I grind my teeth: cheap and expensive night guard options
May 29, 2011 5:11 PM   Subscribe

I'm a newly-diagnosed teeth-grinder. Should I get the custom night guard my dentist wants to make for me or should I try one of the cheap guards available in the drugstore? And while I'm making up my mind about the appropriate path, what can I do in the meantime to reduce stress and grind less? Relevant physical and financial details inside.

1. The drugstore night guard is about $30 while the custom guard is $400-500. I could afford the custom guard, but if all things were equal, it would be nice to use that money elsewhere. (I have braces and a bridge in my future, too.)

2. I have a hyperactive gag reflex while in the dentist's chair. My dentist says that he can create a guard from a harder plastic instead of using a molding material that will go all around my mouth. He's also offering sedation, but both types he has described haven't done much to sedate me in the past.

3. I have one missing lower pre-molar. Would that gap make a gapless drugstore guard useless or actively harmful?

4. Finally, I have a new problem with snoring and the knowledge that sleep apnea runs in my family. My increased snoring may be due to apnea, or to recent weight gain, plus spring allergies leaving me congested. Thus, my dentist wants to send me for a sleep assessment before fitting my nightguard.

As I'm writing this, I can see reason after reason why I should get the custom guard, but would even auditioning a cheap drugstore version be a good first step?

I have seen this thread and this one, but any further advice and insights would be appreciated.
posted by wexford_arts to Health & Fitness (30 answers total) 12 users marked this as a favorite
I've used one of the cheap ones and it was okay. If your gag reflex is such that you're not sure you can tolerate a guard all night, you might want to test-drive the cheap ones before making the monetary commitment to the expensive one at all.
posted by rmd1023 at 5:18 PM on May 29, 2011

another newly diagnosed teeth grinder here, also attempting to avoid the cost of the pro guard. I bought this one from amazon, and so far, not bad. you boil it, then bite down to fit. it comes with both the large and small sizes. the sleep apnea thing would make me nervous, though, so either way you should go for the sleep assessment first.
posted by changeling at 5:22 PM on May 29, 2011

I've had the best experience with the dentek nightguard, the one that you can mold by boiling. It doesn't last too long before it starts breaking up, but you can get them cheaper on Ebay or Amazon, than at the drug store.
posted by spacefire at 5:23 PM on May 29, 2011

I am a tooth grinder (and TMJ sufferer) with gag reflex issues. My dentist made me a guard that I tolerate very well. It fits perfectly, of course (he made me one for karate, too, in softer material). I'd just get the dentist one myself, but if you want to experiment the boil-to-fit ones are easy to set up.
posted by tommasz at 5:27 PM on May 29, 2011

I clench my teeth while I sleep (which is the same level of bad for the jaw, not as bad for the teeth as grinding them). I just want to warn you that some kinds of mouth guards--maybe the cheap kinds in particular, but I don't know for sure--can exacerbate the tooth grinding into TMJ problems.

When I got my braces off as a teenager, I was given a hard plastic, all-around mouth guard style retainer. Obviously, I was wearing the retainer at night. When I'd clench my teeth on it, it caused my jaw to stress, and over the course of about a month my jaw started to click. Stopped using the retainer, continued to clench my teeth with the now-clicking jaw, and it eventually developed into hardcore jaw pain where my mouth would occasionally get locked into half-open positions. Not cool.

