Night Guards

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What are TMJ and Bruxism?

TMJ disorder (also referred to as TMD) and bruxism are two different conditions that can both have a negative effect on the proper functioning of the mouth and oral health but can be related to each other.

TMJ disorder occurs due to misalignment of the joint where the lower jaw meets the skull. Bruxism, or teeth grinding, occurs when you grind your teeth unconsciously, which occurs often at night. Grinding is often a manifestation of  stress and, in many cases, patients are unaware that you grind your teeth.

Despite the distinction, there is an overlap in symptoms between these two conditions. Bruxism can be a symptom of & be caused by TMJ disorder. Conversely, TMJ disorder can cause and or worsen bruxism.

Our initial treatment for both these conditions is the same. We prescribe a night guard or occlusal guard to help alleviate the stress on your teeth and the supporting structures, resulting in less pain.

Treatment Options for Bruxism & TMD

We depend upon oral appliances, or “night guards”, for the management and treatment of TMD and bruxism. These appliances are used to help relieve facial and jaw pain, control the severity of morning headaches, and prevent jaw locking, generally relieving stress placed on the teeth and supporting structures. As a result of using these devices, patients routinely report less tooth sensitivity, less pain, less discomfort and tightness in their jaw muscles and reduced severity of TMJ pain, noises, and jaw locking events, less snoring and morning fatigue. Additionally, we can decrease the wear and tear of our patients’ teeth and restorations, resulting in greater stability and longevity of both their fillings and dentition.

Oral appliances do not stop grinding or clenching activity, they are extremely helpful in preventing or stopping damage to the teeth, jaw muscles and temporomandibular joints (TMJs). The relief obtained by these devices is sometimes remarkable and can occur within a short period of time. These appliances produce the best results when custom-fit, monitored and modified over time. The process of fabricating the night guards involves quick impressions/molds in the office. Two weeks later we will have a lab-fabricated custom fit night guard ready for you. This second try-in visit usually requires quick minor bite adjustments. Over the counter night, guards are available but the vast majority of them will not fit well.  A good fit will increase the chances of proper compliance. Better compliance equates to more protection which is our objective for our patients. Additionally, OTC guards tend to provide a false sense of protection due to the dramatic decrease in thickness during the fitting process, similar to our issue with boil and bite athletic mouthguards.

Important to know, an oral appliance is not designed to move your teeth or rearrange your bite but instead serves as a shock absorber and oral cushion. It may be designed to be worn on your upper teeth or your lower teeth, depending upon the nature of your problem.

TMD / Temporomandibular Dysfunction or Disorder

TMJ disorder is a condition that involves pain and improper functioning of the muscles and joints that attach the lower jaw to the skull.

In order to open and close your mouth to eat or speak, your TM joints must be functioning properly. We all have two TM joints, one on the right and one on the left. These joints, which are moved by muscles and stabilized by ligaments, are therefore part of an orthopedic system. This system can be compromised by overuse, disease, or trauma. Once present, a TMD problem is typically associated with pain and/or limitation of jaw function.

Signs & Symptoms of TMD:

  • Limitation of jaw range of motion
  • Painful jaw range of motion
  • TM joint clicking
  • TM joint locking
  • A sense of a bite discrepancy
  • Tension in the face
  • Daily headaches in the temples
  • Morning headaches on arising
  • Sore jaw muscles
  • Jaw pain while eating
  • Neck Tension
  • Ear symptoms can include pain, a sensation of stuffiness or fullness, and a variety of odd sounds such as ringing, humming, buzzing, and whistling.
  • Loss of balance and a sense of unsteadiness
  • Tingling sensations in the face and jaw


Bruxism is associated with subconsciously clenching or grinding the teeth, especially in situations of stress &/or during sleep.

In most cases, bruxism doesn't cause serious complications. But severe bruxism may lead to excessive wear & tear of teeth, restorations, and crowns or jaw, tension-type headaches, severe facial or jaw pain, or TMD.

Signs & Symptoms of Bruxism:

  • Teeth grinding or clenching, which may be loud enough to wake up your sleep partner
  • Teeth that are flattened, fractured, chipped or loose
  • Worn tooth enamel, exposing deeper layers of your tooth
  • Increased tooth pain or sensitivity
  • Tired or tight jaw muscles, or a locked jaw that won't open or close completely
  • Jaw, neck or face pain or soreness
  • Pain that feels like an earache, though it's actually not a problem with your ear
  • Dull headache starting in the temples
  • Damage from chewing on the inside of your cheek
  • Sleep disruption