A night guard provides an ideal environment for bacteria to collect. After an infection like Strep throat, routine cleaning methods are not sufficient to eliminate the lingering presence of the causative bacteria, Streptococcus pyogenes. Because this appliance is placed directly into the mouth every night, the potential for re-introducing the pathogen and causing a second infection is high. A focused, acute disinfection protocol is necessary to ensure the appliance is completely sanitized and safe for use again.
Understanding the Risk of Strep Contamination
The bacterium responsible for Strep throat, Group A Streptococcus (GAS), poses a persistent risk because it can survive outside the human body for an extended period. This pathogen can persist on environmental surfaces, known as fomites, especially when encased within a protective biofilm layer. The night guard, being a porous oral appliance, can harbor these microorganisms in its microscopic surface irregularities. If the night guard is not deeply disinfected, the residual S. pyogenes can remain viable and potentially lead to a relapse of the infection. This acute risk requires a more aggressive approach than the standard daily cleaning.
The Acute Disinfection Protocol
The primary goal following a Strep infection is to achieve deep disinfection using an effective chemical agent with a short contact time. One highly effective method utilizes a very dilute solution of household bleach, which contains sodium hypochlorite. To create a safe disinfectant, mix one teaspoon of plain, unscented 5.25% or 6.0% sodium hypochlorite bleach into one quart of cool water. This dilution is potent enough to neutralize S. pyogenes but remains safe for the appliance material.
The night guard should be completely submerged in this solution for a maximum of two to five minutes to ensure bacteria are eradicated. A shorter soak time is safer for the appliance material while still providing sufficient contact time. Immediately following the soak, the night guard must be thoroughly rinsed under running water for at least 30 seconds to remove all traces of the chemical solution.
An alternative method is to use specialized anti-bacterial soaking tablets designed for oral appliances. These tablets often contain ingredients like persulfates that generate an antimicrobial reaction. Look for products labeled as anti-bacterial and follow the manufacturer’s instructions for soak time, typically five to fifteen minutes. After using any chemical agent, gently brush the appliance with a soft-bristled brush to remove any loosened debris before rinsing completely.
Material Safety and Damage Prevention
Night guards are constructed from various materials, including hard acrylic, soft vinyl, or thermoplastic resins. Prolonged exposure to disinfectants, even diluted bleach, can cause material degradation, discoloration, or warping. Hard acrylic guards are more resistant to short chemical exposure, but softer thermoplastic or vinyl guards are more susceptible to damage and require the shortest possible soak time.
Avoid common household cleaners like full-strength alcohol, hydrogen peroxide, or vinegar for acute disinfection, as these can chemically break down the appliance material. Abrasive cleaning agents, such as regular toothpaste, should also be avoided because they create microscopic scratches that become new sites for bacterial colonization. Always use cool water for rinsing and soaking, since hot or boiling water can permanently warp the plastic, leading to an improper fit.
Ongoing Hygiene Practices
Once acute disinfection is complete, establishing a rigorous daily cleaning routine is necessary to prevent future microbial buildup. Immediately after removing the night guard each morning, rinse it thoroughly under cool water to wash away saliva and loose debris. Gently brush the entire surface, paying close attention to the crevices and grooves, using a soft toothbrush dedicated solely to the appliance.
Use a non-abrasive soap, such as mild dish soap or a specialized appliance cleanser, instead of toothpaste, as the abrasives can dull the surface. After brushing, rinse the guard completely to remove all soap residue. Finally, store the night guard in a clean, ventilated case to allow for air drying, which discourages the growth of bacteria and fungi.