Temporomandibular Joint (TMJ) disorders represent a range of conditions affecting the jaw joint and the muscles controlling jaw movement, leading to pain and dysfunction. With an estimated 5% to 12% of the population experiencing TMJ disorders, and some studies suggesting up to 31% of adults show signs, these issues are a common source of discomfort. Many individuals experiencing jaw pain, clicking, or difficulty with jaw movement are prescribed night guards as a common intervention. While often beneficial, a frequent concern arises regarding whether these devices can, in some instances, exacerbate TMJ symptoms.
How Night Guards are Meant to Help TMJ
Night guards, also known as occlusal splints, are designed to create a protective barrier between the upper and lower teeth, preventing direct contact. This physical separation helps to alleviate stress on the temporomandibular joint and the surrounding muscles. By preventing teeth grinding (bruxism) and clenching during sleep, night guards reduce strain on the jaw joints.
The appliance promotes muscle relaxation by disrupting the habitual biting pattern, allowing the jaw to find a more comfortable and stable position. This decreases muscle activity and tension, which often contributes to TMJ pain. Additionally, night guards help protect tooth enamel from wear and tear caused by grinding, preserving dental health.
Factors That Can Lead to Worsening TMJ Symptoms
While intended to help, a night guard can sometimes worsen TMJ symptoms due to its fit and underlying jaw mechanics. An improperly fitted night guard is a significant concern, as it can create new bite interferences or put uneven pressure on the jaw. Over-the-counter or “boil-and-bite” guards, which are not custom-made, are prone to poor fit and may shift jaw alignment, potentially exacerbating issues.
The material and design of the night guard also play a role. While hard acrylic guards are often recommended for moderate to severe grinding and clenching due to their durability and ability to reduce muscle activity, overly soft guards might encourage more clenching. If a night guard does not align perfectly with the jaw, it can increase muscle strain and discomfort as muscles attempt to adapt to an unnatural position.
Furthermore, a night guard may not address the root cause of the TMJ disorder. If the underlying issue involves severe joint degeneration, specific disc displacement, or a systemic condition, a night guard alone may be insufficient or could even worsen symptoms if it’s the wrong approach. An incorrect diagnosis of the TMJ problem can also lead to an inappropriate night guard prescription, failing to alleviate symptoms or causing further complications.
Signs Your Night Guard May Be Problematic
Recognizing when a night guard is causing problems is crucial. One of the primary indicators is increased jaw pain or tenderness, new or worsening after starting to wear the guard. Headaches, particularly upon waking, can also signal an issue with the appliance.
Other signs include earaches or ringing in the ears (tinnitus), which can be related to increased pressure on the jaw joint. Difficulty opening or closing the mouth fully, or a feeling that the jaw is misaligned, are also red flags. Changes in your bite, such as how your teeth fit together, or increased teeth sensitivity, suggest unwanted tooth movement or uneven pressure. Worsening clicking, popping, or locking of the jaw indicates negative impact on the joint’s mechanics.
Steps to Take if Your Night Guard Causes Discomfort
If you experience discomfort or worsening symptoms after using a night guard, consult a dental professional. This could be your general dentist, an oral surgeon, or a dentist specializing in TMJ disorders. Do not self-adjust the night guard, as this can lead to further complications.
A professional can assess the fit of your night guard and determine if adjustments or a refitting are necessary. They might recommend a different type of night guard, such as switching from a soft to a hard material, or alternative designs that better suit your specific condition. The dental professional may also re-evaluate your TMJ diagnosis to ensure treatment aligns with the underlying cause of your symptoms. In some cases, they might suggest complementary treatments like physical therapy, medication, or stress management if the night guard alone is not sufficient or appropriate for your condition.