Bite blocks providing an instrument lumen 62 for use during transoral medical procedures may be made from a material having a Shore D hardness less than 60 for improved patient comfort. An air way lumen 64 may be provide in side by side arrangement to the instrument lumen 62 for maintaining the patient's airway. The air way 70 may have a concave guiding channel 72 for helping to guide the instruments down the esophagus.