The Best Night Guard for Teeth Grinding

What is a night guard and who needs it?

For the 40 million Americans who grind their teeth, finding an effective and affordable dental treatment is crucial.

While night guards, or mouthguards, don't cure the grinding, they can help relieve the pain and prevent complications caused by the habit. "Night guards are helpful when patients are dealing with nighttime bruxism. A properly fitted night guard made by a dental professional will fit securely and give the patient a stable surface to grind against," says Miller.

A mouthguard or night guard is a simple dental device that covers your teeth to protect them. Some users wear them at night to protect their teeth from grinding. Others wear them when they play contact sports or when they experience daytime grinding, also called awake bruxism.

Wearing a mouthguard when damage to your teeth could occur can help you prevent:

• Chipped, damaged, or lost teeth
• Painful nerve damage
• Injury to your lips, gums, tongue, and cheeks

How to choose a mouthguard

First, get clear about what your needs are in a night guard.

There are many different types of mouthguard devices available—some that help with snoring, some that are suitable for playing contact sports, and some that are specifically designed for teeth grinding. If teeth grinding is your main problem, be sure you don't use a mouthguard targeted for snorers or athletes. These won't provide the protection you need and won't last long under the repetitive stress of teeth grinding.

Consider the different types of mouthguards.

One-size-fits-all

These mouthguards are ready to wear straight out of the package, but since they aren't specially made to fit your teeth, they usually don't fit well and aren't very comfortable. They are affordable, and you can buy them online or at your local pharmacy.

Over-the-counter adjustable

Like the one-size-fits-all variety, these are convenient and affordable. They differ, though, because they have a sliding band that allows you to change the size to fit your mouth. They feel awkward or uncomfortable for many people.

Boil-and-bite

To use this type of mouthguard, you do exactly as the name suggests. After purchase, you place the mouthpiece in boiling water for the amount of time suggested on the packaging. You remove the mouthpiece from the hot water, place it carefully over your teeth, and gently bite down. The softened plastic molds to the shape of your teeth, giving a more customized fit than other over-the-counter products.

Many people find, though, that these are still not very comfortable; they also may not withstand the force of grinding for a prolonged period of time, requiring replacement every few months. Many brands do allow remolding as many times as needed for a good fit.

Custom-fitted by your dentist

According to Cleveland Clinic, custom-fitted mouthguards fit more comfortably and protect your teeth better than over-the-counter mouthguards. If your dentist suggests a custom night guard, they will take a mold of your teeth in the office. A custom-fitted guard will be made in a lab just for you, and you'll come back to the dentist a few weeks later to receive it.

Most users agree that custom-fitted night guards provide a better fit, are more durable, and provide better protection for your teeth. Unfortunately, a mouthguard from your dentist can cost on average $500–$600, often more. At that price point, most people need to keep their night guards for years without replacement, but what happens if you lose it or the dog chews it? (Yes, this happens.) And especially since you'll be keeping it for years, you'll need to be sure you're cleaning the device properly.

Custom-fitted at home

There's a new, direct-to-consumer option for night guards that allows you to get the same custom fit you want from your dentist's office, but at a much lower cost. The process is the same as you'd get at the dentist, except you'll do your own impressions at home. You can purchase an impression kit online, and the company will mail it to you.

You complete the impression kit and mail it in, the mouthguard is made (often in the same laboratories where mouthguards from the dentist's office are made) and sent to you. Many companies allow you to replace your night guard often, making it unnecessary to keep them for a prolonged period of time.

Determine which features of a night guard are important to you.

Here are a few variables to consider prior to your purchase:

Comfort

It's not easy to sleep with an awkward, ill-fitting device in your mouth. And let's be honest, a night guard does you no good if you don't wear it. Every mouth and bite is different, so custom-fitted devices are always going to fit better and feel more comfortable.

Quality

This purchase can be a hefty investment in your oral health, and when considering the possibility of broken teeth, nerve damage, and chronic pain, the importance of using a quality night guard can't be overstated.

