Braces are orthodontic tools used to align teeth and correct bite issues. A night guard is a dental appliance primarily used to treat bruxism—the unconscious grinding or clenching of teeth—or to manage temporomandibular joint (TMJ) disorders. It is possible to wear a night guard while undergoing fixed orthodontic treatment, but it requires specialized attention and appliances to cushion the bite and protect the teeth from excessive force.
Compatibility and Clinical Necessity
Patients wearing braces may develop or continue to experience bruxism, a habit independent of the orthodontic treatment itself. Bruxism often occurs involuntarily during sleep and can be caused by various factors, including stress, anxiety, or underlying sleep disorders. The initial discomfort and tension from new braces can sometimes even temporarily increase clenching or grinding habits.
Ignoring bruxism while wearing braces poses several risks to the orthodontic process and oral health. The excessive forces generated by grinding can damage or dislodge brackets and wires, leading to unexpected breakages and delaying the overall treatment timeline. Sustained clenching can also intensify oral discomfort, cause headaches, or influence how the teeth move. A specialized night guard is a necessary protective measure to safeguard the hardware and teeth, allowing the straightening process to continue as planned.
Specialized Night Guard Requirements
Standard over-the-counter night guards, such as “boil-and-bite” versions, are unsuitable for individuals with fixed braces. These generic appliances are not designed to fit over brackets and wires and can easily become stuck or apply unwanted pressure to the orthodontic hardware. The pliable material of a boil-and-bite guard may stick to the braces, creating a risk of damage to the appliance or the teeth upon removal.
The only recommended solution is a custom-made night guard provided by the orthodontist or a specialized dental lab. This appliance is fabricated based on a precise impression of the mouth, taken with the braces already in place. The design must accommodate the brackets and wires without hindering the programmed tooth movement.
Specialized guards are made from soft or dual-layer materials, offering flexibility and comfort while providing a durable barrier against grinding forces. A soft, custom-fit guard is preferred because it is less likely to interfere with the teeth’s continuous movement compared to a rigid appliance. Because the teeth shift throughout treatment, the night guard’s fit must be monitored closely. The orthodontist may need to make minor adjustments or periodically replace the guard entirely to ensure it does not impede the progress of the braces.
Managing the Combination for Optimal Results
Using both a specialized night guard and braces requires diligent maintenance and regular professional oversight. The orthodontist must regularly check the night guard’s fit to confirm it is not exerting any unintended forces that could interfere with the prescribed tooth movement. If the guard feels too tight or too loose, it signals that the teeth have shifted enough to warrant an adjustment or a replacement.
Maintaining rigorous hygiene is paramount to prevent complications, as both the braces and the night guard create additional surfaces where plaque and food particles can accumulate. The night guard should be cleaned every morning using a soft-bristle brush and non-abrasive toothpaste. After cleaning, the guard must be stored in a clean, protective container to prevent the accumulation of dust and bacteria. Patients must also carefully clean the areas around their brackets and wires before inserting the night guard to reduce the risk of trapping debris overnight.