Mouthguard for teeth grinding?
March 15, 2013 8:16 AM   Subscribe

Dentist says I need a mouthguard because I grind my teeth in my sleep. I can't afford the $700 custom one he'll sell me. Can you recommend an over-the-counter alternative?

He said there's wear on my upper front two teeth, most likely due to grinding my teeth at night. He also said I should get one that "covers all the teeth" (I wish I'd ask for clarification on this, whether he meant the most number of teeth covered or the most surface space covered of the affected teeth.)

In any case, have you had any luck with over-the-counter mouthguards?
posted by bluecore to Health & Fitness (24 answers total) 14 users marked this as a favorite
Yeah, just get one of those moldable ones at a drugstore--it's better than nothing. (My dad the dentist approves of this action--I've used those before for nighttime jaw clenching at his suggestion b/c I lived too far away for him to make me one.)
posted by leesh at 8:18 AM on March 15, 2013 [1 favorite]

Have you talked to him about a payment plan and/or other options? Very few dentists I know only have one price and refuse to budge on it.
posted by These Birds of a Feather at 8:19 AM on March 15, 2013 [1 favorite]

Oh yeah, that is good advice too!
posted by leesh at 8:23 AM on March 15, 2013

I clench my teeth at night and it causes me horrible TMJ problems. My dentist uncle sent me an Aqualizer in the mail a few years back to cover me for the few months until I'd be able to visit (we live 1000+ miles apart) for him to fit me for a professional mouthguard.

The Aqualizer got the job done just as well as the fancy little doodad he made me.

It's available here for under 30 bucks. It's not a full mouth thing, it goes between your back teeth, but it stops your teeth from biting together, is plenty comfortable, and will keep your front teeth from chomping on each other.
posted by phunniemee at 8:28 AM on March 15, 2013 [6 favorites]

About your "covers all the teeth" question - read this description of 4 different splint types. The NTI type attaches to just your upper front teeth and braces against just your lower front teeth; it sounds like he's saying that a flat plane splint would be better for you. (IANAD - probably because your wear points are on your front teeth, so putting a splint there wouldn't be redistributing the pressure, you'd still be inclined to shove your lower jaw forward and worry at those front teeth, but a flat plane would give your non-front teeth something to bite against??)

In my personal jaw-problems treatments, I've used a hard-plastic dentist-molded flat plane splint, and common drugstore bite guards (which were softer/chewier material, but also flat plane). My particular grinding gave me really really sore molars, so I cut the back 1/4-1/2" off of a drugstore bite guard so I'd have no pressure there, effectively creating my own "modified Hawley" off that first list). Basically, they all worked equally well, so there's not a strong reason I'd recommend going for a dentist-made splint instead. In fact, I can't use the rigid dentist-provided splint any more; everyone's teeth naturally shift around a little bit on a 3-5-year timescale, and my upper teeth no longer fit into that rigid mold comfortably.
posted by aimedwander at 8:36 AM on March 15, 2013 [1 favorite]

Less than $5 at the sporting-goods store.
posted by Rash at 8:38 AM on March 15, 2013

I got a mouthguard from my dentist and I use it every night. I have had a couple adjustments over time but because I wear it so religiously, I haven't experienced the problems with "shifting" that aimedwander described.

The dentist made a cast of my mouth and from that, created a device that clips onto my lower molars. It keeps my front teeth from touching when I bite down.

My understanding is that teeth grinding is a really difficult habit to break and can cause a lot of damage in the long run if you don't care for it properly. I understand that $700 seems like a hell of a lot of money, but my guard has lasted for over 10 years at this point ($0.20 per day!) with no major signs of wear and tear and it's very comfortable.

I doubt that you can get a drugstore alternative that is as sturdy and as comfortable. It may be worth your while to work out a payment plan with the dentist and get this taken care of.
posted by cranberrymonger at 8:46 AM on March 15, 2013 [1 favorite]

Oh, I should point out that the site I linked to is about using bite splints to relieve jaw pain (tmj). As I recall, the idea is partially to redistribute pressure from one contact point to avoid pain at those teeth, but also to make the bite/grind automatic motion less rewarding and discourage involuntary clenching of the jaw (while asleep). My tooth-grinding was stress-related; if I woke up and my jaw was sore, I'd wear my bite-splints overnight for a few weeks, and then kind of phase it out again for a few months, and the frequency of that has dropped off steadily since I got out of school. (Thus, not wearing it regularly, and my teeth shifted around)
If your jaw isn't hurting, and he's just talking about wear spots on your teeth, there's less of a "wear this when your mouth bothers you" vibe, it's more about a long-term tooth health thing. Talk to your dentist about when you'd be wearing this and for how long (every night until forever?) and what kind of results he's looking for (enamel doesn't grow back, but is he going to track the size of the wear spots?), since you won't be getting any short-term feedback (like "gosh my jaw does/doesn't hurt"). Aside from the appliance cost, would there be extra return visits for fittings, extra progress checkups, etc?
posted by aimedwander at 8:52 AM on March 15, 2013

Dude, see if you can get a payment plan. I've had a mouth guard for 20 years. That thing is a life/tooth-saver!

