A night guard is a removable oral appliance worn while sleeping to create a physical barrier between the upper and lower teeth. Its primary purpose is to protect the teeth from the damaging effects of bruxism, which is the involuntary clenching or grinding of the teeth. Since the appliance remains in the mouth for several hours each night, understanding the potential risks associated with its materials and use is important for maintaining oral health.
Understanding Guard Types and Material Safety
The safety of a night guard begins with the type of appliance chosen, generally falling into two categories: custom-made guards from a dentist or over-the-counter (OTC) options, such as boil-and-bite models. Custom-made guards are fabricated in a professional dental lab using an impression of the patient’s teeth, which ensures a precise fit and typically involves higher-grade materials. OTC guards are often less expensive and readily available, but their one-size-fits-most nature and material quality present greater safety concerns.
A common concern revolves around the plastics used, specifically the presence of Bisphenol A (BPA), a chemical linked to potential health issues. Reputable manufacturers and professional dental labs primarily use medical-grade plastics like ethylene-vinyl acetate (EVA) or copolyester, which are generally BPA-free and approved for long-term oral use. Consumers should verify that any guard, particularly OTC varieties, is explicitly labeled as BPA-free, as some lower-grade plastics may also contain phthalates or latex, which can cause allergic reactions or irritation.
Risks Associated with Improper Fit
The most significant safety concern with night guards is not the material, but the potential for an improper fit to cause mechanical problems within the jaw system. An ill-fitting guard, often a risk with non-custom OTC models, can apply uneven pressure to the teeth, which may lead to slight, unintended tooth movement or shifting over time. This mechanical imbalance can disrupt the natural bite alignment, leading to discomfort or soreness that mimics the feeling after orthodontic adjustments.
A poorly fitting appliance can also exacerbate or even trigger symptoms of Temporomandibular Joint Disorder (TMD), a condition affecting the jaw joint and surrounding muscles. If the guard holds the jaw in an unnatural or incorrect position, it can increase muscle strain and tension around the joint, sometimes making clenching or grinding worse. Guards that are too bulky or have uneven contact points can cause the jaw to misalign, leading to pain, clicking, or locking of the joint.
Guards that are too long or have rough edges can cause irritation to the sensitive soft tissues of the mouth, resulting in sores, inflammation, or gum recession. Professional oversight is important because a dentist ensures the guard maintains the correct vertical dimension and proper bite relationship. The precise fit of a custom-made guard is designed to distribute force evenly, mitigating the potential for mechanical complications and subsequent TMD issues.
Maintaining Safety Through Hygiene and Care
Even a perfectly fitted night guard can become a health risk if not maintained properly, as the appliance can quickly harbor bacteria, yeast, and fungi. Worn nightly, the guard is exposed to saliva, plaque, and oral microorganisms, creating an environment where pathogens like Candida can thrive. Failure to clean the guard thoroughly can lead to bad breath, gum inflammation, and an increased risk of oral infections.
Daily cleaning is required immediately upon removal, starting with a rinse under lukewarm water to wash away saliva and debris before they dry onto the surface. The guard should then be gently brushed using a dedicated soft-bristled brush and mild, non-abrasive soap or a non-abrasive toothpaste, as rough materials can scratch the surface. Scratches create microscopic crevices where bacteria can accumulate and multiply, making the guard harder to sanitize.
After cleaning, the appliance must be allowed to air-dry completely before being stored in a clean, ventilated case. Storing a damp guard in an airtight container creates the perfect moist environment for mold and bacterial growth. Guards should be inspected regularly for cracks, holes, or discoloration, as any sign of damage indicates the material is degrading and needs replacement to maintain its effectiveness and hygiene.