Intraoral protective appliance used in teeth grinding (bruxism) and temporomandibular joint disorders that protects teeth from wear and helps relax the chewing muscles.
Indication
- Teeth grinding or clenching during sleep (bruxism)
- Temporomandibular joint (TMJ) pain and dysfunction
- Tooth wear, fractures, or sensitivity due to bruxism
- Morning jaw fatigue, headache, and temple pain
- Pain or hypertrophy of the chewing muscles (masseter, temporalis)
- Protection of dental treatments (fillings, crowns, implants)
- Stress-related jaw clenching
Preparation
- Detailed intraoral examination and TMJ assessment by the dentist
- Dental impressions are taken with a digital scanner or silicone if needed
- Existing decay, periodontal disease, or restorative needs are treated first
- The patient is educated about the appliance use plan (night/day)
- The severity of bruxism is assessed to choose the type of guard (hard, soft, or dual)
How it's performed
- An impression of the upper or lower jaw is taken and sent to the laboratory
- An individualized acrylic or thermoplastic guard is fabricated
- The guard is placed in the patient's mouth and the bite (occlusion) is checked
- Selective adjustment is performed to balance the bite if needed
- Information on insertion-removal, cleaning, and storage is provided to the patient
- Follow-up appointments are scheduled for the initial adaptation period
Post-procedure
- An adaptation period may be needed in the first week; the guard is adjusted if discomfort persists
- First check-up at 1-2 weeks, then periodic check-ups every 6 months to 1 year
- The guard is cleaned daily with a toothbrush and lukewarm water; it should not be exposed to hot water
- It must be replaced in case of wear, cracks, or looseness
- If TMJ complaints persist, physiotherapy or stress management may be added
Risks
- Increased salivation, foreign body sensation, and mild speech difficulty in the first few days
- Bite changes or worsening of TMJ complaints if the guard is not properly adjusted
- Possibility of triggering grinding with soft guards (in incorrect indications)
- Tooth decay or gum disease if oral hygiene is not adequately maintained
FAQ
Does a night guard completely cure bruxism?
The guard does not eliminate the cause of bruxism; it acts as a barrier protecting the teeth and the jaw joint. Stress management, physical therapy, and improving sleep quality are also part of the treatment plan.
How long should I use the guard?
Because bruxism is usually a long-lasting condition, regular nightly use of the guard is recommended. Use may continue for protective purposes even after symptoms decrease.
Are over-the-counter pharmacy guards sufficient?
Ready-made guards may be a temporary solution, but because they do not fit the teeth precisely, they may cause bite problems in the long term. A custom-made guard prepared by the dentist is safer and more effective.
How often should the guard be replaced?
It varies by intensity of use; hard guards generally last 2-5 years, and soft guards 1-2 years. It should be replaced if wear, cracking, or changes in bite are noticed.
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