Orthotic to prevent jaw clenching compatible with Invisalign?
March 8, 2025 3:46 AM Subscribe
Is there some kind of special night-guard that will *prevent* jaw clenching? I have the Invisalign night-guards, which I now have to wear to keep the teeth from moving, and they also prevent damage to the teeth from the grinding. But what I would like is to NOT CLENCH.
Nighttime jaw clenching is severely affecting my quality of life. I wake up dreaming I am gnawing on things. I wake up with my face in a rictus. I wake up with headaches and head pressure and neck and shoulder pain and have a problem with dizziness. The Invisalign had made everything worse -- it increases the compulsion to clench.
I saw a TMJ specialist in NYC and it was such a factory -- very rushed, he didn't examine me, immediately started the hard sell on a $2500 orthotic, then realized I had Invisalign and chastised me for not coming to him for that -- that I was kind of overwhelmed and don't want to go back. But I *would* pay good money for some device that would solve this problem -- I just didn't like that guy or his whole high-speed, ill-mannered, factory-like operation.
Questions: Does a device like this exist? Where do I get it? Can you recommend someone in New York (or really, anywhere from Maryland to Massachusetts). Or, do you have some other experience in dealing with jaw clenching?
My insurance doesn't cover Botox, and I am nearly at the point where I would pay out of pocket, but I would like some guarantee that the effect would be long-lasting.
Thanks for any guidance.
Nighttime jaw clenching is severely affecting my quality of life. I wake up dreaming I am gnawing on things. I wake up with my face in a rictus. I wake up with headaches and head pressure and neck and shoulder pain and have a problem with dizziness. The Invisalign had made everything worse -- it increases the compulsion to clench.
I saw a TMJ specialist in NYC and it was such a factory -- very rushed, he didn't examine me, immediately started the hard sell on a $2500 orthotic, then realized I had Invisalign and chastised me for not coming to him for that -- that I was kind of overwhelmed and don't want to go back. But I *would* pay good money for some device that would solve this problem -- I just didn't like that guy or his whole high-speed, ill-mannered, factory-like operation.
Questions: Does a device like this exist? Where do I get it? Can you recommend someone in New York (or really, anywhere from Maryland to Massachusetts). Or, do you have some other experience in dealing with jaw clenching?
My insurance doesn't cover Botox, and I am nearly at the point where I would pay out of pocket, but I would like some guarantee that the effect would be long-lasting.
Thanks for any guidance.
I will be following this with interest because I just had this discussion with my dentist, who told me no night guard will prevent clenching it will just stop the damage to the teeth. I recognize the damage to the teeth as a problem but I'm also looking to solve for the headaches and jaw pain from clenching itself.
posted by fennario at 4:11 AM on March 8
posted by fennario at 4:11 AM on March 8
I almost hate to say this because it’s orthogonal to your question, but I suffer from the same problem. I don’t grind, I clench, and when it is at its worst I can clench my jaw muscles without my teeth even touching; or at least they are so sore and cramped that I can’t tell what a relaxed position is anymore.
I’m about to start Invisalign and my orthodontist said obviously not to pay for a night guard since my teeth will be moving. In my case he thinks re-aligning my teeth with help with the problem, but he also off handedly asked me if I drink coffee.
I only drink one cup a day, so I didn’t think much of it. But I decided to try switching to tea (still caffeinated, even!) and… my jaw pain nearly disappeared nearly immediately. There is something specific to the jittery coffee caffeine hit that even green tea (which can have a lot of caffeine) doesn’t have.
I will be following this question in earnest, though, because I may be in the same position in a couple years.
posted by misskaz at 4:38 AM on March 8 [3 favorites]
I’m about to start Invisalign and my orthodontist said obviously not to pay for a night guard since my teeth will be moving. In my case he thinks re-aligning my teeth with help with the problem, but he also off handedly asked me if I drink coffee.
