Grinding and Night Guards

For many patients, nighttime grinding and clenching cause a host of problems including broken crowns, worn down incisors and sore jaw muscles. These habits fall under the category of bruxism- the involuntary contraction and movement of the jaw muscles. 

In most instances, bruxism occurs at night when you sleep. It can also occur during daytime hours in periods of intense stress or concentration. Early signs of bruxism include sore jaw muscles, sensitive teeth and "scalloped" indentations on the sides of the tongue. Later indications include fractured enamel, blunted cusp tips and chipped porcelain on dental crowns. It is generally understood that bruxism is caused by stress and external triggers that activate automatic responses in the brainstem. As such, tackling the cause of bruxism involves a deeper investigation into stress, coping mechanisms and mental health. 

From a dental perspective, our office offers custom fitted night guards to protect against the effects of nighttime grinding and clenching. On top of preventing damage to the teeth, these appliances feature a completely level biting surface. This allows all the opposing teeth to contact the guard at the same time, increase comfort and preventing jaw fatigue. Night guards usually need two appointments- one for initial impressions and a followup to deliver and adjust the finished guard. 

Night guards represent only one of many protective and preventative services we offer. If you would like to know more about bruxism, night time grinding or how to prevent it please give our office a call. 

Dental Questions: Why shouldn't I use store bought nightguards?

Are all night guards the same? Not quite...

Store bought night guards, often called "boil and bite" guards are sold at almost every pharmacy and chain store nation wide. If you have problems with grinding your teeth at night (also called "bruxism"), they may seem like a great way to save your smile. Initially, these products will work as advertised, protecting your teeth from premature wear. However, inexpensive guards can create serious problems with longterm use. 

Your jaw muscles can produce a tremendous amount of force, almost 500 Newtons worth. When clenching on a store bought night guard (as you do subconsciously when you grind your teeth at night), these forces are unequally distributed: that is, you will not be biting everywhere at the same time with the same force. This uneven pressure can worsen existing headache/migraine problems or create new ones. You may be saving your teeth, but you will be creating a whole host of other problems!

A professional night guard made by a dentist is fundamentally different from a "boil and bite" night guard. Our guards are custom molded to your bottom teeth using a special clear hard acrylic. The top of the night guard is smooth and contoured so that all your top teeth touch it at the same time with the same force. It is also polished completely smooth, making it feel easy and natural to wear while sleeping. This combination of features allows you to avoid grinding your teeth at night, without introducing new headache pains. If you would like to know more about night guards, please give our office a call!

Video Blog on TMJ Pain and Night Guards

Greetings, my name is Dr. Kari Ann Hong and I have a family dentistry practice where I see patients from all age groups. In my practice, I see a number of patients that clench or grind their teeth at night.  This extra function at night can cause headaches, morning muscle pain when chewing, temporomandibular joint (TMJ) pain, tooth pain, and breakage of teeth.  The number one way to protect the teeth and muscle groups from the clenching and grinding is to wear a custom fitted night guard.

The first step in making a night guard is to take impressions of your teeth and to take an impression of how your teeth come together when your jaw is slightly open.  From the impressions, we make stone models that are used to fabricate a custom fitted acrylic night guard.  Usually we make the appliance for the lower arch.  During the one hour fitting appointment, we adjust the surface of the acrylic so that when the upper teeth touch the appliance, they all hit evenly.  Also, when you grind side to side or forward, the appliance is adjusted so that the majority of the force happens on the front off the appliance. This helps protect the facial muscle groups and the TMJ.

Due to concerns about the cost of a custom fitted night guard, sometimes patients will buy over the counter boil and bite type appliances.  The disadvantage of these boil and bite appliances, is that the opposing teeth don’t have freedom of movement, thereby potentially causing additional interferences for the TMJ and increased firing of the muscle groups that help our jaw open and close.  Depending on your medical and/or dental insurance plan, there usually is some coverage for a custom fitted night guard to treat TMJ pain.  If you would like to find out if a custom fitted night guard is right for you, and what your cost would be, please fill out the contact us page.