Teeth That Go Bump in the Night

There are two types of patients that grind and/or clench.  Those with no pain but have been told by their dentist or a significant other that they grind their teeth; and those with muscle and/or generalized tooth pain.

If you do not have pain, a good start is an over the counter (OTC) plastic nightguard found in the toothbrush aisle of your local drugstore.  It should be around $30 and flexible around the sides of the teeth with a harder plastic you will grind against.  These are very bulky and most patients will take them out at night while they are sleeping.

With persistence, you will most likely get used to the bulkiness, and eventually stop taking it out at night.

Option two for those without pain is a custom soft nightguard.  Impressions are taken in the office and a guard can be delivered usually in a week.  Like the OTC guard, it is still bulky (but slightly less) and you may still take it out at night.  But, it will be much more difficult.  With either soft guard option, they can cause muscle pain due to clenching on the soft material throughout the night.  If this occurs, then I recommend the hard nightguard.

If you have pain, then your only option is the hard nightguard.  Some insurances do cover this treatment so it is worth the effort to check with both your dental and medical insurances for nightguard coverage due to “bruxism with pain”.  This involves one appointment for impressions and then the appliance is delivered 2-3 weeks later.  There may also be a follow up appointment as your muscles relax to adjust the bite.  This type of guard only covers the chewing surfaces (upper teeth usually) with little clasps that can be adjusted as new crowns or fillings are needed in the future.  They are very hard to remove during the night and also act as pseudo retainers that help to keep teeth from drifting in the future.

Anything you do elect to use for grinding will cause you to salivate usually for the first 4 or so nights so patience is a virtue to seek in getting used to your new guard.  However, for most of my patients, once they are used to wearing a guard, it is like a warm security blanket that you can’t sleep without.  I love mine like a member of my family and could never go without it.  Just like dating, it can take a few rounds before you find the magical “right” fit, but it will happen.

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