I only drink one cup a day, so I didn’t think much of it. But I decided to try switching to tea (still caffeinated, even!) and… my jaw pain nearly disappeared nearly immediately. There is something specific to the jittery coffee caffeine hit that even green tea (which can have a lot of caffeine) doesn’t have.
I will be following this question in earnest, though, because I may be in the same position in a couple years.
posted by misskaz at 4:38 AM on March 8 [3 favorites]
What has been stated so far here is puzzling to me, because I used to wake up with terrible jaw pain due to clenching, and my custom-made night guard completely alleviated it. Ollie, I highly recommend that you shop around for a better dentist - I know from personal experience that some are actually terrible and some are waaaaaaay better than others!!!!
posted by SageTrail at 4:42 AM on March 8 [1 favorite]
posted by SageTrail at 4:42 AM on March 8 [1 favorite]
Night guards made me clench harder. I was waking up with a headache every day. I was recommended to get botox injections in my masseter muscles and it solved the issue immediately. You can still chew and everything, you just can clench or grind. I got it redone every 6 months for 3 years and now my body just doesn't remember that clenching is an option. It basically trained me out of it. Highly recommended! You can get it at any med spa, and some insurance will cover it.
posted by ananci at 5:23 AM on March 8 [8 favorites]
posted by ananci at 5:23 AM on March 8 [8 favorites]
who told me no night guard will prevent clenching
The NTI night guard, which I am wearing at this moment because I haven't quite got out of bed yet, absolutely prevents clenching and changed my life. Not being dramatic, just true.
Not compatible with an Invisalign, sadly.
posted by phunniemee at 5:42 AM on March 8 [3 favorites]
The NTI night guard, which I am wearing at this moment because I haven't quite got out of bed yet, absolutely prevents clenching and changed my life. Not being dramatic, just true.
Not compatible with an Invisalign, sadly.
posted by phunniemee at 5:42 AM on March 8 [3 favorites]
NTI completey, absolutely destroyed my bite and cost me thousands of dollars for years of invisalign to correct (plus additional stress and anxiety over the entire situation).
In my sleep, my grinding/clenching INCREASED with the NTI. My molars grew to meet one another so my bite "opened" in the front teeth. The invisalign treatment involved rubber bands, buttons, pain, ...
I've been to various dental offices who were aware of the issues NTIs could cause, and in one case, brought in someone in their office who had been considering the NTI to hear my story to diswade them.
posted by armacy at 6:44 AM on March 8 [2 favorites]
In my sleep, my grinding/clenching INCREASED with the NTI. My molars grew to meet one another so my bite "opened" in the front teeth. The invisalign treatment involved rubber bands, buttons, pain, ...
I've been to various dental offices who were aware of the issues NTIs could cause, and in one case, brought in someone in their office who had been considering the NTI to hear my story to diswade them.
posted by armacy at 6:44 AM on March 8 [2 favorites]
If you do end up getting Botox, there's a savings program. I think it's botoxsavings.com.
posted by bookworm4125 at 7:58 AM on March 8 [1 favorite]
posted by bookworm4125 at 7:58 AM on March 8 [1 favorite]
An orthotic with invisilign sounds sub-optimal.
You don't say where you are but you can get it for $400 - $600 (my sister just had it.) If you live in a HCOL area, it's so worth it to hop on a train or get in the car for 2 hours to save so much off the local costs.
posted by DarlingBri at 8:08 AM on March 8
You don't say where you are but you can get it for $400 - $600 (my sister just had it.) If you live in a HCOL area, it's so worth it to hop on a train or get in the car for 2 hours to save so much off the local costs.
posted by DarlingBri at 8:08 AM on March 8
I know several people who have struggled with this and none of them got any relief until they started doing Botox.
posted by slkinsey at 8:42 AM on March 8
posted by slkinsey at 8:42 AM on March 8
My NTI definitely stops the clenching, but after 3 years of continual use it did affect my bite so that my front teeth no longer touch. I've found the tradeoff worthwhile enough that I will still occasionally wear the NTI when I am under stress and find myself clenching a lot.
posted by platinum at 10:38 AM on March 8
posted by platinum at 10:38 AM on March 8
Magnesium has never made a noticeable difference. Stress does seem to make a difference, it happens more when I'm stressed, but good luck doing anything with that particular fact (I sure can't!).
