In today”s day and age teeth grinders/ Bruxers and clenchers are increasing. In a lot of such patients, teeth grinding becomes a chronic problem, to an extent that that they need treatment. Teeth grinding is most common at night. If it is diagnosed early then it can be treated before permanent damage is caused to the teeth.
Constant grinding can wear out the enamel of the teeth, flattening the teeth surface and exposing the dentine and eventually the nerves. Teeth can get chipped. Enamel can get cracked, fillings can get fractured and become loose, gum recession can happen and teeth can get lost . In severe cases the vertical height of the jaws is reduced and the clicking occurs in the TMJ ie temporo mandibular joint.
To give relief to teeth grinders or bruxers, a special kind of mouth guard is given to them .It is called “Night Guard”. This is custom made for people , for whom grinding teeth at night has become a habit. First the dentist takes an impression of the teeth. Then the model is poured in dental stone. On the stone model the mouth guard is adapted using a special material . These customized night guards are the best. They act as a cushion between the teeth and prevent the parafunctional muscle contraction , bringing relief.
Patients who are bruxers/grinders, get relief from the tension headaches and soreness in temples, forehead and back of the skull within the first few weeks of wearing the night guard. Relief in migranes, take a little longer.
Which arch is the night guard fabricated for?
Usually an upper night guard is fabricated. However if some treatment has to be carried out in the upper teeth then the lower one is fabricated.
If between the upper and lower jaws, one arch has some teeth missing or mobile, then the night guard is fabricated for the arch which has the full set of teeth.
The Nociceptive Trigeminal Inhibition Tension Control Device (NTI Device), is an acrylic mini-splint that hugs the front two teeth, reducing the intensity of jaw-clenching during sleep and the headache that comes along with it. The acceptability of the NTI Device for patients who have a gag reflex, is better as it covers only two teeth and not the whole arch. It is smaller, less bulky so a bit more comfortable. It suppresses the parafunctional muscle contraction by almost 70percent and thus protects the teeth, joint and muscles.
Mouth guards are also worn by all people, adults or children who play contact sports to protect their teeth. They wear them while playing hockey, football, soccer or while boxing/wrestling. They are useful in non contact sports like gymnastics where the teeth can be in danger . Recreational sports like mountain biking or skate boarding also warrant the use of mouth guards, whenever they are playing the sport.
Mouth guards are either
a- custom made
c- bite and boil
a-The custom made are the best, as described above, as they fit snugly on the patient’s teeth.
b-The stock mouth guards are available , over the counter in a good sports store or a department store . They are bulky and donot fit too well as there is no scope of them being adjusted. Thus they are not recommended
c- The “bite and boil” mouthguards are also available in a good sports or department store. They have some scope of adjustment . The patient puts it in boiling water, it gets soft.Then he bites on it and adjusts the size with the finger and tongue pressure. Thus they are slightly better than stock mouth protectors.