5 Musts for your Night Guard if you are Teeth Grinding

7 Mar
Teeth Grinding Headache

Teeth grinding (bruxism) is more common than most people realize. Although about half of the population can grind their teeth from time to time, at least 10% grind their teeth routinely when they sleep and some even when awake. Consistent tooth grinding can lead to all kinds of issues, including tooth wear, sensitivity to cold, chipped or broken teeth, cosmetic issues, and even TMD (Temporo-Mandibular Joint Disorder).

The simplest way to manage bruxism or teeth grinding is to wear a night guard when sleeping. A night guard reduces the grinding and protects your teeth from further wear. But a night guard is only as good as its design and if designed incorrectly and for a different purpose than your particular situation, it can actually do more harm. The analogy I give to my patients is this: if you need shoes and I give you high heels, but you needed shoes for running, that would clearly be the wrong type of shoe, likely very awkward to run in, and if you actually wore them to run, you would probably injure yourself. So night guards are the same. If they are built for one dental issue but given to someone with a different condition, then they can feel uncomfortable or do more harm.

Since night guards are often made from an impression or a scan sent to an outside lab, they are made by someone who was simply told to make a night guard and they don’t know what your condition is. That person then makes whatever design they believe in and sends it back to your dentist to give to you. But if it’s the wrong design to begin with, not only will the night guard not work, it could actually feel worse than just not wearing it at all.

So here are 5 tips that are a must to have in a night guard if you grind your teeth.

TIP 1: Soft or Hard

The first thing to look at in your night guard is whether its made from a hard or soft material. So what do I mean by that? Does the night guard bend when you squeeze it? Why is that important? It has to do with whether you grind or clench your teeth. And the type of material your night guard is made from can make your teeth grinding worse. And many people think that teeth grinding is not a big deal. And it may seem like that … at the beginning. At the beginning, you get some wear. No big deal right?

Then, as you continue to grind, you get more wear. Still not a big deal or is it now? If left to continue, you get severe wear and if you ever want to fix that, it would require massive work like crowns, implants, and cost you tons of money.

But what else are you not thinking about? TMD or Temporo-Mandibular Joint Disorder, is a common condition, which comes with a significant number of signs and symptoms including pain and ear problems. TMD usually starts out with jaw pain, headaches (you may already have them, and just not realize they are related to your grinding), or maybe a click in the jaw. But all these are signs and symptoms of TMD.

So if you grind or clench your teeth, it is really important that your night guard is made from a hard acrylic. NOT soft. And the reason is that if you have a soft guard, you will grind or clench more on it, and that’s not what we are trying to do, right?

Think about it, if I ask you to hold a rock between your teeth, are you going to grind or clench on it? NO! But what if I put something soft and chewy, like a piece of gum or soft candy, your teeth automatically go to chew it.

Tip #2: Upper or lower

Is your night guard an upper or lower? Does it sit on your top teeth or your bottom teeth?  This can actually be quite important, and for many people who grind and have some TMD symptoms, this will make a big difference, especially when tied with tip #5 because tons of night guards are made like this and that’s bad for a grinder…

So if you are a grinder, and especially if you are beginning to develop some TMD symptoms, you want a lower night guard.

Tip #3: Even back tooth support

Do your back teeth touch evenly on the night guard?  When you put your night guard in your mouth, and you bite down on it, does it feel like your teeth, so if it’s an upper night guard, then it would be the bottom teeth touching the night guard, and if it’s a lower night guard, then it would be the top teeth touching the night guard.

Here is how you can check this at home if you are not sure:  you can use a thin piece of paper and put it between your teeth and your night guard in different areas in the back and bite down and then tug on the paper. If the paper is held between your teeth and the night guard when biting down, that means your teeth are touching the night guard in that position. If you can pull the paper out because nothing is holding it there then you are not touching. So if you have say the right side touching and the left side not touching then you know you don’t have even back tooth support.

If you feel like one side touches first, and the other less or not even at all, then that can cause you to grind on the side where it touches more, AND some people will have discomfort or even pain on the side where it doesn’t touch. And the reason is that your jaw muscles are going to try to get your teeth to touch, so they will pull on the side where you don’t and this can cause the jaw to rotate up into your skull and that can cause pain, ringing in the ear, and many other TMD symptoms.

Tip # 4: Canine guidance

So this tip is not as critical as the next one I am going to share with you, and the next one is THE most important one, especially in someone who already has some TMD symptoms.

Canine guidance is is when you slide your jaw to the side, the only teeth touching or “guiding” your slide are the canines, or ‘eye’ teeth. These pointy teeth, although not always pointy in a grinder, these teeth are supposed to “guide” your slide.

So check that on each side and see if your night guard has canine guidance.

It’s not as critical in most cases but if your night guard has it, that’s a good thing.

Tip # 5: NO anterior platform

This is the most important thing in a night guard, especially critical in a TMD patient where there is joint issues like pain or degeneration.

Here is what anterior platform means. When you have your night guard in, and you go to slide forward with your lower jaw, if the only teeth touching the night guard are the front teeth. If your front teeth touch the night guard when your lower jaw slides forward, and the back teeth don’t touch the night guard, that is known as an anterior platform.

If the platform is small, this may be difficult to see and if you are not sure if you can feel it, you can also check that with paper , like in Tip #3. You put the paper in between the front teeth and the front night guard, and slide your lower jaw forward,  and if you can pull the paper through without tugging on it then you don’t have contacts in this area (NO anterior platform). And if you can’t pull the paper through or you feel resistance then you do have contacts (anterior platform present).

So you check back teeth and front teeth in the sliding motion and then you know that if the front teeth hold the paper but the back teeth don’t then you have an anterior platform. And we don’t want that. We want the opposite. We want back teeth touching or the canines touching as you slide your lower jaw forward and we don’t want front teeth touching the night guard when you do this.

The reasons for this are more complex, and I will be discussing this more in future blogs and videos on YouTube, so please check out my YouTube channel if you want more information.

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