We can injure our smile three different ways. We can get cavities which is a bacterial infection that causes break down of the teeth. We can get gum disease which is an infection and swelling around the bone that supports the teeth. We can also grind and clench our teeth in ways that are destructive causing teeth to fracture and the bone to be injured. In this blog, I want to discuss nighttime tooth grinding, how nightguards can help protect teeth, and when do I recommend night guards.
The Reason For Mouth Guards
The medical term for grinding is called bruxism; however, for this article, I will refer to it as grinding. Unfortunately, every person grinds his or her teeth at night, and there are not many ways to stop people from grinding. Each individual grinds teeth differently. Some grind every single night whereas others grind only when they are stressed. Some people grind hard enough to break metal whereas others grind so lightly that it never shows up. Shows mash their teeth together and hold them tight, and others chop their teeth together by opening and closing with enough noise to wake the dead.
It is important to understand that everyone grinds because so many patients view it as a point of personal failure. It is important to understand that you probably grind your teeth to see what negative impacts it has on your personal health. Grinding breaks down teeth which is why I am concerned about it. Grinding can also be a sign of sleep apnea which is a serious condition in which the brain does not get enough oxygen on a nightly basis due to problems with breathing. It can also combine with cavities or gum disease to cause further break down of teeth, and some medical problems such as gastric reflux can speed up the destruction of teeth.
What Are Nightguards?
Nightguards are a hard or soft plastic material that is fitted around the teeth. The softer materials such as those bought from the drug stores simply provide a barrier so that the teeth cannot touch and when grinding happens the night guard is worn down rather than the teeth. While I cannot deny that many of my patients love the feel of a soft night guard, I personally do not recommend them because often they are “chewy” and when our mouths feel something chewy, the jaw muscles will work harder to “play” with the “chewy” night guard. This can make the jaw muscles work over time and lead to having sore jaw muscles in the morning. I personally prefer a hard night guard that is custom fitted to my patient’s individual bite. The hard night guard not only provides better protection to the teeth as it is stronger than the soft ones, but also it helps to relax the muscles by engaging a reflex that our jaw naturally has called the myostatic reflex. The best way to describe this reflex is to bite as hard as possible on your back teeth and then try again with only your front teeth.
You will probably notice that you cannot put near as much force by biting on just your front teeth as compared to your back teeth. A hard night guard can be custom built to ensure that whenever you use your powerful jaw muscles to clench hardest in the motions that are most destructive to teeth that this reflex is activated which relaxes the jaw. I also love hard night guards because even though they are hard, they are still softer than teeth. This means that night guards themselves are not strong enough to hurt teeth and that you will wear through or break the night guard before you wear through or break a tooth.
I personally recommend my hard night guards to three different types of patients. The first type are my patients who chip teeth or have worn through significant portions of their teeth already. Teeth are like M&M’s: hard enamel outside, soft inside. I can see and take pictures to show a patient that they have worn through or chipped the hard enamel outside, and they are likely to start getting into the soft inside, and these patients need a nightguard to help prevent further damage.
Patients with significant gum disease are also in this group as they have broken down the bone around their teeth and need the hard night guard to support their teeth at night and prevent themselves from only grinding on one or two already weak teeth.
The second group are patients who wake up with jaw pain or who have sensitive teeth that don’t respond to sensitivity toothpaste. Sometimes the teeth themselves don’t break down, but the jaw or the teeth feel the pain of being overworked. A night guard will help engage the reflex mentioned above but will also help prevent the overworking of individual teeth which can prevent sensitivity.
The final set of patients for whom I recommend night guards are those with extensive restorative work. Much like teeth, dental work can break which includes night guards. I would personally prefer to repair or replace a night guard than to repair or replace a tooth as it is much easier and cheaper to fix a night guard than the tooth or the restoration on the tooth.
Nightguards are a wonderful non-invasive treatment for many people as night guards can help protect teeth from damaging forces. At NOLA Dentures and General Dentistry, we make night guards to help our patients keep their mouth and their smile healthy. If you feel that you need a night guard, please give us a call today, and we can help you out.