Night guard for non-grinders? Worthwhile or just upselling?

April 27, 2015 10:37 AM

I have a dental checkup this week, and I expect to get harangued to get a night guard—a conversation I’ve had with this practice for the past two or three visits. I’m not convinced I need one. Do I?

Hey--who is my dentist? Not you! I know that, and will not sue (or bite) you over any dental experiences you share.

As far as I’m aware, I don’t grind my teeth—in my sleep or otherwise. I do have some gum recession, and got a gum graft last summer that was not particularly enjoyable (but was a complete success)—but otherwise, I brush and floss every day, and my teeth get rapturous accolades from the hygienist and dentist. I have no jaw pain.

The dentist (and hygienist) have made some assertions that the night guard will help with my gum recession. Perhaps there is some evidence that night guards help with the gums of teeth grinders, though I wonder what benefit I would see as someone who is not grinding his teeth. It seems a bit like asking a barber if you need a haircut.

Dental insurance will cover some of the cost, but I’d be out of pocket a few hundred bucks. That said, I will have extra money in my FSA this year that I’ll have to spend in any event. And, while I really don’t want to wear a night guard, I am relatively mindful of the health of my teeth and gums, and would (reluctantly) use the night guard if it were really beneficial and would extend the useful life of my precious choppers. I’m entirely ambivalent about the pros and cons here.

Dental and periodontal enthusiasts of Metafilter, what has been your night guard experience, particularly if you were a non-grinder? Is it worth the hassle?

posted by Admiral Haddock to Health & Fitness (15 answers total)

Answering a slightly different question: my husband grinds his teeth terribly and definitely needs a night guard. He's used this one, which costs ~$19, for years, replacing it approximately once every 6 months or so. It works perfectly, and his dentist is extremely happy with his teeth since he started using it. Even if your dentist only believes that that kind will be 75% effective, perhaps it's worth using for a while and seeing if it makes a difference. And if your dentist is extremely insistent that only a few-thousand-dollar custom night guard will do, then I would get a new dentist.
posted by brainmouse at 10:41 AM on April 27, 2015 [1 favorite]

Dental insurance will cover some of the cost, but I’d be out of pocket a few hundred bucks.

??? As a major night grinder, I just had to replace my mouth guard. Before insurance, it was $250 - that's before discount or anything. I think I paid $60 total out of pocket.

Um, that just sounds way overpriced to me.
posted by jillithd at 10:42 AM on April 27, 2015

The last time I went to the dentist, he informed me that gum recession is associated with grinding, and informed me that I grind (even though I don't believe I do). IIRC, it's something like grinding (even mild?) puts pressure on teeth and causes them to not be lined up correctly for biting/chewing. Then, when your teeth hit, the ones that aren't quite lined up have a higher impact and because the tooth is hard, it slightly vibrates in the gum. That vibration is actually micro-abrasion and over time, wears down the gum (leading to what we see as recession). Apparently a night guard prevents that pressure at night and allows the bit to relax and adjust so the teeth are hitting properly without that high impact and vibration. This dentist dentist also told me I have a ginormous cavity that's been growing for 5-6 years and need a filling asap (apparently the other dentists I've had in the past 5 years missed it) so I'm not sure whether or not I believe his explanation.
posted by DoubleLune at 10:45 AM on April 27, 2015

I don't grind my teeth. I clench them. Unlike you, however, I've had a whole slew of problems from my nighttime teeth clenching hobby.

Ask your dentist about an NTI. I haaaaate mouth guards (wake up with them spat out clear across the bed) and find them a completely untenable solution for me personally. But my NTI has been great and has solved basically all of my tooth-clenchy issues.

See how much less obtrusive it is than a typical mouthguard? So nice. If your dental team tries to push a mouth guard on you, ask your dentist if an NTI would be a good option for your mouth issues.
posted by phunniemee at 10:46 AM on April 27, 2015 [7 favorites]

If you're a clencher, you can do a lot of damage without grinding. Gum recession and fractured teeth are both outcomes of clenching alone. A mouthguard may not prevent all damage, but it can significantly reduce the damage over time. Custom mouthguards made by your dentist are usually several hundred dollars in my experience. Or, you can make a DIY version with any number of kits that you can buy for $10-20. It takes awhile to get used to wearing one, but now I can't sleep without one.
posted by quince at 10:54 AM on April 27, 2015 [1 favorite]

Anecdotivence: No one mentioned a dental guard to me until I was in my 50s. Then I got a new dentist (because I had moved), and he and my hygienist mentioned it every time I saw them. Then I moved again, and new dentist and hygienist have not mentioned it. THEIR up-sale of choice seems to be water picks. I think most offices have something they push. (Teeth whitening was a favorite at my dentist before the mouth guard office; my current dentist has actively discouraged it). It's always something that anyone might benefit from, and that won't harm you, whether it helps or not. But if they're recommending a solution to a problem you're not aware of really having, you might want to resist.
posted by ubiquity at 11:02 AM on April 27, 2015 [1 favorite]

I am also a non-grinding clencher, and have been wearing a night guard for 24 years now (holy cats!). I have purchased three in that period of time, as they wear out after about 8-10 years, and there are always new and better materials that the designers are developing, so they feel much better now than they did at first. A few hundred dollars sounds about right for my out of pocket cost.