Anyway, stories aside, ask your dentist if he can get you an Aqualizer. They're cheap (just flexible plastic filled with water, meant to be used only a few months), and it's what I use to keep me from damaging my teeth and further damaging my jaw from the nighttime clenching.
posted by phunniemee at 5:28 PM on May 29, 2011

I'm going to recommend the custom one. I had a very unpleasant incident where my jaw slid out of alignment (about 1/2 tooth width) it was incredibly painful and unpleasant. It motivated me to deal with the tooth grinding issue. an OTC guard did not help but once I got the custom one my jaw adjusted itself and I've not had a repeat of that in over 3-4 years. in general I feel my jaw alignment is more stable and the grinding a little diminished.
posted by supermedusa at 5:35 PM on May 29, 2011

You can get custom ones made from labs online for around $100. They send you a tray and putty to make a mold of your mouth, so if you have gagging problems, it's probably not a good idea, though.
posted by zsazsa at 5:38 PM on May 29, 2011

I also recommend the custom guard. When I first discovered my teeth grinding, I bought one of the drugstore ones thinking that the custom guards were overpriced. But while the drugstore one felt okay while I was awake, it never seemed to last me through the night... I would wake up with the guard next to me on the bed, or fallen onto the floor. I guess it was uncomfortable in my sleep and I removed it while unconscious.

I've had a custom one for the last four years or so, and have never had a problem with it. It is much smaller than the drugstore kind, and fits perfectly. I don't remember the molding part being very uncomfortable, and I do tend to have a gag reflex. In my opinion, it's worth the extra money.
posted by barney_sap at 5:41 PM on May 29, 2011

I've used all available.

There are essentially three classes of guard.

The one dollar guard. These are Okay, cheap enough to try, but generally bulky. You boil them, you bite and suck on the warm guard, and it forms to your teeth. I've never used one for long because the bulk bothers me.

The thirty dollar guard. Looks a lot like the one dollar guard, but is generally thinner and may consist of two layers of plastic - one soft layer to conform to your teeth after boiling, and a second layer to absorb the grind. An improvement over the one dollar guard, but only just.

Sometimes these are sold as no-boil guards with weird wings. Don't buy those.

The three hundred dollar guard. Made by your dentist. Mine was $175, it was very thin, not bulky, and went over my bottom teeth instead of my top teeth (like the types above). Somehow that led to less gagging at first (though I no longer gag or have any problems). I'm sad I lost it, but I've been getting by with the thirty dollar guards ever since and I don't mind losing them nearly as much.

Recommendation: try the low end first, it's a lot cheaper than starting with the dentist one. Don't be afraid to modify them. I have a problem tooth, and I trim the guard so that tooth is never touched. Works very well.
posted by fake at 6:05 PM on May 29, 2011 [1 favorite]

My dentist explained to me that while the drugstore varieties will protect your teeth from the grinding, the custom varieties protect your jaw from coming out of alignment. Jaw surgeries are a lot more expensive than custom guards.
posted by emyd at 6:13 PM on May 29, 2011

I ground right through the drugstore bought guards while I was waiting for my custom one to come in. I would, for the health of your jaw and teeth, get a custom one done. I also had half a tooth break off due to my teeth grinding and will now need to get a crown to fix it. Spend the extra money now to save you thousands of dollars later.

I also asked a question about teeth grinding that may be useful to you at some point here.
posted by carmel at 6:19 PM on May 29, 2011

I have a custom guard, and I though I don't know if it helped my jaw issues, it is good cosmetically (doesn't physically wear the tooth down). I have to point out that if you plan to get braces, the gag issue is something you'll have to deal with regardless--I had to get molds made of my teeth before and after orthodontia, and yes it can be a not-great experience. I did notice that years of orthodontia built up my gagging immunity. However, if you're planning on getting your braces soon I advise against investing in a custom guard right now, since it won't fit after you get the braces. I would consult with your orthodontist about how to deal with your grinding/clenching while your molars are behind bars.
posted by therewolf at 6:25 PM on May 29, 2011 [1 favorite]

I had an expensive custom one and I hate hate hated sleeping with it and would take it out of my mouth in my sleep and it would end up all over the place. I would try a cheap one and see how you deal with it. For whatever reason I've mostly stopped grinding in my sleep anyway, without using the guard.
posted by ghharr at 7:02 PM on May 29, 2011

I have had the bite guard you buy at the store and the kind the dentist makes - both horseshoe-shaped. They each, to varying degrees, helped protect my teeth, but I still had jaw pain and headaches and ear aches, because I was still clenching, just into the bite guard, so my muscles were still engaged.

