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, affects an estimated 8% to 31% of adults. Many people grind their teeth during sleep without realizing it. Over time, untreated bruxism can wear down enamel, crack or fracture teeth, damage dental work like crowns and fillings, and contribute to jaw pain, headaches, and temporomandibular joint (TMJ) disorders.
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.
- 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. It fits your teeth precisely, stays in place during sleep, and distributes grinding forces evenly. Custom guards are available in different materials and thicknesses depending on the severity of your bruxism.
Hard acrylic guards are the most durable and are recommended for heavy grinders. Dual-laminate guards have a hard outer layer and a softer inner layer for comfort. Soft guards are 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. While better than a stock guard, the fit is less precise than a professionally made appliance. These guards are typically made from a softer material that wears out faster and may not distribute forces as evenly.
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. They are not recommended as a long-term solution 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 also the least effective. Because they do not conform to your teeth, they can be uncomfortable, poorly fitting, and may even shift during sleep. Most dentists 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 typically involves 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 determine the best type of guard for your needs. 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. This takes 1 to 2 weeks.
- 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 typically resolve within one to two weeks of consistent nightly use. 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 extends the life of your dental night guard and keeps it hygienic.
Daily Cleaning
Rinse your night guard with cool or lukewarm water immediately after removing it each morning. Brush it gently with a soft toothbrush and mild soap or non-abrasive toothpaste. Avoid hot water, which can warp the material. Let it air dry completely before storing it in its ventilated case.
Weekly Deep Cleaning
Once a week, soak your night guard in a denture cleaning solution or a mixture of equal parts water and white vinegar for 15 to 30 minutes. This helps remove bacteria and mineral buildup. Rinse thoroughly afterward. Do not soak hard acrylic guards in mouthwash, as alcohol-based rinses can degrade the material over time.
When to Replace Your Night Guard
A well-made custom night guard typically lasts 3 to 10 years, depending 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.
Cost by Type
- Custom night guard (dentist-made): $300 to $800. This includes the impressions, lab fabrication, and fitting appointments.
- Boil-and-bite guard: $15 to $40 at most drugstores or online.
- Stock night guard: $10 to $25.
- Online custom guards: $100 to $200. These use mail-in impression kits and are fabricated remotely. They offer better fit than boil-and-bite but lack the in-person evaluation and bite adjustment a dentist provides.
Insurance Coverage
Many dental insurance plans cover custom night guards when prescribed for diagnosed bruxism. Coverage typically ranges from 50% to 80% of the fee, 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.
Even without insurance, a custom night guard is often a cost-effective investment. Repairing a cracked tooth or replacing a broken crown can cost far more than the guard that would have prevented the damage. 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 complete 3 years of additional residency training after dental school focused on restoring teeth, managing bite problems, and designing oral appliances.
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 perform a detailed bite analysis and design an appliance that addresses both protection and bite alignment.
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