My TMJ doesn't bother me at all, I can't sleep without it.

See if you can do a payment plan with your dentist because these things are worth the money and they last for mother loving ever.
posted by Ruthless Bunny at 9:01 AM on March 15, 2013

I do strongly recommend a custom one, but are a lot of custom options that don't cost $700! I think I paid $250 for mine three years ago (full - insurance didn't cover it). It would be worth it to check in with some other offices.
posted by susanvance at 9:15 AM on March 15, 2013 [1 favorite]

I had a moldable one for $30 from a drugstore. It seemed to work, but I also spit it out every night while sleeping, and my teeth moved enough that it didn't fit about six months later.

Maybe I wouldn't have spit out a custom one because it fit better. Then again, my mother-in-law had a custom one that broke after only a few weeks.

And when you don't have insurance and you don't make much money, $700 over 10 years isn't a bargain, it's just not possible.
posted by jb at 9:20 AM on March 15, 2013 [1 favorite]

I can't make any suggestions around an OTC one, but, a good reason to get a custom one (if not the $700 option) is: you need something that is biomechanically sensible. If it's too thick (like a sports mouthguard), you're introducing a new stress to your jaw, even if the tooth surfaces are protected from abrasion; plus, if the material's cheap, any force you're applying might go right back up to your jaw, setting you up for TMJ. The custom ones are thin and made of something or other that mitigates that force. It's possible there are drugstore variants that address those points, I don't know, but, I'd think about that when looking at options.

And also look at relaxation techniques.
posted by nelljie at 9:22 AM on March 15, 2013

I've gotten two custom ones. Mine were both expensive, but more on the order of 300$. 700$ seems steep; can you discuss lower cost options with your dentist?

My first one broke after c. 8 years of use; I will be happy if the second one lasts as long. By the time I was twenty (and got the guard) I'd already ground my teeth to the wear of a 35 year old; I had a root canal (due to some combination of grinding and overenthusiastic orthodontics earlier in life); that cost quite a bit. The cost of the guard, even replacing every 8 years, is more palatable.

What I'd suggest, if you grind as much as me, is getting an OTC moldable one from a drugstore for now. In the meantime, save up until you could pay for a 250$ custom one, because it's unlikely you're going to magically stop grinding in the next few years. I really think 700$ seems steep; maybe you can get some price quotes from other dentists?
posted by nat at 9:39 AM on March 15, 2013

Strictly anecdotal, but I'm an occasional tooth-grinder....dunno why, but I go through periods of no problem (that I can tell, anyway) to mornings when I wake up with an agonizing headache emanating from the base of my skull (it hurts to the touch) which was diagnosed as caused by clenching my jaw/grinding my teeth at night. Anyway, my dentist suggested one of those custom-made mouth guards (just short of $800) but lacking those funds I tried an OTC mold-able one instead. It worked OK for about eight months, but then I bit/ground through the back portion of it.

I mentioned this dental distress to my rheumatologist during a routine visit, and he said that muscle relaxers would take care of the problem. He gave me a prescription and I haven't had a problem since. I don't take those pills regularly; in fact, I've only refilled the bottle once in two years. Oddly enough, after taking them initially for about a week or so, I didn't clench/grind so much...only every once in a great while will Mr. Adams nudge me awake and say "You're grinding your teeth (I didn't know I made a noise while doing so), better take a pill."
posted by Oriole Adams at 10:52 AM on March 15, 2013

I'm epileptic* and a night grinder. I've had a bite plate of one variety or another for decades, and the OTC stuff is crap. Yes it sucks to pay big bucks to have one fitted, but it will literally change your life. I agree with the others that it shouldn't cost $700- I had mine done for $200.
Look at it this way. You can pay small amounts every 6-12 months, or a large one one every 8-10 years.

