What Is a Dental Night Guard?
A dental night guard, also called an occlusal splint or bite guard, is a custom or prefabricated device worn over the upper or lower teeth during sleep. Its purpose is to create a protective barrier between your upper and lower teeth so that grinding and clenching forces are absorbed by the guard instead of your tooth enamel.
Teeth grinding, known clinically as bruxism, is reported by an estimated 8% to 31% of adults, although most of these studies rely on self-report. [5] Frequent sleep bruxism is reported by roughly 13% of adults. [5] Many people grind their teeth during sleep without realizing it, and dentists are often the first to notice the signs. [4] Bruxism is linked to tooth wear, cracked teeth, jaw pain, and headaches, and it may be associated with temporomandibular joint (TMJ) problems. [2] [4] Experts view bruxism in otherwise healthy people as a behavior that can raise the risk of these problems, not as a disease by itself. [1] Whether it harms crowns, fillings, and gums is less certain. [2]
Signs You May Need a Night Guard
If you notice any of these signs, bring them up at your next dental appointment. Your dentist can look for physical evidence of grinding, such as wear patterns on your teeth, and determine whether a night guard is appropriate. [4] Loud snoring or pauses in breathing during sleep can signal sleep apnea, which a physician should check. [6] Learn more about bruxism and sleep apnea.
- Waking up with jaw soreness, tightness, or pain
- Morning headaches, especially in the temple area
- A partner who hears you grinding your teeth at night
- Teeth that are visibly worn down, flattened, or chipped without an obvious cause
- Increased tooth sensitivity, particularly when drinking cold beverages
- Cracked or broken teeth or dental restorations
- Soreness or fatigue in the jaw muscles
Types of Dental Night Guards
Night guards fall into three categories based on how they are made and fitted.
Custom-Fitted Night Guards (Dentist-Made)
A custom night guard is made from an impression or digital scan of your teeth and fabricated in a dental lab. A custom guard gives the closest, most comfortable fit and is designed to spread grinding forces across your teeth. [4] Custom guards are available in different materials and thicknesses depending on the severity of your bruxism.
Hard acrylic guards are durable, dual-laminate guards have a hard outer layer and a softer inner layer for comfort, and soft guards are sometimes used for mild grinding or clenching. Your dentist or prosthodontist will recommend the material based on your specific condition.
Boil-and-Bite Night Guards
Boil-and-bite guards are available at drugstores and online. You soften the guard in hot water, then bite into it to create a semi-custom fit. The fit is generally less precise than a professionally made appliance, and store-bought guards may not provide the same protection as one made for you. [4] Softer materials may also wear out faster.
Boil-and-bite guards can be a reasonable short-term option while you wait for a custom guard or if cost is a primary concern. Dentists generally prefer a custom guard for long-term use, especially for moderate to severe bruxism.
Stock (Over-the-Counter) Night Guards
Stock night guards come in predetermined sizes and shapes with no customization. They are the least expensive option, but because they do not conform to your teeth, they can be uncomfortable and poorly fitting. [4] Dentists generally do not recommend stock guards for regular use.
Getting a Custom Night Guard: What to Expect
The process of getting a custom dental night guard is straightforward and often involves at least two appointments.
The Fitting Process
- First appointment: Your dentist takes an impression of your teeth using dental putty or a digital intraoral scanner. The dentist also evaluates your bite and jaw alignment to decide which type of guard suits you. The impression is sent to a dental lab.
- Lab fabrication: The lab creates a custom guard from your impression, typically using hard acrylic or dual-laminate material. Ask your dentist how long this will take.
- Second appointment: You try on the finished guard. The dentist checks the fit, makes adjustments if needed, and shows you how to insert and remove it properly.
Adjusting to Your Night Guard
It takes most people a few nights to get used to wearing a night guard. You may notice increased saliva production, a feeling of fullness in the mouth, or slight jaw discomfort at first. These sensations often ease as you keep wearing the guard. If the guard feels painful or causes your bite to feel off in the morning, contact your dentist for an adjustment.
Night Guard Care and Maintenance
Proper care helps keep your dental night guard hygienic. Follow your dentist's cleaning instructions.
Daily Cleaning
Follow your dentist's cleaning instructions. Ask which cleaning products are safe for the material your guard is made from, and how to store it between uses.
Weekly Deep Cleaning
Ask your dentist whether an occasional deeper cleaning is right for your guard, and which cleaning solutions to use or avoid. Some rinses and cleaners can damage certain materials.
When to Replace Your Night Guard
How long a night guard lasts depends on the material and how heavily you grind. Signs that your guard needs replacement include visible cracks or holes, a loose or ill-fitting feel, rough or uneven surfaces from excessive wear, or a persistent odor that cleaning does not resolve. Bring your guard to your regular dental checkups so your dentist can evaluate its condition.
Dental Night Guard Cost
The cost of a dental night guard depends primarily on whether it is custom-made or purchased over the counter. Costs vary widely by location, provider, and case.
Cost by Type
- Custom night guard (dentist-made): usually costs the most of the three types. The fee often covers the impressions or scan, lab fabrication, and fitting appointments, so ask what is included.
- Boil-and-bite guard: usually costs far less and is sold at drugstores or online.
- Stock night guard: usually the least expensive option.
- Online custom guards: prices vary. These use mail-in impression kits and are fabricated remotely. They skip the in-person exam and bite adjustment a dentist provides.
Insurance Coverage
Some dental insurance plans cover custom night guards when prescribed for diagnosed bruxism. Coverage varies by plan and is usually subject to your plan's annual maximum. Some plans limit coverage to one night guard every few years. Check with your dental insurance provider for your specific benefit details.
Repairing a cracked tooth or replacing a broken crown can cost far more than a night guard, although research has not yet clearly shown how much a night guard prevents tooth wear. [3] Costs vary by location, provider, and case complexity.
When to See a Prosthodontist for a Night Guard
Most general dentists can prescribe and fit a custom night guard for straightforward bruxism. However, a prosthodontist may be the better choice in certain situations. Prosthodontists are dental specialists with advanced residency training after dental school in restoring and replacing teeth.
Consider seeing a prosthodontist if you have TMJ pain or a clicking jaw along with grinding, if you have already damaged multiple teeth or dental restorations from bruxism, if your bite feels uneven or has changed over time, or if previous night guards have not been comfortable. A prosthodontist can evaluate your bite in detail and plan an appliance and any needed repairs. For jaw joint pain, an orofacial pain specialist may also be a good fit.
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