Is An OTC Night Guard the Best Way to Treat Bruxism?

nightguards Woman in Bed

Do you often wake up in the morning with a sore jaw or a headache? Do you notice your teeth having “sharp” edges, chips, or even small cracks? If so, you might be one of about 30 million people in the United States who grind their teeth while they sleep!

Teeth grinding, a condition medically known as bruxism, may not be life-threatening, but it can cause pain and damage to your teeth. Additionally, it may be a sign that your sleep health in jeopardy! In today’s post, we’ll talk about the condition, drawbacks of the most common treatments, and how the latest dental technologies can help you.

But I’m also very thoughtful about the new technologies that I integrate into my practice.  I like to be confident that any protocols, technologies or techniques I bring into my practice are going to be improvements on traditional alternatives. I want to make sure I’m offering my patients the best treatment options for gum disease, tooth decay, TMJ function and other dental health issues.

Diagnosing Bruxism

Usually, bruxism isn’t too hard to spot. Many people suspect that they’re grinding their teeth, either because their partner has mentioned it to them or because they’ve looked up their symptoms online.

When examining a patient, it’s generally easy to tell when someone has been grinding their teeth– especially if it’s been going on for a while. I look for chips and damage to tooth enamel, such smoothly worn surfaces, as well as damage to crowns, fillings, and dental implants, and also ask about headaches and jaw pain.  But the most important aspect of bruxism, or night grinding, is that it may be an indicator of something more serious: sleep apnea.

Night Guard: The Traditional Bruxism Treatment

The most common treatment for bruxism is some form of bite guard. A bite guard is a dental appliance that’s worn in the mouth during sleep that prevents you from grinding your teeth together. It’s similar to the mouth guards that athletes wear when playing sports– but they are thicker, less flexible and meant for sleep, not basketball!

The Drawbacks of an Over-the-Counter Night Guard

Many dentists begin treating bruxism and teeth grinding by recommending an over-the-counter night guard to their patients. I think this is a mistake.

Over-the-counter bite guards are usually made from a soft plastic material that can be heated in the microwave or dipped in boiling water to make them more pliable. Then you bite down on the softened material to create a “custom fit”.

I put that in quotes because the fit isn’t custom, it’s customized. That’s an important difference you should be aware of. An OTC (over-the-counter) bite guard isn’t made just for you, it’s meant to fit a wide variety of jaw and mouth sizes, so it’ll never fit you perfectly.

Additionally, the materials in an OTC bite guard are soft and a little chewy– otherwise you wouldn’t be able to customize them to fit your own teeth. Let’s think about this for a second. If you’re chewing, grinding, and clenching while you’re asleep, how will putting something chewy and soft in your mouth help the problem? It won’t.  Experience has shown me that most people will grind through this style of bite guard in just a few short months.

Because of their nature, soft plastic night guards just encourage you to keep chewing, grinding, and biting down while you’re asleep. That just doesn’t make sense!

Custom-Made Acrylic Night Guards

Luckily there’s a better option. Many dentists, including myself can create a truly custom hard acrylic night guard. Custom night guards are made just for you using an impression of your own teeth, ensuring a perfect fit.

For years, the only way to make an accurate impression of your teeth was to use a goopy material that hardened to make a mold. Talk about gross! The whole process was frustrating, as it could take a few tries to get the impression right and it simply isn’t fun to have to hold a mouthful of goop still while it hardens! In fact, many people found it so uncomfortable they would gag! Yuck!

Luckily, there’s a better way. Recently I introduced the Trios 2 system to my practice, Blodgett Dental Care. The Trios 2 is a really amazing device that can capture a picture-perfect 3D image of your teeth in just seconds. It’s 100% non-invasive and completely pain-free.

The best part is that the pictures taken by the Trios camera can be sent to a lab to make dental appliances like crowns and, you guessed it, night guards! How cool is that? That means you can be measured for a truly custom night guard in less time than it takes to make a cup of tea!

The other advantage of custom-made acrylic night guards is in the material. Acrylic isn’t soft and chewy. It’s firm. When used as a material for a night guard, it doesn’t encourage biting, clenching, or grinding. Your teeth naturally rest against it and there’s no instinct to bite down on it. That way, your teeth are protected and you’re not encouraging the behavior you’re trying to stop.

    Prescription Medications for Bruxism


    prescription treatment

    In some cases, a dentist might even prescribe medication to help prevent tooth grinding. The most frequently prescribed medicines are muscle relaxants of some kind that are meant to help patients relax while they’re asleep.

    Unfortunately, this isn’t a great approach. Instead of attempting to understand and resolve the underlying issue, prescribing medications is just treating the symptom by masking it with a pill. This isn’t a good long-term solution.

    Treating Bruxism Holistically

    As a holistic dentist, I try to look beyond the traditional treatments and find a holistic solution to help my patients. While bruxism is a problem that manifests itself physically, the root causes can be surprising.

    Bruxism & Sleep Apnea

    Believe it or not, bruxism is often a warning sign of sleep apnea– a common and potentially dangerous disorder. The grinding response can be triggered when you stop breathing during sleep– the definition of sleep apnea.

    If we ignore this warning sign, the complications can be very serious. The longer sleep apnea goes undiagnosed, the worse you’ll feel, and the harder it’ll be to treat.

    That’s why I look at bruxism from a holistic perspective and try to find the underlying cause rather than simply treating the symptom.  If I see signs of bruxism, I will generally have a conversation with you about your sleep quality and recommend a non-invasive at-home sleep test to assess your sleep health.  As with any other health condition, early diagnosis and prevention are the keys to living a healthy life!

      Psychological Causes of Bruxism



      Worried Woman on Couch

      Bruxism isn’t always 100% physical. Stress, anxiety, major life events, and other psychological factors are estimated to be a factor in as many as 70% of bruxism cases. If a patient’s bruxism can’t be explained physically, I encourage them to practice good sleep hygiene and to try meditation, yoga, and other relaxation techniques before bedtime.

      What is good sleep hygiene?

      • Not eating right before bed.
      • Sleeping in a room that’s dark but that receives natural light in the morning.
      • Avoiding unnatural light– like computers, phone, and TV screens for an hour or so before bed. And no phones, TVs, or other light sources in the bedroom!
      • Using your bed for sleep- not laying around reading, listening to the radio, or other sleep-disrupting activities.
      • Spending at least 7 hours in bed, even if you’re not asleep the entire time.
      • Exercising regularly in the morning or late afternoon.
      • Minimizing caffeine intake and naps, both of which can make it harder to sleep at night.

      By adhering to these best practices, it’s possible to achieve deep, restful sleep and eliminate your bruxism.

      Ask Your Dentist!


      If you suspect that you’re grinding your teeth, ask your dentist for help. He or she can confirm the diagnosis and work with you to develop a treatment plan that works for you.

      If you live in the Portland area, contact me, Dr. Kelly J. Blodgett at Blodgett Dental Care. Call (503) 894-5802 to schedule your appointment today! I’d love to help you sleep and feel better.

      Photo Credits: Sodanie Chea, Charles Williams, Erik Drost


      Call Blodgett Dental Care at (503) 713-6980 to schedule your next appointment!

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