Durability

Night guards must be able to endure the wear and tear of teeth grinding over a prolonged period of time. Over-the-counter options generally wear out within a few months' time, but custom-fitted devices may last for several years.

Cost

Store-bought varieties are inexpensive—roughly $20 at your local drugstore. If your teeth grinding isn't severe, this may be a good option for you, even though you may have to replace them every few months. Custom-fitted devices from your dentist may cost $500 or more, but mail-in, custom-fitted devices will be significantly less expensive, costing around $100–$200.

Convenience

While a cure is always desired, many people find that teeth grinding is a lifelong problem. Find a solution that allows you to protect your teeth without disrupting your life. Over-the-counter devices can be very convenient, but trips to the dentist often aren't. At-home custom-fitted devices may fulfill the need for convenience without sacrificing quality.

How to do an impression kit at home

Completing an impression kit is typically much easier than you think it would be. The company usually sends you a kit with everything you need (often free of charge). Many companies offer tutorials or step-by-step videos to make it simple.

You'll spread some putty into a tray, then bite down on it and hold it there for four to five minutes. Package it up and mail it back to the company, and you're done. All that's left to do is wait for your custom-fitted night guards to arrive.

What causes teeth grinding?

According to the American Dental Association (ADA), a combination of physical, psychological, and genetic factors may contribute to repetitive clenching and grinding of teeth. The habit is associated with stress and anxiety, but sleep disorders, an abnormal bite, and missing or misaligned teeth can affect clenching and grinding as well.

Bruxism occurs frequently in children as well as adults. While teeth grinding is often stress related in adults, physical causes—mouth irritation, allergies, or misaligned teeth—are more likely the cause in kids.

How caffeine, alcohol, and tobacco play a role in bruxism

If you drink alcohol or caffeine or smoke tobacco, you're more likely to experience teeth grinding and clenching. And if you're experiencing stress, consuming alcohol, tobacco, or caffeine can make it worse. In children, secondhand smoke and sleep problems contribute to bruxism.

How to relieve the pain at home

If you experience jaw pain or headaches, you can try some simple pain-relieving tactics, such as applying heat or ice to sore jaw muscles. You should avoid hard foods and chewing gum, and you can try stretching exercises to relieve muscle tension around your jaw.

Additional treatments to consider

Night guards don't usually cure teeth grinding; they simply provide protection from the harmful effects of this ongoing problem. However, your dentist may recommend other options to minimize teeth grinding. Since bruxism is strongly influenced by stress and anxiety, medications that address these underlying issues may help. Some people have also seen success with Botox (botulinum toxin) injections in the jaw area. Muscle relaxing medications may be beneficial in relieving the tension.

"When a patient has muscle symptoms, it's important for the night guard to be adjusted precisely to the patient's bite," says Miller. "People who have troublesome symptoms from teeth grinding may need splint therapy, a treatment in which they wear a night guard to protect the muscles."

If you aren't sure how to manage your teeth grinding, speak to your dentist about the proper treatment to protect and maintain your dental health.

Frequently asked questions

How do I clean my night guard?

It's essential to include cleaning your night guard in your everyday dental routine.

Be sure you follow the manufacturer's directions for cleaning. First, rinse the night guard with warm water after wearing it. Then brush it lightly all over with your toothbrush. You can use the same one you use for your teeth. You shouldn't use toothpaste on your night guard. Some use mild dish soap instead of toothpaste, which can be abrasive.

You can deep clean it once a month by putting your night guard in a glass of water with a denture cleaner, or you can soak it in white vinegar for 30 minutes, rinse with water, and soak for another 30 minutes in hydrogen peroxide. Rinse with water again and leave it out to dry for 30 minutes before putting it in your night guard case.

Note: Never leave your night guard soaking longer than 30 minutes to prevent damage.

Each time you clean your night guard, be sure to let it dry thoroughly before putting it in its case to prevent bacteria from forming. Plus, you should wash your night guard case every few days with mild dish soap and water.

Which is better: Hard or soft night guard?

If you grind your teeth heavily at night, a hard night guard is typically the best option. It does a better job of protecting your teeth and is more durable.

