruption.
- Less snoring – Tongue cribs ease airflow resistance and fluttering tissues which generate loud snoring vibrations during inhalation.
- Better sleep quality – As apnea and snoring episodes decrease with improved breathing, sleep becomes deeper and more restorative.
- More energy – Ample oxygen all night and uninterrupted sleep cycles mean waking with fewer headaches and more consistent positive energy.
- Clearer speech – Holding the tongue steady allows for better pronunciation and enunciation for patients with tongue-based speech issues.
Are Tongue Cribs Permanent or Temporary Treatments?
The framework of custom metal wires and braces cemented onto your teeth is designed for long-term durable use as a permanent fixture in your mouth. The wires may need occasional replacements from stress.
How long you actually NEED to wear your tongue crib each day and night varies individually based on health improvements and personal goals for treatment. Your sleep doctor can advise you on expected usage periods or indefinite nightly use if needed.
Some patients become less reliant on tongue crib therapy over time if diligent about doing daily tongue and throat exercises to build muscle tone preventing airway collapse. However, consistency is key for ongoing positive results.
Are There Risks With Tongue Crib Therapy?
There are a few notable risks to consider before committing to treatment with a custom tongue crib:
- Tooth alignment changes – The constant pressure from a tongue crib can over time minimally rotate or shift teeth. This may require some orthodontic correction.
- Mouth discomfort – Tongue cramping, soft tissue impingement and irritated gums are not uncommon during the break-in phase until adjustments are made.
- Permanence concern – Full removal later requires cutting off any dental cement bonds. And there may be uncertainties how retainer-free oral alignment will be afterward.
- Infection vulnerability – Poor cleaning could allow bacteria around the fixed wires and braces. Monitor your mouth closely and treat any unusual swelling promptly.
Discuss your concerns thoroughly with your treatment team. Get their guidance on added precautions you can take – like vigilant hygiene and dental checkups – to prevent any negative outcomes over the long run.
Finding the Right Specialist to Work With
The expertise and help of an experienced dentist, orthodontist or sleep professional are key to success with tongue crib sleep therapy. Ask your primary physician for referrals or contact local dentist academies and sleep associations for recognized providers.
Schedule thorough consultations about tongue crib options until you find a knowledgeable specialist you work well with. Their expertise fitting the appliance properly and coaching you through adjustments is invaluable for optimal comfort, use consistency and lasting effectiveness.
With an increasing array of oral device treatments now available for snoring and sleep apnea, best practices are advancing. Seek tongue crib guidance from seasoned clinicians actively expanding their skill with such therapies to support patients’ changing needs.
Conclusion
A custom-made tongue crib can effectively improve multiple health and sleep problems without medication or oxygen devices. By deliberately repositioning your tongue to keep upper airways open, breathing is enhanced both night and day.
Adjusting to consistent tongue crib use requires patience and perseverance through initial discomforts and speech changes. But most users report substantially increased energy, eliminated snoring and better sleep quality within the first weeks to months.
Under guidance from a trained dental sleep professional, a properly fitted tongue crib prevents the tongue from restricting your airway. This allows ample oxygen intake for typically restful nights and vibrant wakeful days ahead.
