Short answer: A night guard is a protective device made of acrylic or a soft material, custom-made from impressions of your mouth, that prevents the teeth from grinding against each other during sleep in people who clench and grind their teeth (bruxism). It protects the teeth from wear and fractures and helps spread the load on the jaw muscles and joint. It does not eliminate bruxism completely, but it limits the damage. Clear orthodontic aligners and retainers are not designed to take over the full function of a night guard.
If you wake up with jaw fatigue and temple pain in the morning, notice wear on the tips of your teeth or hear from your partner that you grind your teeth at night, you are most likely dealing with the clenching and grinding habit known as bruxism. The most commonly recommended protective solution for this is a night guard. In this article we cover what a night guard is, who should wear one, how it is made, the rules for using and cleaning it and whether clear aligners can replace a night guard.
What is a night guard?
A night guard is a custom protective device worn over the upper or lower teeth during sleep that prevents the teeth from touching and grinding against each other directly. In the medical literature it is also called an occlusal splint. The guard absorbs the forces generated during clenching and grinding instead of the teeth and spreads these forces over a wider surface.
The purpose of a night guard is less to treat bruxism and more to reduce the damage bruxism does to the teeth, fillings, crowns and jaw joint. Causes of bruxism include factors such as stress, anxiety, sleep disorders (for example snoring and sleep apnea), certain medications, caffeine, alcohol and smoking. That is why a night guard should be part of a holistic approach that, where needed, also addresses stress management, sleep assessment and changes in habits.
Who should wear a night guard?
A night guard is recommended especially for people who show symptoms or damage related to clenching and grinding. If one or more of the following signs are present, it is helpful to have an assessment:
- Flattening or wear on the tips and chewing surfaces of the teeth
- Cracks in the teeth, or fillings or crowns that break often
- Pain and fatigue in the jaw, facial muscles, temples or around the ears in the morning
- Clicking, catching or limited opening of the jaw joint
- Notch-shaped wear and sensitivity at the necks of the teeth
- A sleep partner hearing grinding sounds at night
- Tooth marks on the inside of the cheeks or the edges of the tongue
In addition, night guards are often recommended for patients with known bruxism who have extensive restorations such as implants, crowns or veneers, to protect these restorations. Teeth grinding in children is often temporary and does not always require a guard; the assessment should be made by the dentist.
How is a night guard made?
A night guard is custom-made in a laboratory using an impression of your teeth or an intraoral digital scan. The process usually consists of the following steps:
- Examination: Wear on the teeth and the condition of the muscles and joint are assessed; X-rays are taken if needed.
- Impression or scan: An impression of the teeth is taken, or a three-dimensional model of the mouth is created with a digital scanner. The bite relationship is recorded.
- Fabrication: The guard is made in the laboratory in the planned thickness and material. Hard acrylic guards are the type most often used for bruxism; soft or dual-layer guards may be preferred in certain situations.
- Delivery and adjustment: The guard is tried in the mouth, its fit is checked and it is adjusted to ensure balanced contact when you bite.
- Follow-up: After the first weeks of use, the guard is checked again and further adjustments are made if needed.
Over-the-counter guards sold in pharmacies or sports stores are not custom-made, so they may not fit properly, can negatively affect the bite and, because of their bulk, may increase clenching in some people. That is why guards made by a dentist are recommended for long-term use.
How should a night guard be used and cleaned?
A night guard should be worn every night before going to sleep and cleaned after it is removed in the morning. Getting used to the guard may take a few nights; increased saliva or a slight feeling of pressure eases within a few days for most people.
Cleaning and storage tips
- After removing the guard in the morning, rinse it with cold or lukewarm water; hot water can warp it.
- Clean it gently with a soft brush and an unscented, non-abrasive liquid soap. Toothpaste can scratch the surface of the guard because of the abrasive particles it contains.
- Let the guard dry and store it in a ventilated case.
- Do not leave it in the sun, near a radiator or in a hot car.
- Store it out of reach of pets; dogs tend to chew on guards.
- At the intervals your clinic recommends, for example once a week, you can deep-clean it with suitable cleaning tablets.
- Bring your guard to your check-up appointments; wear, cracks or fit problems are assessed.
Similar cleaning rules apply to clear aligners; for detailed information, see our how to clean clear aligners article. The lifespan of a night guard varies with the severity of the bruxism and how well the guard is cared for; guards that wear down or crack over time need to be replaced.
Can clear aligners replace a night guard?
No, orthodontic clear aligners and the retainers used after treatment are not designed to replace a night guard. Clear aligners are made from a thin material, and their purpose is to move the teeth or hold them in their new positions. A night guard, on the other hand, is made from a thicker, more durable material and is adjusted to withstand clenching forces and provide balanced contact when you bite.
That said, in people undergoing clear aligner treatment, the aligners partly prevent the teeth from grinding directly against each other, so they can provide some protection during treatment. However, heavy clenching can cause wear, holes or cracks in the aligners. We cover these and other possible aligner problems in our clear aligner problems article.
If a patient with bruxism is about to start orthodontic treatment, this must be discussed with the orthodontist. The protection plan to follow during and after treatment, including aligner thickness, type of retainer and, if needed, the use of a separate night guard after treatment, is determined by the orthodontist.
What else can be done besides a night guard?
The effect of a night guard can be supported by also addressing the factors that trigger bruxism. Trying to notice during the day whether your teeth are touching is a good start; at rest, the lips should be closed and the teeth slightly apart. Cutting back on caffeine and alcohol in the evening, reducing screen time before bed and keeping a regular sleep schedule can ease the tendency to clench. Habits such as chewing gum and biting pens should be limited because they tire the muscles unnecessarily. If snoring or pauses in breathing during sleep are noticed, a sleep assessment may be recommended. For some patients with severe muscle pain, the dentist may also suggest supportive methods such as warm compresses or guided jaw exercises.
When should you see a dentist in Ankara about teeth clenching?
If you wake up with jaw pain in the morning, notice wear or cracks on your teeth or keep dealing with fillings that break, it is important to have the damage from clenching assessed before it progresses. At our clinic in Oran, near Panora Mall, we examine your teeth, muscles and jaw joint and assess together whether a night guard is suitable for you, along with other supportive measures.
Frequently asked questions
Does a night guard stop teeth clenching completely?
No. A night guard does not eliminate the cause of bruxism; it helps reduce the damage to the teeth, restorations and jaw joint. Stress management, assessment of sleep quality and changes in habits are also important.
Is a night guard worn on the lower or upper teeth?
The guard can be made for either the upper or lower teeth. The choice is made by the dentist based on the person's bite, missing teeth, restorations and comfort expectations. In most cases the upper jaw is preferred.
How long is a night guard used?
Wearing a night guard is recommended for as long as bruxism continues; for most people this is long-term. The guard needs to be replaced when it wears down or no longer fits properly. Its condition is assessed at check-ups.
Can an over-the-counter night guard be used?
Over-the-counter guards are not custom-made, so they may not fit properly and can negatively affect the bite. Apart from short-term temporary use, guards made by a dentist from impressions should be preferred.
