My dentist says I'm grinding my teeth - mouth guard?

July 2004

At my last dentist visit I was told that I grind my teeth. I didn't know that since I am doing it when I sleep. I have a lot of small cracks and he said it would get worth if I would't wear a mouthguard. Strangly, my insurance doesn't pay for it even though the damage it does to my teeth will cost much more in repair. I have to save money for it first which will take a while. In the meantime I could wear a mouthguard which I've seen at Wallgreens and advertised on TV. I just don't know if they are any good ? Did anybody wear a mouthgard from a drug store ?

I use a cheap (about $3.) mouthguard that I got at a sporting goods store (I happen to go to Mary and Joe's on San Pablo in Albany), and I am very happy with it- it actually feels good to me. I have cracked 2 teeth from grinding, one in the back had to be pulled, and another up front had to be crowned (many $). I asked my dentist about the custom made ones, and she said that there was absolutely no reason to get one if I was happy with the cheapie. Cecelia
If you are grinding your teeth in your sleep, then you just need to learn to sleep without grinding your teeth. An easy way to do this is to teach yourself to keep your tongue between your teeth when you are asleep--you will wake yourself up the first time you chomp down! ! ; You may bite your tongue a few times while you are learning, but you'll learn fast, too. You might also check that your side teeth are resting or hanging apart during the day, because keeping them closed all day will make your jaw tense for sure. Unlike the sets of teeth you see on the dentist's shelf, the side teeth shouldn't touch unless you are chewing (some people say swallowing, too, but lots of people don't touch their teeth together when they swallow). There is lots of practical information available about things to avoid if you are in the habit of tensing your jaw--sleeping on your side, crunching on hard foods, on and on--a library or internet search should do the trick. Also, as voice therapists are generally aware, any good singing or voice and speech teacher will have a wide repertoire of exercises for loosening the jaw--you can find this info in voice books in your local bookstore, too. Als! o, you might find someone to help you learn simple stretches for your head and neck alignment, since many people thrust their heads forward or back, and this puts pressure on the joint of the jaw. ''TMJ'' is a misnomer, since it stands for temporo- mandibular joint--in other words, everyone has one unless you don't have a jaw. Tension in this joint can range from occasional to habitual (can be changed with clear information) to chronic (does not change because no clear information has been given) to debilitating (people here have described breaking their teeth and other painful things). All of these have come popularly to be called ''TMJ.'' It's catchy, but if you can just learn how not to tense your jaw, then it's pretty much overkill to treat you as someone with a ''disorder.'' The real problem with a night guard is that it encourages you to bite down, which is the opposite of useful.&nb! sp; Anyway, this is just to say that there are tools and a lot of information for people who grind their teeth, and they are not operating in the dental/medical model. Basically, unless you are unable to function, you can choose whether you sleep with something in your mouth, or learn to sing.

Are mouth guards really necessary?

My dentist told me that I am grinding my teeth at night and that I need to wear a mouth guard. She contacted my insurance provider and found that insurance will pay 60%. I'm not particularly worried about the money, but am wondering if these mouth guards are necessary. The conversation with my dentist left me suspicious - she seemed very eager to get me to do it right away, and was unusually helpful about the insurance, etc. Later, a friend told me that she believes these mouth guards are a scam, that everyone grinds their teeth. I may get a second opinion from another dentist, but wonder if anyone else has experience with this issue.
I have clenched my teeth for years and recently saw a dentist who also suggested a mouth guard. She explained that our teeth are not meant to take the constant hard pressure of pressing against each other without food as a buffer. She was able to show me hairline cracks that were developing in my teeth as a result of the clenching/grinding, and she recommended a mouth guard. I decided to trust her on this and did go ahead and get one. It takes a bit of getting used to, but now I can sleep just fine with it. One plus, is that besides protecting your teeth when you press them together, it makes your mouth rest in such a way that you be come much more aware of when you're pressing together - and in some cases may stop the habit and ultimately not need the night guard. Valerie
No, the night guards aren't a scam. The fact that your dentist was quick and helpful simply means that she is...quick and helpful. My bruxism (grinding) is due to poor occlusion (my upper and lower jaw don't match, the teeth don't line up). I didn't have orthodonture as a child which might have corrected my bite, and I'd have to do some extreme orthodonture to fix it now (many extractions), so instead I wear the night guard. I was experiencing cracking in my teeth and gum recession, as well as a sore jaw, and this has largely abated since the night guard. In any case, if you don't believe me, check out Medline: http://www.nlm.nih.gov/medlineplus/ency/article/001413.htm Natasha B.
Yes! Night guards are necessary and worth every cent. I am 36 and have five crowns! I wish I had coughed up the money when my dentist first recommended a night guard when I was 25. I've been wearing one for three years and I sleep much better at night knowing that I'm no longer wearing my teeth away.

