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Ask the Experts
Night Guards
Sometimes, we take our teeth for granted. Our smile is one of our greatest assets, but we often don’t care for our teeth as diligently as we should. In fact, we often end up needing dental work due to decaying or weakened teeth. It’s not just poor brushing and flossing that can cause problems. Many people grind their teeth, especially at night. Our jaw exerts tremendous force on the teeth, which can cause damage to them over time.
Night Guards are a common and effective way to help protect the teeth from nighttime grinding and keep them from becoming damaged. Our detal professionals offer our patients high-quality Night Guards, to help patients preserve their teeth and live in comfort.
What is a Night Guard?
A night guard is a device that is fitted over the teeth to help protect them from the forces of clenching and grinding during sleep.
Also known as occlusal splints, bite guards, and muscle relaxation appliances, these simple devices can protect the enamel and the teeth from becoming worn away, cracked, and broken over time. Bruxism (grinding the teeth) can also cause sensitivity, pain, yellowing, and even receding gums.
During the day, it’s possible to monitor tooth grinding, but at night while you’re asleep, you can’t always prevent yourself from clenching and grinding.
A night guard can prevent some of the potential damage caused by nighttime grinding. Guards can also help alleviate TMD, a dysfunction of the TMJ.
What causes teeth grinding?
Usually, bruxism is a “multifactorial” condition, meaning it can be caused by a combination of many different factors. Common causes of teeth grinding/bruxism include:
- Disordered sleep breathing (sleep apnea)
- ADHD in children and teens
- Depression and/or anxiety
- High levels of stress/poor stress response
- Poor occlusion/bite (when your upper and lower teeth don’t meet the way they should)
- Chronic or acute trauma to the mouth and/or jaw
- Genetic predisposition
- Neurotransmitter disruptions
- Neurodegenerative disorders like Huntington’s or Parkinson’s diseases
- Use of antidepressants, amphetamines, anti-anxiety drugs, or antipsychotics
- Nicotine use
- Frequent alcohol use
- Excessive coffee intake
Types of Night Guards
There are 5 types of night guards to choose from. Our dentists do not recommend using an over-the-counter night guard for any longer than 2 weeks.
Night guard types include:
- Stock mouth guard (over-the-counter) – Stock mouth protectors are the only kind of night guard with no custom fit option.
- Boil-and-bite night guard (over-the-counter) – Over-the-counter night guards may come with an impression kit that allows you to boil the mouth guard and mold it to your bite. These moldable dental guards are made with a flexible thermoplastic material.
- Soft night guard (professional fit) – Soft night guards are the most common night guard prescribed by dentists for mild bruxism. They are typically flexible and thin. Your dentist will take physical or digital impressions of your teeth and send them to a lab, where your night guard can be manufactured.
- Dual laminate night guard (professional fit) – Also called a bilaminar night guard, dual laminate night guards are used for severe bruxism. Some literature considers these “splints” rather than true night guards. They are made from ethylene-vinyl acetate and polycarbonate with a soft inside and hard outer layer.
- Hard acrylic night guard (professional fit) – Made from cured acrylic in variety of colors, hard night guards are used for extremely severe cases of bruxism. They may be better for TMJ than other options. Hard acrylic night guards are used to realign the jaw.
The best night guard for grinding is a dual laminate night guard custom fitted by your dentist. If your grinding is mild, a soft night guard may be a less expensive option to try. They are the best night guards for grinding in the short-term.
For maximum benefit, make sure you only use a night guard that touches all tooth surfaces (not partial arches). Partial coverage night guards may ruin your teeth by causing problems with your bite.
It can be difficult to get used to sleeping with a night guard. Often, the bulk of a new dental device or an awkward fit are to blame.
To adjust to sleeping with a night guard:
- For the first few days, try wearing your night guard during the day to get used to the feel.
- Talk to your dentist about a thinner material, if possible.
- If your night guard makes you sore or feels sharp, discuss a fit adjustment with your dentist.
- Try wearing only the upper or lower portion of the night guard at first.
- Don’t give up for 30 days.
If you’re still having trouble after a month, you may need to pursue other alternatives to a night guard.
Unfortunately, a poorly fitted night guard can make sleep worse by being too thick. A thick night guard can open up the vertical dimension of your mouth and close your airway.
Individuals with sleep apnea may struggle more than average to sleep with a night guard because their airway is already obstructed. In these cases, the night guard is only a Band-Aid for the primary problem, which must be corrected for optimal sleep.
If you have sleep apnea and just started using a night guard, try mouth taping. This can help reduce mouth breathing and the consequences of a dry mouth.
Similar to most dental devices, the best way to take care of your night guard is to keep it moist when not in use and prevent the buildup of bacteria.
To take care of your night guard:
- Each morning, rinse your night guard with warm water (no soap) for 20 seconds.
- Soak the night guard in ¾ cups of water and 1 teaspoon of baking soda while not in use. (For best results, use a stainless steel container.)
- Once a week, combine water, baking soda, and white vinegar and soak your night guard for 15-20 minutes to eliminate excess bacteria.
- Do not brush your night guard. A toothbrush can create micro-abrasions that can house bacteria.
- Use an ultrasonic cleaner to further protect your night guard from damage and bacteria.
- Thoroughly wash the case with dish soap or in the dishwasher at least once a week.
Avoid effervescent cleaners like Polident or Efferdent. These ADA-approved cleansers may cause allergic reactions in some people.
Obstructive sleep apnea (OSA) is the most commonly identified cause of bruxism. This severe form of sleep-disordered breathing may be responsible for up to a third of all teeth grinding.
When your breathing stops due to sleep apnea, your brain may wake you up by clenching your teeth together so you start breathing again.
Grinding may also be a result of the poor sleep of people with OSA.
If sleep apnea is to blame for your teeth grinding, a night guard may not be the right treatment.
At worst, a night guard could interrupt the necessary response of grinding. Grinding is what your brain uses to open the airway during an apnea, and a night guard can interfere with that.
Additionally, while a night guard will protect your teeth from grinding, it can’t protect your grinding muscles from overuse and harm.
If you have sleep apnea or another form of sleep-disordered breathing, it’s important to work with your healthcare team to address that as the root cause of your issues.