How to Tell if You Need a Nighttime Mouth Guard – and How to Choose One

Updated February 13, 2021

Have you ever woken up in the morning with a sore jaw, but you aren’t really sure why? Or perhaps your dentist has noticed signs of trouble with your teeth, such as small cracks or worn-down enamel. If any of this sounds familiar, it’s very likely that you are grinding your teeth at night.

Nighttime teeth clenching and grinding, also known as bruxism, is quite common. As many as 10% of adults and 15% of children grind their teeth during sleep. And if you have a family history of teeth grinding at night, you’re more likely to do it as well. Most people first learn of the issue from their dentist, as your teeth with show wear from the constant pressure over time. When left untreated, bruxism can cause serious dental issues, including eventual tooth loss, so it’s important to address the problem as soon as it’s spotted. The most common treatment is a nighttime mouth guard, which helps stop the grinding and protects your teeth.

Understanding Bruxism 

female sleeping on a fluffy pillow with mouthguard

The teeth grinding and clenching that are the hallmarks of bruxism are typically brought on by stress and anxiety. Researchers have found that people who are high achievers or are more determined than average tend to be more susceptible to bruxism. Drinking alcohol or caffeine or smoking before going to bed can also increase the likelihood that you’ll grind your teeth while sleeping, as does sleep apnea. Issues with the alignment of your teeth may also lead to bruxism.

Although most people discover that they grind their teeth at night during a visit to the dentist, there are other signs that you could have an issue. In some cases, the grinding is loud enough that a sleeping partner will notice and mention it to you. Bruxism also tends to cause jaw pain or soreness, morning headaches, and tooth pain, especially in advanced cases. In some cases, bruxism is confirmed via a sleep study, or the use of an overnight bite strip that detects jaw activity, but most people are diagnosed via the damage spotted by the dentist.

If you have bruxism, ignoring it could mean serious consequences for your health. The most obvious issue is tooth damage: Chronic teeth grinding can wear away at your enamel, exposing the dentin underneath. This can lead to painful and expensive dental work in an attempt to save the tooth, or ultimately tooth loss if the damage is severe. Cracked or broken teeth are also a risk.

Bruxism can also contribute to migraines or severe headaches, due to the constant movement of the jaw muscles and the associated tension. And of course, you can’t overlook the effect that a lack of sleep can have on your overall health: Although you may not realize that you’re clenching and grinding while you sleep, it can still wake you up or disrupt your sleep cycles.

Because teeth grinding can be so detrimental to your overall health, it’s vital that you visit the dentist for regular checkups and follow instructions to avoid damaging your teeth. It’s also worth discussing the issue with your primary care physician, as treating underlying causes like anxiety or apnea can prevent grinding.

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What Is a Night Guard?

The most common treatment for bruxism is a nighttime mouth guard, which creates a barrier between your teeth so you cannot harm them. The guard helps reduce the tension in your jaw so you don’t wake up in pain, while also protecting the enamel on your teeth.

If your dentist recommends a nighttime guard, you have several options. The least expensive option is an over-the-counter guard available at the pharmacy. These guards may be soft and customizable using boiling water or have a soft inside with a harder protective coating. The drawback to these guards is that they aren’t always customizable (and even when they are, they may not be an exact fit or very comfortable) and they aren’t as durable as other guards, typically lasting about six months or so. Over-the-counter night guards aren’t designed for people who are severe grinders and are typically not a permanent solution.

For people who are severe grinders or who want a more comfortable custom fit, a prescription nighttime guard from the dentist is a more suitable solution. These guards are more expensive, but they are made using an impression of your mouth and are therefore typically more comfortable to wear. A prescription guard might be thicker than a soft guard from the pharmacy, but it’s likely to be more durable and effective in the long term.

Sleep Apnea and Bruxism

In a study of more than 13,000 people who reported grinding their teeth at night, almost a third of the cases were due to sleep apnea. Sleep apnea is a condition in which you stop breathing for short periods throughout the night because the muscles in your airway collapse while you sleep. To reopen the airway and start breathing again, the natural response is to engage the jaw, which can lead to teeth grinding – all in a matter of seconds without you even noticing, at least until you wake up exhausted with a sore jaw.

The problem is that a typical nighttime mouth guard used for bruxism isn’t going to work if you have sleep apnea. Sleep apnea needs to be treated using other measures, such as a CPAP machine, to stop the teeth grinding. Therefore, if you are diagnosed with bruxism and experience other symptoms related to sleep apnea, it’s important to be tested for apnea before investing in a nighttime mouth guard to ensure you are treating the correct problem.

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What to Consider When Purchasing a Night Guard

If you and your dentist determine that a nighttime mouth guard is necessary to prevent more damage to your teeth, there are some factors to consider.

female putting in mouthguard

  • Comfort: Most people find sleeping with a nighttime guard to be uncomfortable at first; it can take four to six weeks to get used to it. However, the size and material of the guard can make a significant difference with regard to comfort: The more customized the guard, the more comfortable it will be.
  • Cost: Prescription mouth guards made from mouth impressions are more expensive than OTC guards, but your dental insurance may cover some or all of the cost. Consider the cost of the damage to your teeth in the long term as well; crowns, bridges, and dentures are also expensive, and if you don’t address your bruxism, you could be looking at some significant dental bills in the future.
  • Durability: Harder mouth guards tend to be more durable than soft guards, as it’s less likely that you will inadvertently chew on a hard guard during your sleep. More expensive guards also tend to be made from more durable materials, meaning they can potentially last a few years rather than a few months.
  • Effectiveness: The severity of your bruxism may be the most important determining factor in which type of mouth guard you need. Minor to moderate cases may be alleviated by soft OTC guards, while severe cases that have already caused significant damage will likely require a more advanced intervention.

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Other Ways to Help 

Using a nighttime mouth guard will help reduce tooth damage caused by bruxism, but it’s also important to address the underlying causes and determine why you grind your teeth so you can find a way to stop altogether.

Since misaligned teeth are a common cause of grinding, the problem may be solved by straightening the teeth with braces or aligners. Focusing on stress reduction can also help keep you from grinding your teeth. Take time to wind down before bed every evening and add some stress-reducing activities, including exercise, to your daily routine so you go to bed relaxed and calm.

Finally, talk to your doctor about lifestyle changes that can improve your sleep. Reducing or avoiding caffeine, alcohol, and nicotine can all help curb bruxism. Also, note that certain medications, including some antidepressants, can cause you to grind your teeth, so if you notice a sudden change, talk to your doctor about your medications. By making these changes, you can stop grinding your teeth and eliminate the need for a nighttime guard entirely.