Ask your dentist about a cheap alternative to the hard-plastic kind. Mine is made from a pliable rubber material and it only cost $100. Joanna

I too was told that I ground my teeth at night and needed an expensive night guard. I overheard my dentist telling other patients the same thing. It was costly, I've never thought I ground my teeth, and so I ignored her advice. She hasn't mentioned it again (this was over a year ago), and nothing dire has happened due to this supposed grinding. I'd be interested to hear what a second opinion reveals... also dubious
I don't think that it is a scam about your dentist recommending a night guard. I have been wearing one for about 10 years. I ground my teeth so much that I have actually had to have them built up in places. Without the nightguard I would have a lot more damage. Nightguards are a hassle but they will save you a lot of expense in the end and your teeth will look better in ten years - because they won't be so worn down - than if you hadn't worn a nightguard. MGD
I'd like to answer this question from 2 perspectives! I am a physical therapist (with some experience in TMJ treatment) who grinds her teeth at night and has ended up with some serious TMJ problems! I agree that unless the mouth guard is fitted by a practitioner with experience in TMJ abnormalities (not just any dentist, or any PT), then the mouth guard is useless. The purpose of the night guard is not only to protect wearing down of the teeth, but also to protect the TMJ joint itself. If it is going to achieve both purposes, the guard must be fitted so that the patient's TMJ joint is resting in what is called its ''neutral'' position. Otherwise, you are grinding and putting a lot of pressure on this joint in an abnormal way (even with a ''guard'' that is not fitted properly), thus putting you at risk of developing TMJ problems if you do not already have them. Some say just to go to the drug store and buy a football mouth guard that you can heat and fit to your mouth -- BAD IDEA! Instead, if you are feeling lots of jaw pain, do your research and ask questions! You are very lucky that your insurance covers 60% of the cost -- most do not cover any cost of mouthguards. Call around and ask for dentists or PTs who have specific TMJ experience. Do not just go to anyone who says that they have experience making mouth guards. Ask if they consider the neutral position of the TMJ joint when fabricating. If they pause or don't seem to understand, move on! I'd be happy to help you with any questions, if I can. I know of an excellent orthodontist in Napa (far, I know, but he made my most effective splint) and a PT in Walnut Creek who has lots of experience in this area. Good luck! falconcrest
I'm surprised to hear the comment about night guards being a scam. I've had one for several years (if properly cared for, they last about five years) and have noticed substantial reduction in gum recession, my personal bete noire caused by tooth grinding. That's my own experience. I would suggest that if you are suspicious of your dentist's motivations, that you at least get a second opinion, if not consider switching dentists. anonymous tooth grinder
Many years ago my dentist told me that from his examinations it looked like I was grinding my teeth and clenching my jaw at night. He recommended that I get a mouth guard. Unfortunately I didn't take his advice and I wound up cracking a tooth! These mouth guards are really needed by some people (although they are a drag to wear and fairly expensive). anon.
my sister, who is a dentist, wears are night guard. her husband, also a dentist, agrees that night guards are an important part of prevention of further dental problems. if your dentist can see signs of wear or flattening of the tooth surface, then most likely, you are grinding or clenching enough to cause damage. sometimes, your partner can tell that you grind at night. some people grind or clench in the daytime so a night guard is not helpful. it doesn't hurt to get a second opinion. it seems that the younger doctors are more prone to prescribe things that are for prevention. suzie
I went to the dentist absolutely positive that I had a cavity because I was experiencing a lot of sensitivity with one particular tooth. It turned out to be a small, hairline crack in the tooth, called an abfraction. This was from clenching my teeth while I slept. (I'm a clencher, not a grinder.) Clenching or grinding causes teeth to become very sensitive and painful, but in my case wearing the mouth guard at night has totally made it feel better. I noticed a difference in about a week. I can't explain why, because the mouth guard obviously doesn't heal the crack, nor does it stop you from clenching or grinding. But it does relieve the pressure as you do clench or grind, preventing further problems. Plus, they're super sexy and you feel like a real beauty queen when you pop it in and get into bed. Hope that helps. julie
I have a night guard that I do not wear very often (it is one more thing to clean, much like brushing your teeth). I do grind my teeth and sometimes wake up with a sore jaw from clenching it at night. The mouth guard prevents me from getting a good grip on my teeth and is quite affective. My suggestion: if you wake up with sore teeth or jaw then get a night guard. kathryn
My husband ground his teeth every night for years - especially when he was stressed. It eventually started wearing down his enamel, and was giving him a sore jaw. He got a mouth guard a couple of years ago, and it stopped the grinding immediately. He says it feels sort of slippery, and his teeth can't get a grip on it, so he can't grind. It has helped immensely. Not everyone grinds their teeth, but the night guard certainly helped my husband. Jwheelis
