Custom Night Guards for Teeth Grinding

Not everyone who grinds needs one. The NHS says treatment is not always needed. Leeds Teaching Hospitals NHS Trust notes that sleep grinding is not necessarily harmful and treatment usually targets the problems it causes rather than the grinding itself.

A guard is worth considering if your teeth are wearing down, you have jaw or muscle pain, or you wake up with headaches. We can check your teeth and discuss whether a guard would help during a dental examination.

Here is the honest picture. A night guard creates a barrier between your upper and lower teeth, so that grinding wears the guard rather than your enamel. For many people it also takes some strain off the jaw muscles.

What it does not do is stop you from grinding. Some people clench harder on a soft guard, and some chew straight through one, as Leeds Teaching Hospitals NHS Trust points out. A 2020 systematic review in the British Dental Journal, covering 37 trials, rated the certainty of the evidence for splints in bruxism and TMD as very low, and no trial had measured tooth wear. That does not mean guards are useless. Dentists commonly use them to help protect teeth, and many patients find them helpful. It does mean you should not expect a miracle, and that a review after a few months of use matters.

The main types are:

• Soft guards. Flexible and often more comfortable at first, though they can wear through faster and some people clench more on them.
• Hard (stabilisation) splints. Made from a firmer acrylic, designed to give even contact across your teeth. They tend to last longer. The Royal College of Surgeons of England guidance on temporomandibular disorders prefers full coverage hard splints for jaw muscle pain, and treats soft splints as a short term, closely supervised option.
• Mandibular advancement devices. These are a different appliance, worn on both the upper and lower teeth, used for suspected or confirmed obstructive sleep apnoea, not simply for grinding.

Your dentist will advise which type suits your teeth, your bite and how you grind. [CONFIRM: which types are made at Maida Smiles]

Shop bought and boil in the mouth guards cost a lot less. The problem is fit. Leeds Teaching Hospitals NHS Trust advises that a splint should be made by a dentist, as ill fitting splints can cause problems with your teeth or gums. A guard that is too bulky can feel uncomfortable, make you gag or be taken out in your sleep, and one that does not fit properly may not protect your teeth. A custom guard is made from an accurate record of your own teeth, so that it fits securely and comfortably.

The NHS says a night guard can be made to fit over your upper or lower teeth. Which one you get depends on your bite, your comfort and what your dentist is trying to achieve. We make this decision with you at your assessment.

• Assessment. We examine your teeth, gums, jaw and bite, and talk to you about your symptoms and sleep. If something else could be causing your pain, we will say so.
• Impressions or scans. A precise record of your teeth is taken.
• Laboratory. Your guard is made to fit.
• Fitting. We check how it fits and feels and adjust it where needed.
• Review. We see how you are getting on after a few weeks and again after a few months.

[CONFIRM: number of visits, scan or impression method, laboratory turnaround and what is included in the fee]

Guidance on temporomandibular disorders suggests judging a splint after around three months of regular night time use, so we plan reviews with that in mind.

The first few nights can feel odd. You may notice extra saliva, a dry mouth or slight soreness. These usually pass within a week or two. If the guard feels uncomfortable or your bite seems different in the morning, let us know. A small adjustment often solves it.

Wear it every night for the best results. If you are not wearing it, it cannot protect you.

• Rinse it in cool water after each use and brush it gently with a soft brush and mild soap.
• Avoid hot water, which can distort the plastic.
• Store it in its case, away from pets, which love to chew them.
• Bring it to your check ups so we can look for wear or cracks.

Guards do not last forever. How long yours lasts depends on the material and how hard you grind. If it cracks, gets thin or no longer fits, it needs replacing. [CONFIRM: care instructions with the clinical team]

Many people grind without knowing. These are the signs that most often prompt a visit.

• Teeth that look flattened, chipped or worn.
• Sensitive teeth, particularly to cold.
• A tight or sore jaw, or tired facial muscles, in the morning.
• Headaches around the temples when you wake up.
• Earache with no sign of infection.
• A partner who hears grinding or clicking at night.
• Disturbed sleep that you cannot explain.

Leeds Teaching Hospitals NHS Trust notes that up to one in five people clench during the day as well, often without realising. Catching yourself with your teeth together while you work or drive is a clue. Keeping your teeth slightly apart and your tongue resting gently on the roof of your mouth can help.

The NHS links grinding with stress, caffeine, alcohol and smoking. Cutting down on caffeine and alcohol, especially in the evening, giving up smoking and building in time to wind down before bed may all help. None is a guaranteed fix, but each is good for your health anyway. If stress or anxiety is a big part of your life, your GP can talk you through support options.

After fitting, it is normal to need a small adjustment, and we expect to see you back for a review. Guards can crack, wear thin or lose their fit if your teeth change, for example after a new filling or crown. If that happens, bring it in. We can look at whether a repair will do or whether a new guard is the better choice.

It is not unusual for children to grind their teeth. The NHS suggests seeing a dentist if the grinding continues or if it is causing problems. We would not make a standard adult guard for a growing child without careful thought, so please talk to us about your child's particular case. [CONFIRM: whether children's night guards are offered]

Some situations need a different approach or extra checks. If you snore loudly, stop breathing at night or feel exhausted during the day, see your GP or dentist, as grinding can be linked to sleep apnoea. A guard may also need to be considered carefully if you have loose teeth, active gum disease or partial dentures. And if the real driver is stress, a guard protects your teeth, but dealing with the stress is what may help in the long term. The NHS suggests speaking to your GP about stress and lifestyle causes.

Keep the guard in its case whenever it is not in your mouth, and put the case somewhere you will not forget it, such as beside your toothbrush. Pack it when you travel, because skipping a few nights can bring the jaw tension straight back. Bring it to your check ups so that we can check the fit and look for wear.

At a review, we ask how you have been sleeping, whether your jaw feels better, and whether the guard is comfortable. We check it for wear and fit, look at your teeth for any change, and adjust it if needed. If it is helping, we carry on. If it is not, we talk through the alternatives, including whether the guard is the right approach for you at all.

You will be examined by a dentist, and the guard will be made specifically for your teeth. Our Maida Vale dental practice is on Sutherland Avenue, two minutes from Maida Vale tube, and open until 8pm on Tuesdays and Thursdays. If jaw pain is the main issue, tell us and we can look at the whole picture together.

No. It protects your teeth and may ease strain on your jaw muscles, but it does not stop you from grinding. Leeds Teaching Hospitals NHS Trust says treatment generally aims to manage the problems grinding causes.

It varies with the type of guard and how heavily you grind. We check yours at your reviews, and replace it when it is worn, cracked or no longer fits well.

They are cheaper, but fit is the issue. Leeds Teaching Hospitals NHS Trust advises splints should be made by a dentist, because poorly fitting ones can cause problems with your teeth or gums.

Either can be made, and your dentist will recommend one based on your bite and comfort. The NHS says guards can be made for the upper or lower teeth.

It is £400 per arch, as shown on our fee list. We will confirm what is included at your appointment.

It may help muscle related jaw pain, according to Royal College of Surgeons guidance, but it is not a guaranteed fix. We would review it after around three months of use.

No. Sports mouth guards are designed for impact. A night guard is designed to sit comfortably through the night and protect against grinding.