At my dentist's suggestion, I got an NTI - it's about the size of a dime and snaps onto your front teeth so you won't swallow it or anything. You still can clench or grind, but the pressure/tooth contact is limited to your very front upper and lower teeth, which disburses the tension. It cost $400, but the difference is extraordinary.

For gagging, you can request that he or she fits the form into your mouth while you lean forward. It moves your tongue to the front, opening up your airway, and you can't gag as easily with your head tipped down. Also, for the NTI, they don't need to do the longer form that covers to your back teeth.
posted by Ink-stained wretch at 7:49 PM on May 29, 2011 [1 favorite]

If you can afford the $400 kind, you can afford to try the $30 kind and be wrong.
posted by JohnnyGunn at 7:50 PM on May 29, 2011 [1 favorite]

NTI NTI NTI. Seconding - heartily - Ink-stained and the NTI (Nociceptive Trigeminal Inhibitor). I, too, have both expensive and cheap horseshoe-shaped night guards and rarely use them as they are so unwieldy. And as Ink-stained says, you can still grind with a night guard, it simply protects your teeth from being ground down. My NTI cost only $75. It was offered by a dentist as a temporary solution to my temporarily extreme grinding, and he made it in just a few minutes by sticking a blob of goo between my front teeth and having me bite and hold for a few minutes. I had ground so badly and had such jaw pain that I feared I had damaged something permanently, so I was in a bit of a crisis state when I saw the dentist and my desperation must have been enough for him to make me the temporary NTI facsimile.
posted by lulu68 at 8:54 PM on May 29, 2011

I had the same problem recently and got the custom one. Your jaw is the most complex joint in your body. I went about a month before I was finally able to get mine made, and it was miserable. My jaw ached constantly and popped when I ate. If you can spring for the better one then do it in a heartbeat. The jaw is one of those body parts that can bring you to your knees when it gives you trouble, and I would be very hesitant to gamble relatively moderate sums of money on it.
posted by resiny at 10:13 PM on May 29, 2011

I have a custom guard. It took me a week or two to get used to it. I now don't mind it at all anymore.

If you have braces in your future, won't your teeth move enough that a custom guard would not fit anymore? I'd ask your dentist about that--it may be worth using the cheapos until you're done with braces--if they can co-exist.
posted by mvd at 4:25 AM on May 30, 2011

A custom guard is million times better than something over the counter. Mine, which I've had for almost 8 years, just clicks in snugly. It doesn't bother me at all. Best money spent ever. No more jaw pain!
posted by teedee2000 at 4:51 AM on May 30, 2011

I've recently been told by a RMT that people who grind their teeth should go to an RMT with special training in TMJ issues and have their jaw worked on. I haven't done so yet but plan to. I've had a guard for over three years and I still grind my teeth and my jaw clicks whenever I open or shut it, which is VERY BAD according to my RMT friend. According to him you can obliterate the disc by grinding your teeth — and you need that disc for the rest of your life.
posted by orange swan at 6:35 AM on May 30, 2011

My hard guard is much better than the soft one I had, both from a dentist. The soft guard protected my teeth but didn't stop me from grinding my teeth, so my jaw was still sore. The hard guard is moulded so my top teeth sit in a way that stops me from grinding. When I wear it I don't have any jaw pain or sore teeth in the morning.
posted by Gor-ella at 7:01 AM on May 30, 2011

I've been clenching and grinding my teeth since I was about 8 years old. My custom fit night guard is one of my most prized possessions.

Mine is made by NTI and has a "prong" at the front that prevents my teeth from touching and forces my jaw into proper alignment. This is what it looks like. Because of the intensity of the clenching, a drugstore brand would just cushion my teeth but wouldn't prevent grinding/clenching and would do nothing to protect the disc issues orange swan mentioned. The brand I have make it literally impossible for my teeth to come into contact with each other, protecting both my teeth and jaw.

