What are Custom Dental Night Guards (Bruxism Guards) & Do I Need One?
Why Do I Need a Dental Night Guard?
» Stress on Teeth from Clenching and Grinding at Night: The purpose of night guards is commonly misunderstood as an active treatment for TMJ/TMD. Night guards are preventative in nature, meaning they help prevent further damage when patients clench and grind in their sleep. When properly fabricated they are very comfortable and early worn while you sleep.
» Retainers after Invisalign / Ortho Night Guards: Once you complete your invisalign or ortho treatment you move into the retention phase where you wear retainers at night to keep your teeth in their new position. Night guards can be fabricated to function as a retainer and night guard. Thus you only need a lower retainer and the upper night guard. Be sure to ask us about this option when having your night guard made.
» Stress and Anxiety: The most common source or reason our patients need a hard soft night guard is stress / anxiety. Commonly lumped under lifestyle choices (though we would argue this category), stress and thus anxiety tend to cause us to clench while sleeping. Some patients tend to clench during the day as well and can we wear their night guard as a day-use bruh guard. It is important to take a wholistic view of this and consider your own personal lifestyle choices that could be adding unnecessary stress, anxiety and thus clenching into your life and your sleep.
» Medication Changes - SSRI/Blood Pressure/Anxiety/Depression Meds: More often than not doctors will prescribe various medications for one indication, not knowing that the medicine can cause or exacerbate bruxism. The most common medications that tend to increase bruxism and cleaning are SSRI and blood pressure meds. Ironically, the SSRIs are used to treat stress, depression and anxiety, only to increase the amount that patients clench on their teeth in their sleep and during the day. Be sure to pay attention to this if you are on any medications for anxiety, depression, mood disorders, blood pressure, birth control, etc. Ask your prescribing doctor if there is a correlation with bruxism and clenching. If so, we can make a night guard for you while you are on these meds, and hopefully minimize any damage to your teeth and smile.
» Uneven Bite or Malocclusion: Another common reason patients need bruxism guards or night guards is uneven bites or what is known as malocclusion. This leads patients to bite harder on one side than another and load their teeth unevenly. Chips, cracks, breaks, lessening, and shifting of their teeth can occur from their malocclusion. Many patients will choose to fix or remedy the bite problems with invisalign, braces, or occlusal adjustments, and then have us make a custom fit night guard to better protect their teeth.
What is a Dental Night Guard Used for?
Simply put, a dental night guard is a bumper for your teeth. Some patients tend to clench or grind their teeth at night and during the day. This can lead to damage to their teeth such as chips, breaks, cracks, sensitivity, inflamed gums, bone growths, etc. While a night guard is not designed as active therapy, it can help minimize further damage. If you find that you continue to clench or grind even while wearing your night guard you can explore a neuromuscular orthotic. Most people get great benefit out of the custom fabricated night guard worn while they sleep.
How Much does a Custom Dental Night Guard Cost?
We work with many different dental insurance plans to help minimize the out of pocket cost for dental night guards or bruxism guards. Most dental insurance plans will cover 50-80% of dental night guards. However, some plans do not. In the case that your dental insurance plan does not cover or contribute towards your dental night guard, we do two things to help you out. First, if your plan has a reasonable allowable rate we will honor this cost or price point. Second, we often can offer a cash discount option for night guards. Most plans will have a price around $400-$695* . So we can usually offer night guards to patients without insurance, paying cash, in this price range. Be sure to ask us to submit a pre-auth for your night guard. This way you can understand the financial commitment before starting. Most dental insurance plans will provide a pre-auth letter to you explaining the cost, the discounts, and the coverage.
Can I use a Night Guard from Walgreens or CVS or Amazon?
