• Dr. Saumitra Saravana

Should I get a Nightguard from the store or get a custom Nightgurad from my Dentist?


Night Guards also known as Occlusal Splints are a common treatment for Teeth Grinding and TMD problems. Teeth Grinding is more properly known as Bruxism. Temporo Mandibular Disorders or TMD is a catch all term for a long list of problems affecting the joints in front of your ears and the muscles surrounding the jaws. The joint it self is called Temporo Mandibular Joint or TMJ and many a times patients come to us and tell "Doc, I have TMJ". Its akin to saying, " I have a knee" instead of saying I have a Knee pain.


Bruxism is a problem where patients grind and clench their teeth that is not related to chewing, speaking or swallowing. They might do this while Awake, called Awake Bruxism which is more prevalent among females or they might Brux at night, called Sleep Bruxism. Sleep bruxism has no particular gender prevalence. Sleep bruxism is now thought to be a Sleep Disorder.

Studies examining the occurrence of bruxism have reported prevalence ranging upto 88%. What I see commonly in our own office is that a lot of people grind their teeth at sometimes during their lives. This may or may not be related to other problems like Headaches or Face Pain. A national poll found that adults working full time miss work because of head and face pain more often than for any other site of pain.

So if its so common what is the big deal?

Firstly during Bruxing, enormous pressures are put on teeth. It is estimated that upto 6 times the normal bite force can be generated during these grinding episodes. Its surprising, but most people exert about 160 pounds of pressure during chewing, 6 times that is around a 1000 pounds per square inch!

Such great forces put on teeth can cause them to break or wear down and look unsightly. Secondly depending on the person, grinding on teeth will lead to muscle soreness, headaches and or joint pain.Teeth also get very sensitive if patients have been grinding on them. Another very important reason that you should care about Teeth Grinding, is that it could be linked to other problems like Sleep Apnea.

So what to do about this problem?

Firstly, there needs to be an evaluation as to if grinding is an isolated problem the person has or if there are other problems linked to it. This requires a careful medical/dental history along with a comprehensive examination that includes a check up of the muscles in the face, the joints, the teeth and other related structures such as your throat.

If the problem is just a grinding issue than typically any splint might be used to protect the teeth. Store bought ones might also suffice, although they do not stay in as well. However, with patients with facial pain and other TMD the kind of splint that is used is very important. There are a variety of splints and the diagnosis will lead the Dentist to recommend a particular kind of splint. So, this is an important take away, not every Splint is the same and different patients require different splints. Most therapeutic splints are hard and have specific design features that are customized to your bite and joint condition. Customized therapeutic nightguard, they tend to be expensive but they last a long time, reduce muscle soreness and headaches, help your joints function better. Its hard to a put a price on being healthy and pain free!

While Splints will help a lot of patients, there are other ways to combat this problem. People who grind or clench when they are awake can unlearn these habits and can learn Self Regulatory techniques to reduce episodes where they are clenching or grinding.

Butler Company makes a device that you can put on your temple that senses when your muscles are clenching and sends a small electric shock that stops muscles from clenching. Obviously this a very low dose and is not painful. These devices are not available in the U. S yet I am told.

Store brought soft splints will make bruxing worse. Therefore, if you have joint issues or muscle pain in addition to your Teeth Grinding habit your symptoms might worsen! So please understand that for some people a store brought night guards work fine, but for others a Therapeutic Dentist fabricated Nightguard is necessary after a careful medical/dental history along with a comprehensive examination is completed.

If your are looking for a dentist near you/ in Fredericksburg area or you need to get a free consult or have any questions about Dry Mouth call our office at 540 370 8504 or email us at smile@pearlfamilydental.com.

References:

http://www.dentistrytoday.com/prosthodontics/prosthetics/1716

Bruxism: A Literature Review;J Indian Prosthodont Soc. 2010 Sep; 10(3): 141–148.

Published online 2011 Jan 22. doi: 10.1007/s13191-011-0041-5


53 views