I've done botox, which helps temporarily, but hasn't cured it yet, and is pretty $$$ at least from my particular dentist/location. I'd say for me it lasts more than 6 months, less than a year; I have done it twice. It might be starting to cause lasting change after the round I did 7 months ago, but I am in a relatively low-stress period of life (modulo the global circumstances) so I can't tell if it's the botox causing lasting changes or that.
posted by ch1x0r at 11:12 AM on March 8
I've done botox, which helps temporarily, but hasn't cured it yet, and is pretty $$$ at least from my particular dentist/location. I'd say for me it lasts more than 6 months, less than a year; I have done it twice. It might be starting to cause lasting change after the round I did 7 months ago, but I am in a relatively low-stress period of life (modulo the global circumstances) so I can't tell if it's the botox causing lasting changes or that.
posted by ch1x0r at 11:12 AM on March 8
NTi worked great for me for many years until somehow I figured out a way to clench on even it in my sleep, and my teeth started to move in undesirable ways. My jaw clenching triggers migraines, and migraines make me clench more, in a horrible cycle, but night guards other than NTI don’t prevent clenching and do nothing for the migraines.
Fortunately there turned out to be a solution for me. My dentist gave me botox injections which were too low-dosage to do anything to help, plus were very expensive since insurance didn’t cover it, but she sent me to a neurologist who is excellent for botox for migraines (and gets my health insurance to pay). It has worked marvelously, reducing the clenching to zero, stopping the tooth damage, reducing the number of migraines dramatically, and making the migraines I do get less painful.
posted by metonym at 12:35 PM on March 8
Fortunately there turned out to be a solution for me. My dentist gave me botox injections which were too low-dosage to do anything to help, plus were very expensive since insurance didn’t cover it, but she sent me to a neurologist who is excellent for botox for migraines (and gets my health insurance to pay). It has worked marvelously, reducing the clenching to zero, stopping the tooth damage, reducing the number of migraines dramatically, and making the migraines I do get less painful.
posted by metonym at 12:35 PM on March 8
You could also consider physical therapy, for example from Postural Restoration Institute, which deals more directly with TMJ than most physical therapists. (I've worked with PRI practitioners for other symptoms but found that it improved my clenching as well.)
The PRI system says that the teeth are one of the reference centers that the body uses to orient itself in space. When you lie down to sleep, you can no longer use your feet as a reference, so you're more likely to use your teeth instead. It's just another strategy to find stability in the body. However, if you train your core and other muscles, you can use those for stability instead, and won't need to clench your jaw at night. This is the long-term fix.
You can find a PRI practictioner here or look for any physical therapist who specializes in treating TMJ.
posted by danceswithlight at 9:20 PM on March 8 [1 favorite]
The PRI system says that the teeth are one of the reference centers that the body uses to orient itself in space. When you lie down to sleep, you can no longer use your feet as a reference, so you're more likely to use your teeth instead. It's just another strategy to find stability in the body. However, if you train your core and other muscles, you can use those for stability instead, and won't need to clench your jaw at night. This is the long-term fix.
You can find a PRI practictioner here or look for any physical therapist who specializes in treating TMJ.
posted by danceswithlight at 9:20 PM on March 8 [1 favorite]
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More: I have tried magnesium, it didn't do anything. I tried cranio-sacral, it was relaxing but I don't believe in that stuff and can't do it every day or even weekly anyway. It's expensive. I had a custom night-guard before I did the Invisalign, and again, it stops the damage to the teeth but doesn't stop the actual clenching.
posted by Ollie at 3:53 AM on March 8