This is a very common question, usually related to the cost of a custom made night guard. The short answer is, yes you can wear a low-cost night guard purchased over the counter or on the web as long as you understand the risks involved with the use. The most common problem patients have when they wear other the counter, or boil and bite bruxism night guards is shifting of their teeth. The low cost night guards do not fit and do not support your teeth as well as a professional made night guard. So while you are sleeping, and clenching and grinding, the poorly fitted night guard is bending, flexing, and moving your teeth around. Usually it will not affect your teeth or bite for a few weeks to a month. Eventually you will start to notice gaps forming between your teeth or your bite starting to feel as though it does not line up properly when you chew. These are signs of occlusion shit and tooth shift. We call it interproximal gapping. The only way to fix this is to wear Invisalign for a few months to tighten your teeth back up, and then make a properly fitting professional fabricated night guard that holds your teeth in your natural position, while protecting them from one another grinding. So in short, the low cost CVS, Walgreens, Amazon night guards can work, but they can also cause more problems than they are solving. Be sure to ask Dr. Tsai to show you an example of a night guard next time you come in for your cleaning appointment. You will see a significant difference in the build quality and rigidity of the guards you can find on line or in your local pharmacy.
Pros and Cons of Professionally Made Custom Dental Night Guards versus the Store or Web-Bought Guards
Very rarely do we try to talk patients out of using over the counter products as much as we do for dental night guards. Other than price, we really cannot come up with a good reason to endorse over the counter, or web bought, night guards. They are almost all misinformation and poor marketing methods to get patients to purchase them while not warning them about all the downsides. Here is a brief list of why we do not recommend the boil and bite or over the counter night guards for bruxism, clenching and grinding.
» Come with a six month warrantee against breaks and cracks but tend to last 1-5 years.
» Are easy to get used to wearing as they fit properly.
» Do not shift your teeth or bite - they hold your teeth firmly in place like a retainer.
» They generally last 1-5 years or more.
» Easy to take care of and maintain.
» Usually partially covered by most dental insurance plans.
» Over the counter or store bought night guards tend to shift your teeth.
» Not designed to last long - typically last about a year.
» Very poorly fitted, usually boil and bite or just a flat piece of plastic.
» No way to make adjustments should your teeth change from crowns/fillings.
» Tend to cause tooth shift and thus gaps and bad bite.
Alternatives to Dental Night Guards for Bruxism
To be honest, there are very few alternatives to bruxism guards unless you are looking for active TMD / TMD therapy. The majority of the time that night guards are recommended patients already show signs of symptoms of bruxism such as sore teeth and gums, chipped or worn down teeth, or sensitive to hold and cold. A night guard really is the best immediate treatment while patients are looking for a longer term solution if the problem is chronic. For chronic patients we have a number of TMD / TMJ treatment methods including STI Splints and neuromuscular orthotics as well as TENsing sessions to help resolve tight and sore jaw and neck muscles. All of this can discussed with Dr. Tsai at your next cleaning appointment. Or if you prefer to set up a dedicated TMD/TMJ appointment please call our office.
Do Night Guards Treat
Currently night guards do not treatment snoring and sleep apnea, but the opposite is true for sleep apnea oral appliances. There is a strong correlation between patients with obstructive sleep apnea (OSA) and bruxism or clenching and grinding. A high percentage of people with OSA or sleep apnea tend to clench and grind their teeth while sleeping. The sleep apnea oral appliances we made for sleep apnea patients and heavy snoring patients help treat bruxism or at least work and function like a traditional night guard. They protect teeth from one another while the patinet is sleeping and clenching. A nice benefit from the sleep appliances. If you suspect you have obstructive sleep apnea, heavy snoring, or OSA, be sure to discuss this with Dr. Tsai at your next cleaning appointment. You can also set up a dedicated sleep apnea or snoring consultation with Dr. Tsai and our office if you prefer.
Have questions about Custom Dental Night Guards, Bruxism, Cleaning, Grinding, or Sleep Apnea and Snoring? email or call us: (650)-583-5880
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* These are suggested ranges of bruxism and night guards. They are not actual prices are not quotes of our prices. Prices vary with tooth number, location, color, additional procedures needed, aesthetic qualities, insurance coverage, network rates, etc. Please ask our office for a clinical evaluation and a financial estimate for your situation.