About 5 years ago, I was having jaw problems occasionally when I bit into sandwiches on hard bread, or apples. My dentist thought it was a TMJ problem and refered me to a TMJ specialist but also told me that it was inevitable that I would HAVE to wear a night mouth guard because it was a given that I MUST be grinding my teeth at night. In the meantime, I was in a minor car accident and decided to see a highly recommended chiropractor just for a check-up. She found that my head and neck were displaced (common from childhood orthodontia at least in the old days, she said; probably not from the minor car accident). I didn't mention any jaw problems (it didn't even occur to me that they could be related). After two chiropractic sessions, I could ''magically'' chew effortlessly again and my jaw opened straight up and down again (not off to the side like it had) -- a lot of other annoying things with my body that I didn't even realize until the minor chronic problems all cleared up also disappeared. I never went to the TMJ specialist (although now I'm curious what he would have diagnosed and how he thought it should have been treated!) and I never wore a guard. Since then, I've had no jaw problems at all. I'm not sure if my problem could be related to your reason for posting or not; however, I was told by my dentist that I must be grinding my teeth even though I and my husband didn't think this was the case ! anon
I am a dental hygienist with 23 years experience. I discuss nightgaurds with patients every day. Not everyone grinds or clenches their teeth, but many people do and are unaware of it. The most common sign of bruxism (grinding) is enamel wear. I have seen patients that are in their 20's and 30's and they have grinded off the cusps of their teeth to where their mouth looks like that of someone in their 60's or 70's. There are many symptoms that you could or couldn't have. They are most noticeable upon waking. Headaches, shoulder/neck stiffness, occasional jaw pain that disguises itself like a toothache but then goes away, sporadic cracking/chipping teeth, earaches and more. Previous orthodontic work(braces) is very common in a bruxer. The most common complaint I hear is ''I had this pain and then it went away after a day''. Nightgaurds are far from being a scam. They have been around for many years but are the most underdiagnosed thing in dentistry. Remember that your mouth is different than anyone else's mouth. What goes on in your friend's mouth has nothing to do with yours. There aren't many solutions as simple as a nightgaurd that have such great benefits. I always have clients tell me they sleep better and don't have anymore pain. If you are unaware that you grind, one way of telling might be to look at your teeth in old photos and then look at them now. Do they appear shorter? Like a receding hairline you see the progression with time. We dental professionals are always faced with a patient not wanting to do work unless it is covered by their insurance, so we go out of our way to find out patient's benefits, so that you can make your decisions on what work you would like to do. Nightgaurds are commonly not covered by insurance and at best they are covered at 50%. I think your dentist is trying to help you. My guess is she was happy for you, that you had coverage, most people don't. After doing this work for as long as I've been doing it, it always seems to bother me that people always think dentists are bad guys, selling some line. I work for a very ethical practice and we keep the best interest of our patients in mind. Of course we all work for money too, dentistry is a business, but contrary to popular belief, anyone that can do what we do is mostly in it because we care about your oral health. I h sgp
I love my night guard. I have been grinding my teeth for years; it is more pronounced during stressful times. Looking closely at my teeth, you can see where the grinding takes places and I can sometimes feel tightness in the jaw when NOT wearing my night guard. It is a personal decision. For me, it is very helpful and I can feel the difference. Good luck with your decision. anon
A moldable plastic night guard is available at Mary and Joe's Sporting Store on San Pablo and Solano. It's about $2 and not hard to use. Grinding my teeth has led to TWO crowns (@$900 each) and hurts my jaw. When I use the mouth guard, my mouth does not hurt. M.
Go to the sporting goods store, get a football mouthguard - the kind that you drop in hot water to soften up to fit - Cut the strap off with a sharp knife and Voila! A night mouth guard for about five bucks. I did this for tooth grinding, works great. My uncle the dentist told me about it, and an ear nose and throat MD confirmed that it's a great solution. Jon
Hi: I have a nightguard. When my dentist recommended it I had the same reaction as you....sounds like they're trying to make some money from me (heavy sell). But now that I've used it for a few months, I can see the benefits. My jaw is much more relaxed. Also I was grinding my teeth down fast, so the guard will hopefully save me from costly crowns in the future. My advice...get the guard Lisa
I wear a night mouth guard and I truly believe it works. My dentist advised me to get one because I was grinding my teeth at night and was causing alot of stress and wear and tear on a molar that has a dental implant and crown. The dental implant was super expensive (not covered by insurance either) and the first one I had failed, my dentist thinks because of the teeth grinding. This is my second implant and I have used the night guard the entire time. It has been about a year and a half and I think I am out of the woods for this one failing. This leads me to believe that the guard is really helping.