However, hard night guards can be uncomfortable for some, making a person less likely to wear it. In this case, a soft guard might be best. Soft night guards are also preferable for some because they don't cost as much as hard night guards. However, hard night guards typically last longer than soft ones.

Is a top or bottom night guard better?

You don't need to wear both. Choose the one that is most comfortable for you.

Do over-the-counter mouthguards work for TMJ?

TMJ stands for the temporomandibular joint. It is like a hinge that connects the lower jaw to the temporal bone in the skull. Some people who grind their teeth (bruxism) end up with TMJ problems that cause jaw pain.

Mouthguards for TMJ issues should hold your jaw in the correct position. You can find over-the-counter mouthguards for TMJ, but it's crucial that you are custom fit for this device.

If you want to get an over-the-counter mouthguard, first talk about it with your dentist to ensure it's right for your TMJ problem.

How do you permanently cure TMJ?

With proper treatment, TMJ is curable. This can often be done withcustom-made night guards for your lower or upper teeth. For some, corticosteroid injections may help as well. Surgery is a last resort when these options don't work.

Can night guards ruin your teeth?

If your night guard doesn't fit properly, it can damage your gums. When your gums are irritated, this opens them up for infection, which can, in turn, ruin your teeth. If you use a soft night guard and constantly grind your teeth, you could wear out the guard. If this happens, it leaves you exposed to teeth grinding, which will eventually damage them. This is why it's important to schedule regular visits with your dentist to ensure your night guard works for you.

Do night guards change your bite?

If your night guard doesn't fit properly, it could cause your teeth to shift. Pressure from an ill-fitting night guard can cause this over time. It could even alter your bite as the alignment of your jaw may also shift. If you believe this is happening, be sure to make an appointment with your dentist.

Is TMJ a medical or dental problem?

Temporomandibular joint dysfunction and the muscles controlling the jaw are considered medical issues. Medical insurance is typically the primary payor for TMJ problems when it's proven that treatment is medically necessary.

How do I stop grinding my teeth at night and during the day?

Teeth grinding may be caused by stress and anxiety. In this case, stress-reducing options may help. This goes for teeth grinding and clenching during the day as well. You should talk to your dentist to learn how stress management can alleviate your teeth grinding habit.

Teeth grinding at night can also be caused by sleep apnea (when you wake up throughout the night without realizing it). In this case, you should talk to your doctor about undergoing a sleep study. If necessary, you will be prescribed a device to wear at night or a sleep apnea mouthguard to prevent this issue from occurring.

Why do people grind their teeth at night? What causes grinding of teeth?

As mentioned above, stress, anxiety, and even sleep apnea may cause people to grind their teeth at night. Plus, sleeping on your back may increase the chances that you'll grind your teeth.

Another issue that may cause you to grind your teeth could be an abnormal bite or the fact that you have crooked or missing teeth.

What can grinding your teeth cause?

Several things can result from teeth grinding, including:

• Headaches
• Earaches
• Facial pain
• Stiffness and pain in the temporomandibular joint (TMJ) and muscles surrounding it
• Problems sleeping
• Wearing of teeth, tooth loss, and broken teeth

Can bruxism be cured?

There is no cure for bruxism. However, proper treatment can reduce it.

Things like stress reduction therapy, altering your sleep position, medication therapy, and biofeedback therapy can help.

What vitamin deficiency causes teeth grinding?

Vitamin D, magnesium, and calcium deficiencies have been linked to general sleep disorders and teeth grinding. Speak with your doctor or dentist to learn if you're getting enough of these vitamins.

How can I stop grinding my teeth in the daytime?

Train yourself to loosen and relax your jaw muscles. Try putting the tip of your tongue between your teeth when you notice that you're clenching your jaw or grinding your teeth during the day. This will help you relax the muscles in your jaw.

Dr. Courtney Schmidt is a clinical consultant pharmacist and geriatric care expert. Since completing her Pharm.D. at the University of Florida., Dr. Schmidt has worked in multiple clinical settings and has served as an Adjunct Professor at the University of Central Florida.