Nightguards are an important part of preventive dentistry. They are also known as mouthguards, mouthpieces, appliances, and biteguards. Not everyone needs a nightguard, but more and more people are wearing them these days.
What is a Nightguard?
A nightguard is a protective device worn over the teeth to keep them from getting hurt by the heavy forces that happen when you clench or grind your teeth. There are many different kinds of nightguards made of different materials and shaped, sized, and used in different ways. The most common and helpful kind of nightguard is a custom-fitted, hard acrylic mouthpiece that covers all of the upper or lower teeth.
Because there are so many different kinds of nightguards, it’s important to go with what your dentist suggests. For example, a nightguard for someone with headaches and muscle pain from clenching their teeth too hard needs to be shaped differently than one for someone with TMJ problems (jaw joint). Many people find that over-the-counter or homemade nightguards make their muscles tighter and cause them to get headaches more often.
What is the Purpose of a Nightguard?
A nightguard has a lot of different, important jobs to do. Not every nightguard does all of these things, so it’s important to talk to your dentist about the symptoms you’re having to find the right one.
Protecting the Teeth
A nightguard is a piece of material that physically separates the teeth. This keeps your teeth from rubbing against other teeth or dental restorations like crowns when you clench or grind them. Covering each tooth makes it less likely that it will crack or break.
By covering all of the teeth with a single hard appliance, it also redistributes the biting forces so that no single tooth gets too much pressure. It makes the bite “even.” The thickness of the nightguard and the way it keeps the upper and lower jaws apart decrease the amount of force that the facial muscles can produce as a whole. This means that the teeth under a nightguard take less of the force of clenching or grinding.
Protecting the Gums
Most people don’t know that clenching or grinding their teeth hurts their gums. When people clench and grind their teeth, which is bad for their teeth, the gum tissue can “back away” or recede. This is especially important when only one tooth gets the wrong amount of bite force. It’s not uncommon for us to look at a single tooth with receding gums and find that it hits the opposing tooth harder or at a different angle than the other teeth in the area.
With a well-fitting nightguard, bite forces are spread out in a way that protects the gum tissue and stops further gum recession. Some heavy forces can actually hurt the jawbone around a tooth, which can make it loosen or change the way you bite. Even this is stopped by nightguards!
Reducing Muscle Force
This is the most important function for people who get headaches often. People who clench or grind their teeth all night often wake up in pain or with very tight muscles in their face and temples. As you work those muscles too hard all night, they get sore just like the biceps or quadriceps that have been worked too hard.
By stopping these facial and temple muscles from fully bending, a nightguard reduces the amount of force they can make. If you can’t get your teeth together, you can’t make the same amount of force with your upper and lower jaws.
Protecting the Jaw Joints (TMJs)
Over time, clenching and grinding your teeth too hard can hurt the joints in your jaw. The TMJs are ball-and-socket joints, and if you use too much muscle force, the ball can move into the socket and damage the joint. A nightguard protects the joints by reducing the overall force of the muscles and keeping the joints from getting too much pressure.
Who Needs to Wear a Nightguard?
Your dentist will be able to tell if you clench or grind your teeth at night. Heavy forces on the teeth, gums, muscles, and joints leave signs that can be seen or found by a dentist. This means that we can see whether or not you are clenching or grinding your teeth.
Signs on the Teeth
- Crack lines
- Small chips of enamel
- Flat spots called wear facets
- Shortening of the front teeth
- Notching at the gumline called abfractions
- Small gaps or spaces opening between the teeth
Signs on the Gums
- Receding gums
- Isolated gum recession, especially in a sharp “V” shape or notch
Signs in the Facial & Temple Muscles
- Enlargement of the cheek muscles (masseters)
- Enlargement of the muscles in the temple (temporalis)
- Asymmetry (where one side is noticeably larger than the other)
- Pain in facial or temple muscles on clenching the teeth together
Signs in the Joints
- Popping or clicking sounds
- Pain in the joint or ears
- Ringing in the ears
- Locking in the jaw joint (either closed where you cannot open your mouth, or open, where you cannot close your mouth)
Other Signs in the Mouth
- Callous line on the inside of the cheeks
- Scalloped sides of the tongue (also known as “pie crust tongue”)
What Happens if I Do not Wear a Nightguard?
If you need a nightguard but don’t wear one, you may be more likely to have dental problems like broken teeth or receding gums. Most of the time, the cost of fixing problems caused by grinding or clenching your teeth too hard is much higher than the price of a nightguard. For example, a crown costs about twice as much as a nightguard to fix a single cracked tooth.
A nightguard is just too good of a way to stay safe to pass up. If you think you might be clenching or grinding your teeth at night, ask your dentist the next time you see him or her. The best thing to do is always to stop teeth grinding before it does damage.
Dr. Motiwala in International Press
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