I have no perceptible gum recession, although I don't know if that is from the guard, but I do hear that tooth clenching can lead to gum recession as well as cracked, worn, or loose teeth, headaches, and neck pain. I originally got the guard because I was waking up with headaches, and it has helped a lot.

Personally, if I was having gum recession to the point of needing corrective surgery, and my dentist said a guard would slow that process, I would do it. If, after a few years with the guard, you haven't seen a slow down of the recession, you could always stop wearing it.
posted by blurker at 11:08 AM on April 27, 2015

My dentist has mentioned a mouth guard for me in a low-key way a couple of times now.

This weekend I was at CVS and saw one for $30, so I bought it. I haven't tried it yet, so I can't speak to how well it works. But a $30 experiment was a lot more palatable (ahem, sorry) than a $XXX one.
posted by pmurray63 at 11:17 AM on April 27, 2015

I do grind, and I am now on my second guard (after a decade I chewed through the old one).
Before I got my first one, my dentist recommended I try one of the cheapo ones linked above. And again when I had to wait for my new one to be made, new dentist made the same recommendation. They told me the main problem is that I would chew through the cheap ones way too fast.

So why not try a cheapo one for a while to see if it helps with your gums?

Also I think the total cost for my (non-cheapo) guards has been a few hundred bucks each, if it is anywhere close to 1k I would be skeptical.
posted by nat at 11:23 AM on April 27, 2015

I'm a grinder, and after a couple times of my dentist showing me what my teeth were doing to each other and recommending a night guard, I bought one of those drug-store cast yourself varieties and couldn't stand it. Too much goop and it was stimulating the roof of my mouth too much to sleep. I finally relented and got one professionally made through my dentist. A real nice polycarbonate one based off a mold of my teeth that snaps into place on my lowers and is minimally intrusive. The first morning after wearing it found it underneath me in the bed. the second night I got used to it, and I've worn it for about 2 years now. After seeing how much I've worn it down I'm almost scared not to sleep without it. This was all to protect the structure of my teeth, not about my gums, but I'd recommend if you try the cast-your-own kind and don't like it, try a pro one - which cost me between $100 - $200 (after insurance).
posted by achrise at 11:49 AM on April 27, 2015

Similarly my dentist for years said I should use a nightguard against grinding. I never believed him or understood what the problem was. I chew food all the days right?

Then recently I had a minor chipping on a front tooth where he says the cause and future worsening is and will be due to my night grinding/clenching as this puts many many more pounds of pressure than chewing food will ever do. To envision, he says: clench your teeth as hard as you can, imagine grinding and this is far, far more damaging than chewing food. I still said that it is hard for me to believe that I grind as I am, you know, unconscious while said thing happens. He then proceeded to show me the grind marks on the backs of my front teeth from my bottom teeth.

So ... I tried a mouthguard from Target for about 20-25 dollars that is much more low profile than the others and can be easily fitted by microwaving in water. The full confirmation of my night grinding is the grinding pattern in the mouthguard when I wake up! And, surprise, I actually like it because I don't have the feeling of my teeth pressing together when I fall asleep and wake up in the night (probably due to the grinding!). I sleep better.

I do wish he would have explained better and I do wish I would have tried the 20-25 dollar easy solution that proved the problem existed a lot earlier and will hopefully help my teeth to last 40 years with fewer issues.
posted by RoadScholar at 12:45 PM on April 27, 2015 [1 favorite]

My dentist recommended a mouth guard for my clenching. I didn't have dental insurance and thought $500 sounded like way too much. Eventually I cracked a tooth in half. The extraction cost more than $500. If you can get by with a cheapo one, fine. But they're bulkier than the dentist-made ones. It may seem ridiculous, and you may feel like it's a profit center for the dentist, but having a cracked tooth pulled is no damn fun, and I've got a space because a few thousand bucks for a bridge or implant just doesn't fit in my budget. I wish I'd sprung for the night guard sooner instead of being penny wise and pound foolish.
posted by rikschell at 1:10 PM on April 27, 2015

I would have said I didn't grind, but after 5 years of wearing a custom guard (I think I paid close to $500 for mine) I, too, am a little afraid to sleep without it because I can see from the wear pattern that I needed it. Wish I'd gotten it before I'd cracked a few of my teeth. If you don't have any cracks or other indications, you might try a cheap one first to see if you see signs of clenching/grinding.
posted by ldthomps at 1:28 PM on April 27, 2015 [1 favorite]

You can get get custom-fitted night guards from labs online for a lot less than through your dentist. I've used Sporting Smiles and have been happy with the results.
posted by zsazsa at 2:08 PM on April 27, 2015

I am a clencher, but like you I was skeptical. After getting used to my NTI, I find it easier to sleep and my dental health has improved. I could never do the big guards they use for grinding because I gag pretty easily. But the NTI is unobtrusive and I miss it now if I forget to put it in.
posted by tuesdayschild at 6:30 PM on April 27, 2015