If you have alot of dental work that you would like to protect, or if your teeth seem to be shifting at all, this is one way to keep them in place. Net net, I am really happy with my night guard and have a hard time going to sleep without it! Julie

Hi, I've been told (by my wife), that I've been grinding my teeth, practically since she's first known me (over 20 years now). My dentist noted (independently) that my teeth appeared to have an unusual amount of wear, and he asked me if I was grinding my teeth. Thus, I got fitted for the mouth guard... I don't recall how expensive it was, but, as in your case, insurance only covered a portion. There is another alternative-- most sporting goods stores sell ''bite-guards'' in the football section of the store. For ~$10, you can get one of these-- you drop them into boiling water and then bite down to get a 'custom' fit. I'm betting that it's about as good as the dental piece, and I'll probably use this, if I ever lose my more expensive piece. The only danger is that you may kick it out of your mouth during the night, but that has happened sometimes with my dental piece too. Jim
Hi - had to answer about the mouth guard. I've had one for over 20 years (and get new ones every so often) and the difference in how my teeth feel with and without it is night and day. My husband not only ground his teeth but snapped his jaw so hard it woke me up. He didn't get a guard until he damaged his teeth so much he had to have expensive and painful dental work. Now he wears his every night, too. It's not romantic, but so worth it. Happy with night guard
Definitely get a second opinion. I have known since I was a child that I grind my teeth. Your friend is wrong, not everyone grinds their teeth. But in graduate school I starting grinding my teeth to the point that they hurt in the morning. I thought I had a cavity, but it was the grinding. I put off getting a mouth guard for about 3 years and as a result I put so much stress on one side of my mouth, I cracked my tooth and it now has a crown. That was only the beginning. I need to wear it every night, otherwise my teeth get so sensitive they hurt. It is now 10 years later and I still grind my teeth but with a mouth guard. I can see the battering I do to the gard and am glad I'm not still doing that to my teeth. They are the only set of teeth you have left, they are worth the protection. -my two cents
While I think your friend is right that everybody grinds or clenches at night, I think there are degrees to the severity and results.

