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The Brush Up

    What is an occlusal guard?

    The term “occlusal” refers to the surfaces of your teeth that are used for chewing. When you are damaging those surfaces by clenching or grinding your teeth, an occlusal guard may be recommended by your dentist. 
     

    Also referred to as a nightguard, bite guard, or bite splint, an occlusal guard is a removable appliance that fits over your upper or lower teeth. It helps prevent damage to your teeth that can be caused by grinding and clenching, a destructive oral habit also known as bruxism(1).

    While occlusal guards don’t necessarily stop you from grinding or clenching, they do help protect the tooth surfaces from damage caused by those actions. Occlusal guards can also help alleviate the symptoms associated with bruxism including jaw pain, head and neck muscle pain, tooth wear and fracture, tooth sensitivity, and headaches.

    Occlusal guards are similar in appearance to sports mouthguards but are typically less bulky and are made of smoother, thinner plastic(2). They can be custom-made by your dentist to fit your mouth exactly, bought at a neighborhood drugstore ready-made (boil-and-bite or microwaveable), or purchased online. 

    Do you need an occlusal guard or nightguard?

     

    You may be wondering if you're in need of an occlusal guard or nightguard. While occasional teeth grinding or clenching should not be a major cause of concern, consistent, long-term bruxism can lead to pain, broken teeth, loss of tooth enamel, and in severe cases – loss of teeth themselves. For these individuals who experience moderate to severe bruxing, an occlusal guard could greatly benefit oral health. 

    Bruxism is a fairly common problem. It is estimated that about 10 percent of adults and as many as 15 percent of children are affected(3). This grinding and clenching typically occurs at night, but may also be a daytime habit, and most people are unaware they have the problem. Unless your sleep partner complains about the noise, your dentist is usually the first to recognize the damage to your teeth and raise concern. 

    Some symptoms that may indicate the need for an occlusal guard include(4): 

    o   Teeth clenching and grinding

    o   Jaw pain or stiffness

    o   Fractured or worn-down teeth and dental restorations

    o   Loose teeth

    o   Temperature-sensitive teeth

    o   Headaches, earaches, toothaches in the morning

    o   Facial pain

    o   Disrupted sleep

    o   Sleep partner complains about the noise

    Types of occlusal nightguards(5)

     

    There are three common types of occlusal guards used to limit the effects of bruxism. If you have any questions about which type is the best for you, then we recommend speaking with your dentist who will be able to advise. 

    1. Soft nightguard – Used to alleviate symptoms for mild cases of bruxism. They fit comfortably and are usually easy to get used to wearing.

    2. Dual laminate nightguards – Designed for moderate to severe teeth grinders. They have a soft, comfortable, inner surface and a hard, durable outer surface. 

    3. Hard nightguards – Used for very severe cases of bruxism. They are made from acrylic, are extremely durable and long-lasting, and will need to be custom-fit by a dentist. 

    Other things to know about occlusal guards(6)

     

    Your occlusal guard is intended to make your mouth feel more comfortable. If it doesn’t, then you may not have the right fit. Your occlusal guard may need to be adjusted after placement, and, if it feels uncomfortable in any way or if you experience any pain, then it's best to let your dentist know. They’ll be able to help. 

    Most occlusal guards are worn at night only, but those who grind or clench their teeth during the day may also benefit from daytime wear.  If esthetics are a concern, your dentist can make a custom guard for daytime use that is significantly less visible from the front – but may also be less durable than those worn at night. 

    It is extremely important to clean your occlusal guard before and after each wear as they are prone to colonization by bacteria or other microorganisms7. Insufficient care can lead to greater oral health problems or the spread of other diseases. 

    Final thoughts

     

    Occlusal guards won’t stop you from clenching or grinding, but they can be a very effective way to protect your teeth during the day or night if you suffer from those unconscious destructive oral habits. If you do decide to get an occlusal guard, the type you choose will depend on the severity of your individual condition, as well your comfort needs and financial limitations. 

    If you have any questions about whether you need an occlusal guard, we recommend seeing your dentist for an evaluation. He or she will be able to diagnose any bruxing damage and help guide you through treatment options.  
     

    Sources

    1 Teeth Grinding. (n.d.). Retrieved August 14, 2020, from https://www.mouthhealthy.org/en/az-topics/t/teeth-grinding

    MJ;, G. (n.d.). Occlusal accommodation and mouthguards for prevention of orofacial trauma. Retrieved August 14, 2020, from https://pubmed.ncbi.nlm.nih.gov/19408816/

    3 ASA Authors & Reviewers Sleep Physician at American Sleep Association Reviewers and Writers Board-certified sleep M.D. physicians. (n.d.). Bruxism - Teeth Grinding Symptoms, Treatment & Causes. Retrieved September 09, 2020, from https://www.sleepassociation.org/sleep-disorders/more-sleep-disorders/bruxism/

    4 (n.d.). Retrieved August 14, 2020, from https://www.nhs.uk/conditions/teeth-grinding/

    ASA Authors & Reviewers Sleep Physician at American Sleep Association Reviewers and Writers Board-certified sleep M.D. physicians. (n.d.). Night Guard for Bruxism: Teeth Grinding and Clenching. Retrieved August 14, 2020, from https://www.sleepassociation.org/sleep-treatments/night-guard/

    6 Lal, S. (2020, February 06). Bruxism Management. Retrieved August 14, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK482466/

    Cleveland Clinic. “Mouthguards Information & More.” Cleveland Clinic, 2020, my.clevelandclinic.org/health/articles/10910-mouthguards?_ga=2.201488917.569986366.1590773216-787185363.1590773216.