People who grind or clinch their teeth often have pain in the temporomandibular joint (TMJ), a small “ball and socket” joint located slightly in front of the ear. This grinding or clenching, referred to as bruxism, can also cause the muscles of the face to become sore and damage the teeth. To treat bruxism, patients may need to reduce emotional stress, and are often fitted with an oral appliance called a night-guard. In the past, night-guards were often made of rigid acrylic, and were difficult to wear for some patients. Now, a new hard, but flexible guard is available to treat bruxism more comfortably.
When treating patients with bruxism, the dentist should first evaluate the underlying cause. In many cases, emotional stress contributes to the problem. Stress can be situation-driven, like planning for a wedding or buying a home, and the bruxism may be short-lived, ending when the stressful situation ends. If the stress is constant, bruxism may persist indefinitely. Patients should make every effort to reduce or eliminate stress, and a custom night-guard may be required to help alleviate facial discomfort.
To make a night-guard, the dentist takes molds or impressions of the upper and lower teeth. Next, the patient will need to bite into a piece of soft wax to record the position of the upper and lower jaw. A week or two is needed for the appliance to be made. When the night-guard is ready, the dentist may need to make a few minor adjustments to improve the fit. The patient should wear the appliance at night while sleeping, or during the day, whenever bruxism occurs.
Over the years, some of my patients expressed difficulty wearing the night-guard. The acrylic was too tight and uncomfortable around the teeth. Recently, I discovered a new style of night-guard called thermaguard. Unlike the rigid acrylic night-guard, the thermaguard has more “give” around the teeth. In fact, before wearing the thermaguard, the patient needs to soak it in warm water. This allows the thermaguard to become even more flexible and then comfortably mold around the teeth. My patients tell me that the thermaguard is much more comfortable than the hard acrylic night-guards that they have used in the past.