Since the night guard has trained my muscles in the jaw into alignment for 8 hours a night, during the day muscle memory kicks in and I don't clenching my teeth nearly as much as I used to. When I do, I notice it and recite "lips together, teeth apart."
posted by Hop123 at 7:02 AM on May 30, 2011

I've been a clencher for at least 10 years, and I've had a couple different types of bite splints (night guards). The first was one from my orthodontist - it was huge and bulky, fit over my top teeth. I would actually take it out in my sleep! I don't know how much it cost because my parents paid for it. I'm pretty sure they had to send out for a lab to make it.

When I lost that one, I was living in a new city and my new dentist made splints on site. She made one for my lower teeth that is a thin rubbery substance, and I like it so much better. It's less than $100 (plus the cost of doing the impression), and not as cumbersome as the other one - I can actually talk while wearing it!
posted by radioamy at 7:40 AM on May 30, 2011

Oh and as for other things to do, I was taught to swish hot water around in the back of my mouth to loosen up the muscles, and I also use a (clean) finger to massage the muscles. Yoga and stretching to de-stress the muscles in your head and neck will also help.
posted by radioamy at 7:44 AM on May 30, 2011

From Ms. Vegetable:

- Diagnosed with grinding in high school; dentist himself recommended the drugstore variety.
- Went through multiple drugstore varieties to find one I liked.
- Checked through them.
- Finally sucked it up and got a custom one made and OH MY GOODNESS IT'S SO MUCH MORE COMFORTABLE. Plus I feel like it keeps my teeth in line a little bit more than my old one - which is nice, because I can't wear both my retainer and my bite guard at the same time.
- I agree with others as to trying a cheapo one before shelling out the money for a custom one.
- AND I agree with others as to take care of this now - much cheaper than crowns later in life (of which my dad now has several due to cracking teeth in his sleep).
posted by a robot made out of meat at 8:43 AM on May 30, 2011

I was told I'd need a very expensive custom-made one, but I decided to try one of these first. The sides rubbed my gums raw so I took scissors and trimmed it down to resemble this variant. After that it was perfectly comfortable, did the job, and I haven't needed it in years. It was so long ago that I can't remember how long it took to feel the results, but it wasn't very long at all.
posted by K.P. at 9:49 AM on May 30, 2011

The NTI night guard is the best thing for people who tend to gag. I used to spit out my full-mouth guard in my sleep because it made me gag. The NTI doesn't cause gagging the way other night guards do.
posted by artistic verisimilitude at 11:13 AM on May 30, 2011

If you are getting braces soon, invis-align braces are more-or-less equivalent to night guards.
posted by chairface at 11:59 AM on May 30, 2011

I have been using $30 drugstore ones for the past 3 years. I have had no problems, they are perfectly comfortable, and when they start to get too gross I just throw it away and get a new one.
posted by comatose at 6:08 PM on May 30, 2011

Response by poster: Thanks, everyone! I think I'll try a cheap drugstore version first, if only to see if I can make it work without triggering my gag reflex. This is especially relevant if I'm going to get braces, which are almost certainly going to be invisalign. I'll talk to my dentist about the grind-worthiness of invisaligns and see if I could just go straight to those.

Re the obvious question (why get a mouthguard now if I need braces?) braces are more expensive and I may not be able to afford them this year. The clenching is getting bad enough that something has to be done, and I know that after braces, I'd need a new mouthguard. At that point, an extra $400 is a trifle.

The NTI sounds AMAZING -- tiny, somewhat cheaper, and no gagging! -- but I am a little concerned about the potential choking hazard. I know you're supposed to get it fitted very tightly, and that when it loosens a bit, to go back and get it re-fitted, but from what I can see, a lot of people don't do that. And some people go to great lengths to avoid choking. But I'll ask my dentist about this.
posted by wexford_arts at 4:59 PM on May 31, 2011

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