Custom night guards

What it is

Many people grind or clench their teeth in their sleep without knowing it. Dentists call this bruxism. Over time, it can wear teeth flat, chip their edges, crack fillings, and leave your jaw muscles sore.

A night guard doesn’t stop the grinding. It puts a layer of plastic between your teeth, so the guard wears down instead of your enamel (the hard outer layer of each tooth). A custom guard, usually made in a dental lab, is thinner and fits more closely than the boil-and-bite kind sold in stores.

Who it helps

A night guard may help if you:

• wake up with a sore jaw, tight face muscles, or a headache near your temples
• have been told you grind your teeth in your sleep
• have teeth that look flat, short, or chipped at the edges
• have cracked teeth or fillings, or crowns you want to protect

Your dentist may notice signs of grinding before you do. A night guard doesn’t treat snoring. If you snore loudly or wake up tired, tell your dentist. Snoring can be a sign of sleep apnea (pauses in breathing during sleep), which needs a sleep test and different care.

What happens

1. Exam. Your dentist looks for wear, cracks, and sore jaw muscles, and asks about your sleep, any jaw pain, and the medicines you take.
2. Impressions. We take an impression (a mold or a scan) of your teeth. For a mold, you bite into a tray of soft putty for a minute or two. It feels cool and bulky, but most people don’t find it painful.
3. Making the guard. A dental lab usually makes the guard to fit your teeth and your bite.
4. Fitting. At your next visit, your dentist checks the fit and smooths any spots that press too hard. It should feel snug but not tight, and your teeth should touch it evenly when you close.
5. Follow-up. Bring your guard to your checkups. Your dentist checks it for wear and adjusts it if your teeth or bite change.

Recovery and aftercare

The first few nights may feel strange. You may drool more than usual or wake up aware of the guard. Most people get used to it within a week or two.

Each morning, rinse the guard and brush it gently with a soft toothbrush and cool water, since hot water can warp it. Let it dry, then store it in its case, away from heat and pets. Dogs love to chew them.

Call the office if the guard cracks, feels loose, or makes your teeth or jaw ache.

Cost and insurance

The cost of a night guard depends mostly on the type and the material, which can be soft, hard, or layered.

Coverage varies a lot. Some dental plans pay part of the cost of a night guard, and others don’t cover guards at all, so check your plan before your visit. For other ways to pay, see insurance and financing.

Alternatives

• A store-bought guard. Boil-and-bite guards cost less, and you can buy one today. They’re bulkier and don’t fit as closely, which can make them uncomfortable, and they tend to wear through quickly. Some people use one for a short time while they decide.
• Easing the habit. Less caffeine and alcohol in the evening, and ways to manage stress, help some people grind less. They don’t protect your teeth the way a guard does, though.
• Treating a related problem. Grinding is sometimes linked to sleep apnea or to certain medicines. If so, treating the apnea, or talking with your doctor about the medicine, may help.
• Waiting and watching. If the wear is mild, you can wait. Your dentist can compare your teeth from visit to visit and tell you if the wear is speeding up.