I happen to have a very strong jaw along with an overactive nocturnal habit of clenching and grinding that has caused considerable harm to one of my molars. My dentist attributes the many cracks in my teeth to this activity, and these cracks have led to fillings, crowns, and in one extreme case, a root canal.

I got a mouth guard about a year ago and had to pay for the entire bill out of pocket (not as generous of an insurance company). I was very disappointed to finally get the guard and find that it was a stiff, plastic mouthpiece that fits over the top set of teeth. It seemed completely contrary to the goal of minimizing the impact of my grinding and clenching. I thought it would be softer, more maliable, so I could sink my teeth into it rather than into my bottom teeth. Nevertheless, I put it on. After several trips back to the dentist for adjustments I can safely say that I find it to be WORTHLESS! Whether I grind and clench with my own teeth, or I use the mouth guard to smash my bottom teeth, it's still causing harm. My teeth and jaw are still sore, just like they were without the guard.

I actually ended up using the tray that came with my teeth whitening kit and because it's soft and flexible it has seemed to really help me.

I recommend trying a cheaper alternative like a sport mouthguard or whitening tray to see if 1) you can stand something in your mouth all night, 2) you want/need something that's flexible and takes the brunt of your activity, 3) if this method of prevention actually works for you. Good Luck! anonymous

I have had a mouth (occlusal) guard for years (first one covered by insurance then in a bag that was stolen, second not covered AT ALL by insurance so you are lucky at least 60% is covered, I paid about $500). I got the first guard after I had to have a root canal because I clenched so much I cracked a tooth which got infected. Ouch! Those early 30s were pretty stressful :-) I have been on and off using it, but a recent visit to the dentist had him saying a similar thing to yours, use it every day without fail etc. or else risk further damage. I just could not use it during my pregnancy and after, there was just so much going on and sleep was so broken I couldn't bring myself to keep putting in the guard after waking up for the umpteenth time to nurse the baby. Now that we're older and sleeping a little better, I'm trying to use it more faithfully but wonder, as you do, if it's worth it. The root canal was so so awful I tend to use the guard so I can avoid another. I wish there was a way to measure how much damage I'm really doing and see if the guard is worth wearing. Good luck... Jocelyn
My Mother-in-Law, who's in her early 60s, ground her teeth for years and caused considerable damage, to the extent that she had to have her front teeth capped. She now uses a night guard. I have similar issues and swear by them. Might be worth trying -- you only get one set of teeth! Anon
Before going to a TMJ specialist to get fitted for a night guard, I'd first go to ww.tmj.org, which has an entire section devoted to night guards/splints. Also, be aware that there are hundreds if not thousands of dentists and physical therapists in the Bay Area who claim to be TMJ specialists. Some of them are lying. My general understanding is that mouth guards can be handy for people with serious bruxism. The use of splints in treating TMJ disorders, however, isn't backed by ANY scientitic studies. Repositioning splints, in particular, are harmful, in that they damage patients' bites irreversibly. Bear in mind that people aren't designed to be perfectly symmetrical. Just because a person's bite doesn't line up with Germanic precision doesn't mean there's anything wrong with it. Anon
I have had the tooth grinding problem off and on for years - although oddly enough - never when I was pregnant or nursing - hardly stress-free times! A friend was recently told by her dentist that she had cracked many of her molars from grinding and fitted her for a mouth guard.

