Tube gags do not compromise breathing as much as many other gags do. However, that doesn’t mean BDSM practitioners do not need to be careful with them. A dominant should monitor their submissive closely while the gag is in place. The submissive should never be left unattended. Wearing a tube gag can also place pressure on the front teeth, so care should be taken to avoid dental injuries.
Breathing through a tube gag can take practice, so it’s a good idea for submissives to practice wearing one outside of a scene first. This should be done under the dominant’s supervision. As with all gags, a submissive should never be left alone wearing a tube gag. As tube gags allow breathing, they are not as sound proof as some other gags. However, speech and sounds are often not as clear as they would be without the gag. For this reason, it’s a good idea for couples to create a safe action to indicate when a scene should stop.