Stop the nightly grind
July 16, 2013 12:22 PM   Subscribe

For the past couple of months, I have started to regularly grind my teeth, loud enough to wake my boyfriend and cause me a significant amount of jaw pain. I really want this to stop. I have tried two different drug store nightguards--the boil & bite one did not fit so great, and another non-boil one which seems to fit pretty well, but neither one of them seems to stay in my mouth while I sleep. I am a very active sleeper, and I suspect I am taking them out of my mouth while I sleep since I have woken up a few times with the nightguard in my hand. I have seen my dentist, but I am not sure what else I can do. More details below.

I have discussed this with my dentist, and she recommended I either get a custom fitted nightguard ($350), or invisalign ($4500+)--for the second time. I had invisalign retainers about five years ago, but my teeth have shifted significantly since then (my old retainers do not fit), my orthodontist went out of business, and I appear to be out of luck. My dentist believes that because I never had my wisdom teeth removed (my orthodontist didn't recommend it), my teeth have sifted significantly since I stopped wearing the retainers all day. I now have a cross-bite, which my dentist said may contribute to the grinding, but even if it is corrected, there's no guarantee the grinding will stop.

Do nightguards "lock" into place like a retainer does? I am concerned that even if I get a custom guard, I will pull it out of my mouth while I sleep, making it useless.

Is there anything else I can try, or is there anything else I should be discussing with my dentist or doctor? I am not stressed or on any new medications. I have tried applying a heating pad to my face prior to bedtime. I have read about Botox as treatment for bruxism, but there's not much data on that yet.
posted by inertia to Health & Fitness (21 answers total) 15 users marked this as a favorite
I have a custom fitted night guard and I've used them for over 20 years now. They last for EVER!

I'm only on my second one. It looks and fits like an Invisilign. It's hard plastic and fits snuggly over my top teeth. You have to snap it in place, it's not likely to come undone.

I am so glad I have it! I love it! I sleep great and don't have an aching jaw any more.

Best $350 you ever spent. Trust and believe.
posted by Ruthless Bunny at 12:28 PM on July 16, 2013 [6 favorites]

Do nightguards "lock" into place like a retainer does? I am concerned that even if I get a custom guard, I will pull it out of my mouth while I sleep, making it useless.

The brace my wife has fits around her teeth snugly, and has to be manually removed--it won't just fall out, it's locked in place, as you say.

Can't vouch for whether you'd pull it out though!
posted by Admiral Haddock at 12:29 PM on July 16, 2013

I would absolutely start with the custom fitted night guard. They are great and much, much better than the boil and bites from the drugstore. They fit snug and last forever.
posted by Lutoslawski at 12:29 PM on July 16, 2013

I have a nightguard. Mine is an NTI, styled like this one. It doesn't move until I want it to, and it has helped my horrible horrible TMJ issues significantly.

Try the nightguard.
posted by phunniemee at 12:32 PM on July 16, 2013

I have a nightguard made at the dentist and that thing does not move AT ALL. I have to push it into place on my teeth and there is a very solid clicking type sound when it's all in place. In the morning I have to pretty forcefully tug on it to snap off my teeth. This is definitely what you want.
posted by joan_holloway at 12:36 PM on July 16, 2013

Oh! If you want to try something else, you should also try an aqualizer. It's what I used for several months before I got the NTI fit. It should only run you about 20-30 bucks.
posted by phunniemee at 12:36 PM on July 16, 2013

If you can afford the custom night guard, do it. I've had them for the last 20 years or so. Like you, I am adept at removing the OTC ones in my sleep; the custom fit ones snap into place. Although I know I've tried to remove them in my sleep (I've woken while dreaming of trying to dislodge toffee or gum from my teeth--I was actually trying to pry the guard off my teeth with my tongue), they have always remained firmly in place.

My teeth do shift occasionally and I have chewed/ground holes in the guards, but each one normally lasts a few years with good care.
posted by hurdy gurdy girl at 12:37 PM on July 16, 2013

Another vote for the custom nightguard. I went through a lot of cheap ones (boil, no boil, athletic, not) and finally gave in and spent the money. I used to fling them across the room in the middle of the night (which is gross).

I did chew through the first one in two years, but better that than my teeth.
posted by Ms Vegetable at 12:46 PM on July 16, 2013

Best answer: I have had 3 custom nightguards, and unlike the others who've posted, I have no problem removing it in my sleep. I wake up with it in or near my hand. Sometimes I wake up holding it over my face, as if I've just removed it and haven't put my hand down yet.

Although this is a problem, it's worth the money to me to have one, because even if I don't wear it all night, I still have less pain than when I don't wear it at all. I also wear it while I'm driving. One thing I've learned is to ask to have it made in a bright color -- mine is orange -- so that when you take it out at night, you can easily find it in your sheets. There's nothing worse than trying to find a clear object against a white background while you are groggy.
posted by OrangeDisk at 12:59 PM on July 16, 2013 [1 favorite]

Yet another vote for the custom nightguard.
It is worth the money and helps prevent tooth damage--mine stays in place just fine. Mine is the all plastic type and has lasted 7 years.