I had been having bad headaches recently and I am pretty sure they were from the grinding. Figuring I didn't have much to lose before spending hundreds of dollar on a mouth guard, I went to Long's Drugs and got an off-the-shelf item for about $25. It has a very detailed description of how to fit it which involves softening it in boiling water, etc. I have been using it off and on for a couple of weeks and no more headaches.

You might try it. If you do, don't give up after the first night wearing it. I found it molded itself to my mouth over the first week or so and feels much better now than it initially did. Good luck! Lisa

Thank the lord for giving us the smarts to make these things! My whole family has to use them and let me tell you they are life savers. I didn't get one until my early twenties and I wish our family dentist had insisted on us wearing them when my sister and I were much younger. Before the night guard I almost ground the tops off of my lower teeth down to the nerves. I've been wearing one religiously since my late twenties and sleep much better at night. More importantly, I have a better chance at keeping my teeth because it protects them from becoming even more worn down. If you have dental insurance it will cover most of the cost of having a custom guard made. Don't settle for less! The over the counter guards are very uncomfortable and don't work nearly as well as the one your dentist will make for you. Once the dentist makes the first mouth guard, you should be able to get somewhat of a price break if you need another. Things to watch out for when using a night guard.

Always put it in the container and make sure the container is far away from dogs or cats. They have eaten many a mouth guard tucked safely under one's pillow.

Night guards can break after an excessive amount of wear and tear! I have to get a new one made after 3-4 years of service. I pretty much destroyed it. I'm grateful it was the guard I destroyed and not my teeth!!

If you have any other questions, please feel free to contact me off the list. bk

I have had a problem with grinding my teeth since I was a child. When I was in college, the dentist I had at the time attributed grinding my teeth to a bad bite and some bad fillings. He ground down some of the fillings, and I think the grinding lessened as a result. However... some twenty years later, I'm still grinding my teeth at night. My current dentist, who has been my dentist for 15 years and whom I like very much, recommended that I get a night guard because she said that my gums, which are already starting to recede, are becoming 'notched'. She says that it is a result of grinding my teeth, plus my age (48). My teeth also have little cracks in the enamel.

p I have had the night guard for about a year. I wear it most nights. I haven't had an exam since I got it, so I don't know if my dentist will see an improvement. I don't actually expect that my gums will improve, but I'm hoping that they won't get worse. So I look at the night guard as 'insurance' to prevent me from further fracturing my teeth and to prevent further 'notching' of my gums. I'll be interested to read other postings on the subject because I didn't do any reading about night guards before getting mine. - anonymous

First, may I suggest that you seek out a dentist in whose recommendations and treatment plan you can place your trust. For several years I was the patient of a dentist who, I was convinced, was only interested in extracting as much revenue as possible from my mouth. In that light, ANY treatment that he suggested was suspect, regardless of its basis in good dentistry. When I finally found a dentist that I felt was trustworthy, (a valued friend who's his dental assistant vouched for his integrity), he suggested that a possible cause of the procession of cracked teeth requiring root canals and crowns that I'd been experiencing might be excessive nighttime teeth grinding and that a night guard might help. (My previous dentist had provided the root canals and crowns, but not suggested the night guard.) I had him fit me for the guard, (to the tune of $300- not cheap!) and I've not had another cracked tooth in the past 3+ years since. (Subsequent dental work has required modifications to the original and recasting of a new one which my dentist has done for no additional charge.) You should be aware that having the thing in your mouth takes some getting used to and it only works if you wear it every night. (I know two other people that have been fitted for them and neither of them continues to use it.) On several occasions I believed that I was no longer grinding my teeth at night and left the night guard on the bedside table only to awaken with an aching jaw- proof that I was still grinding away. At one point I misplaced my dentist-made night guard and tried the over the counter model available in drugstores, but due to the amount of excess material in the fitting process it made for a very poor substitute. Hope this helps. anon