How do I know if I need a night guard? If I do need one, what kind should I get? What are the differences between ones from the drug store and the one I would get from my dentist?
Dental guards, or mouth-guards, are actually believed to have originated from boxing. Back then, boxers would clench the material between their teeth to protect them during fights. However, these guards were made out of simple materials like tape, cotton, wood, or sponge. Definitely nothing like what you would find in today’s versions of the mouth guard. In 1892, a British dentist by the name of Woolf Krause began producing mouth-guards made from rubber resin. The first mouth guard made of acrylic resin was produced in 1947.
We asked a number of dentists to help clear up some of our questions regarding these appliances. Read on to hear what they had to say.
In my office, about 33% of my patients need and wear night guards. The reasons vary, but the most common three are:
- TMJ pain and the night guard is designed to stop clenching, thus minimize the TMJ pain.
- The patient has severe wear on their teeth, either back teeth or front teeth or both front and back teeth. Most people do 100 X’s more grinding at night while asleep than they do while awake during the day. This appliance stops the nighttime grinding.
- The appliance is worn to protect a lot of dentistry that has been performed (usually a lot of ceramic crowns), which can be broken while grinding at night.
Store bought night guards do protect the teeth. They are bulkier and are usually much looser, flopping around at night while sleeping. They also can’t be made to stop grinding, as is needed in TMJ pain. It is our experience that about 50% of dental insurance companies cover a percentage of the cost of the night guard. We also make snore appliances which are highly effective, and they are nothing more than an upper and lower guard connected at a forward bite.
Night guards are an excellent way to prevent trauma to teeth from night-time grinding and clenching. If you notice your back teeth wearing flat or your front teeth wearing short, it is important to do something to prevent this destruction of your teeth from getting out of hand. Store bought night guards can protect your teeth from trauma but will do nothing to prevent or stop trauma of the jaw joint known as the TMJ (Tempromandibular Joint). In fact, store-bought night guards, particularly the soft kind, can cause increased damage to your TMJ and the muscles that allow you to chew. Also, if the bite on the night guard is uneven, it can lead to severe displacement of your teeth that may require orthodontics (braces) to correct. A custom-made mouthguard made just for your mouth by your dentist can prevent tooth trauma as well as prevent TMJ disorders and pain. It is important to consult with your dentist prior to starting any night guard use.
Obviously, if their dentist told them they are wearing down their teeth they need a night guard or sometimes braces to realign their bite. If they are having jaw pain they might need a special night guard. If there is pain I would not recommend one from a store. If they only need to protect their teeth from nocturnal bruxing a soft night guard may be ok. I would look for one that they can boil and then fit to their teeth. Something that goes between the teeth but moves freely I do not think will be stable enough to be protective. Night guards made in a dental office from a mold of your teeth will fit much better and should last longer.
Primarily, there are three different types of night guards, and each type is ideal for varying severity of bruxism.
The soft night guard, like the ones mentioned by Dr. Lanie and Dr. Sachs above, is intended for those who have mild cases of teeth grinding. Typically, these patients do not experience teeth grinding on a daily or nightly basis; it is also more suitable for patients who are prone to teeth clenching rather than teeth grinding. Because these guards are softer, it is able to cushion more of the force produced by clenching.
For a more durable option, the dual laminate night guard is intended for those who suffer from more frequent teeth grinding. This night guard is soft on the inside and hard on the exterior, allowing more protection.
The acrylic night guard is intended for patients who experience excessive or severe teeth grinding. It is reported that acrylic night guards can last up to 5 years with proper care and cleaning. Because the acrylic night guard is such a rigid appliance, it is incredibly important that the patient is using a mold that is perfectly fitted to their teeth. A guard that is not accurate or too loose could result in damage or pain to the patient. For this reason, it is recommended that you use night guards that have been professionally made by your dentist.
While the styles of night guards used to prevent bruxism create a protective barrier between the lower and upper teeth, a guard designed to treat TMJ disorders is going to be different. Bruxism guards have varying levels of hardness, but a TMJ guard will always be made of rigid acrylic. This is because the acrylic is better suited to reposition the jaw and raise the patient’s bite, in turn relieving the pain and discomfort the patient is feeling. Those who are seeking relief from TMJ should never buy a night guard over the counter or online. Because the guards might need multiple adjustments, it is ideal for a dentist to come up with the solution that best fits the patient’s needs.
Finally, there are devices called the mandibular advancement device. This is intended for people who suffer from severe snoring and sleep apnea. While it looks like a common mouth-guard used in sports, it works by forcing the lower jaw to move down and forward. The prevents breathing problems because the device is working to keep the airway open.
Night guards can be helpful for patients who grind their teeth, for protecting dental work, for those who snore or suffer from a temporomandibular joint disorder.
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