Don't get one with a metal frontpiece to hold on to your teeth: my orthodontist recommended it a few years before and the metal bits damaged my front teeth slightly, because I was grinding so much. The hard plastic guard that encapsulates the upper teeth has been great.

I have found that acupuncture, which I originally started for other reasons, has also helped my jaw pain/grinding. Your mileage may vary.
posted by bessiemae at 1:00 PM on July 16, 2013

Is there something else that might be causing you to grind your teeth in your sleep, like some stressful life event? I ask because I had to deal with something similar and, in the course of dealing with that, I stopped grinding my teeth. By looking for an expensive and high-maintenance solution like a nightguard, you might be treating a symptom as opposed to a cause that lies outside of dental care.
posted by Blazecock Pileon at 1:00 PM on July 16, 2013 [1 favorite]

My custom nightguard fits so snugly that it's almost a concentrated effort to remove the thing.
posted by Coatlicue at 1:00 PM on July 16, 2013

I agree that stress in a major trigger for grinding; I had terrible TMJ during one period due to this, and it was stress. I even broke a tooth! The usual stress reducers--self-care, rest, yoga, meditation--plus a magnesium supplement (forget where I turned up that tidbit) eased it, but it did take a few months. I used a sport guard at night but had the same experience of it never being in my mouth when I woke.
posted by Riverine at 1:29 PM on July 16, 2013

I have been clenching/grinding for over 15 years. A nightguard has been such a help!

The first one I had was very hard, almost ceramic-like, and I hated it. I would take it out at night.

The kind I have now is a softer jelly-ish material. It fits in my mouth on top of my lower teeth. I doesn't snap in quite as much as an invisalign but it's pretty snug. It's fairly unobtrusive - I can talk while wearing it with only a small lisp.

The downside to the softer ones is that they do wear out as you eventually grind through them in a few years and you have to get them replaced. My new dentist recommended trying the NTI when I'm ready for a new one. He said they don't work for everyone but for some people they are lifesavers.
posted by radioamy at 1:53 PM on July 16, 2013

Custom nightguards are nice, but my neurologist prescribed bedtime klonopin for my tooth grinding, which was contributing to daily headaches, and it's been amazing. It took some experimenting to find a dose that did the trick without giving me a hangover, and it's a really small dose, like half of a quarter-mg tablet.

I'd add too that if you are not a long-time tooth grinder but might be having a shorter-term problem, a muscle relaxer might help break the habit as well. I have done this when I have gotten into a phase of grinding more than usual.
posted by not that girl at 2:29 PM on July 16, 2013

I use a custom fit night guard and it does lock (pop) into place.
posted by michellenoel at 2:34 PM on July 16, 2013

Custom night guards are a lot less expensive if you don't buy them through a dentist. I've ordered from Night Guard Lab and SportingSmiles and both fit perfectly. You pick the kind you want (I like the dual laminate; the soft felt too thick to me) and they send you a kit to make the impression yourself. You squish together the rubber putty stuff, put it in a tray, put it over your teeth, wait, then take it out. Once you send it back you get your night guard in about a week.
posted by zsazsa at 2:54 PM on July 16, 2013 [3 favorites]

A possibly very easy solution to grinding: B complex vitamins, including pantothenic acid. It works for me in 3-5 days.
posted by oneirodynia at 4:07 PM on July 16, 2013

Custom made night guards will work a lot better than store bought ones. I've used a variety of types - soft, an NTI, and hard plastic. And I don't think I've ever lost one in the middle of the night.

I chewed through the soft ones in about 2 years. The NTI worked well, but I ground so much at night I wore grooves into that got sharp and became uncomfortable. I figured I'd be smart and file off the sharp points. After a couple of cycles of this it changed the fit and made the grinding/clenching worse at night.

My current one is hard plastic, and it's held up so far (but I've only had it a few months). I'm not going to be filing off any sharp points from this one.

If you clench your jaw, something else that can help is opening your jaw against pressure. Make a fist, put it under your chin, and open your jaw while providing resistance with your fist. It won't help at night, but if you clench your jaw during the day it might help a lot.
posted by unix at 4:40 PM on July 16, 2013

I've had mine (hard clear plastic, fitted by my periodontist) for two years and it has really helped with the grinding. Like others report, mine kind of clicks over my upper teeth and has stayed in all night, no problems at all. I was surprised at how quickly I got used to it. At first it felt a little bulky in my mouth, but now, I feel naked if I got to sleep without it.

On a family vacation, my nephew woke me up and then wanted to know why I slept with a mouth guard. I told him I played ice hockey in my sleep. :-)

Spend the money to have it professionally fitted, it will be worth it.
posted by NoraCharles at 8:22 PM on July 16, 2013

Response by poster: Thanks so much for the answers everyone! I am relieved to know that a custom fit guard will probably fit snuggly enough to prevent me from removing it in my sleep. Also, i had no idea they could be made in bright colors, but I'm definitely going to ask!

While grinding my teeth is new, there isn't anything I can think of that is causing my additional stress, no changes in medication. I do take a stimulant (concerta) but I have taken it for years, and recently stopped taking it for a week and was still grinding my teeth.

I do take a multivitamin, which includes pantothenic acid. I'm being tested for pernicious anemia, but I don't think that's related.
posted by inertia at 7:59 AM on July 18, 2013

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