* My grand-mals can rock the house for 3 minutes at a time. Think CCM permanently embedded on my forehead, and full mouth reconstruction in my 30's. Let me tell you about how much it sucks to pay 60k for the privilege of spending 8 hours at a stretch in the chair. Get the guard.
posted by whowearsthepants at 11:22 AM on March 15, 2013

I should also probably get the custom night guard, but basically every one I've ever picked up at the drugstore has worked fine (including these, which I like to keep one or two of in my travel toiletries bag). I'm not a heavy grinder, so I don't destroy the OTC ones too quickly, but I do replace them a couple times a year.

My current favorite is the Sleep Right night guard. It's only got pads that go between your molars, so it might not suit you, but I've found it the easiest to adjust to and maintain wearing.
posted by EvaDestruction at 12:11 PM on March 15, 2013

I use these.
posted by 4ster at 12:24 PM on March 15, 2013

I'm not a heavy grinder, but it's enough to show on my teeth. My dentist suggested the blue DenTek guards (link). They work great for me, are pretty cheap, last a long time, AND fit my mouth!

You should look for one that covers all teeth in that all teeth are in contact with the guard. When I was looking around I tried one that was a little too small and left the last two molars uncovered and it caused a lot of jaw and tooth pain and definitely didn't feel right. I guess it has to do with how the pressure gets distributed, which should be evenly across all of your teeth.
posted by Bearded Dave at 12:27 PM on March 15, 2013 [1 favorite]

I've tried all the cheapo OTC night guards (Plackers being my favorite, but still not ideal)...and most of them were either too bulky and uncomfortable OR caused me to just bit down harder, meaning I'd wake up with sore/sensitive teeth anyway (not good, as I believe this clenching can lead to bone loss in your jaw even if the enamel of your teeth themselves is not being obviously affected).

Finally sprung for a $400-500 custom, hard acrylic night guard from my dentist. It's SO much more comfortable. Worth the money. $700 sounds steep. If you do get one of these, don't be shy about requesting numerous initial adjustments to make it feel just right (mine felt a little tight in places and they shaved it down for me--and it took multiple visits before I was happy).
posted by bennett being thrown at 4:44 PM on March 15, 2013

An NTI is better - as mentioned above - because rather than mitigate damage to your teeth due to grinding by covering them with a thick layer of plastic (i.e. you can still grind, it just won't wreck your teeth), it prevents you from engaging in the grinding motion at all. I had a dentist make me a short-term NTI for about $75. It wasn't perfectly fitted or anything, but I still have it 8 years later.
posted by lulu68 at 7:15 PM on March 15, 2013

i got a tiny and effective custom one done at the dentist's office for only $300. you should try calling around to dentists who can do this. if you have no luck try one of these:
posted by zdravo at 8:47 PM on March 15, 2013

I would strongly discourage you from going for an NTI. I have one I wear sometimes for the sake of convenience, but despite my dentist insisting that there is simply no way I could be bringing my back teeth together while I'm wearing the thing, I often wake up with my back teeth grinding together. (I don't even know how the hell I do it. I usually can't do it while I'm awake. But somehow, when I'm asleep, I find a way.) Also, it's very small and easy to lose... And if you wake up and it's not in your mouth and you can't find it anywhere, you won't know if it fell out, or if you swallowed the god damned thing. So, either you're out a lot of cash, or you're out a lot of cash and you've got a medical emergency. NTIs are the devil.

Also, do not bother with boxing or hockey-type guards from the sporting goods store. They are just too big and uncomfortable, you'll never fall asleep wearing one. I've had OK luck with the boil-and-mold guards from CVS, but bear in mind that with any guard you use, you may still experience tooth and jaw pain. I read something recently about how night guards can slow down the damage, but they aren't great for eliminating the actual pain, and my experience sure supports that.
posted by Ursula Hitler at 11:59 PM on March 15, 2013

I think my NTI is totally worth it. I'm a clencher, which I can still do with the over the counter guards, but the NTI restricts that motion.
posted by coolsara at 12:29 PM on March 16, 2013

So, a little known fact is that most dentist don't make the mouth guards themselves. They get made at a dental lab (I know this because my mom owns a dental lab)... the price the dental lab charges is usually only in the ~$100 range. The dentists have a pretty hefty markup (hey, gotta pay for that Porche somehow).

There's a bunch of ways you can get a custom mouth guard directly from the dental lab: you can try calling a local lab in your neighbourhood... a small lab night deal with you directly, or you can do a search on Amazon: comes up with a bunch of results. A search on Google also gives a bunch of results (e.g. here)
posted by netherus at 9:42 AM on April 4, 2013

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