An occlusal guard is a removable dental appliance designed to fit over the teeth, typically worn during sleep to protect the oral structure. Occlusal guards serve as a therapeutic tool for individuals experiencing symptoms related to excessive force on their teeth and jaw. This article explains what these devices are, the medical conditions they address, the differences between custom and pre-made options, and how to properly maintain them.
What an Occlusal Guard Is
An occlusal guard is an oral appliance often referred to as a night guard, bite guard, or occlusal splint. The term “occlusal” refers to the chewing surfaces of the teeth, which the device is designed to cover and shield. It is a protective barrier that fits over either the upper or lower dental arch, preventing direct contact between the teeth.
These devices are fabricated from materials such as hard acrylic resin, softer thermoplastic vinyl, or a combination of both. They are less bulky than typical sports mouthguards and are engineered for extended wear. The core function is to absorb the forces created by jaw muscles, distributing pressure evenly across the entire dental arch rather than concentrating on individual teeth.
Medical Reasons for Using Them
Occlusal guards are recommended for managing two distinct but often related conditions: bruxism and temporomandibular joint disorders (TMD). Bruxism involves the involuntary clenching or grinding of teeth, which most commonly occurs during sleep. This persistent activity generates intense pressure, leading to symptoms like chipped teeth, enamel erosion, tooth sensitivity, and chronic headaches. The guard acts as a sacrificial surface, absorbing the destructive forces of grinding and protecting the integrity of the natural teeth and existing dental restorations.
The device also plays a therapeutic role in managing TMD, which affects the jaw joint and the muscles controlling jaw movement. TMD symptoms can include persistent facial pain, muscle tension, and difficulty opening the mouth. By creating a stable, balanced occlusion, the guard helps to reposition the jaw into a more relaxed position, which reduces strain on the joint and surrounding musculature. This adjustment promotes neuromuscular harmony, often resulting in a reduction of associated pain and tension-type headaches.
Custom vs. Over-the-Counter Options
The two main avenues for acquiring an occlusal guard are through a dental professional for a custom-fitted device or by purchasing an over-the-counter (OTC) option.
Custom Guards
Custom guards are fabricated using precise impressions or digital scans of the patient’s teeth, ensuring an exact, comfortable fit. These professional devices use high-grade, durable materials, such as hard acrylics, chosen based on the severity of the patient’s clenching or grinding habit. The personalized fabrication ensures the guard properly aligns the bite, offering superior effectiveness and longevity for chronic issues like bruxism or TMD.
Over-the-Counter Options
OTC options, frequently sold as “boil-and-bite” models, are made from softer, less durable thermoplastic materials. These guards are affordable and accessible, providing a quick, temporary solution for occasional grinding or as a diagnostic tool. However, their one-size-fits-all nature often results in a bulkier fit and a less precise alignment of the bite, which can sometimes exacerbate jaw discomfort. Due to the softer material and less accurate fit, OTC guards wear down faster and are not recommended for long-term treatment of severe conditions.
Proper Care and Longevity
Maintaining an occlusal guard correctly is necessary to maximize its lifespan and ensure oral hygiene. After each use, the device should be cleaned by rinsing it with cold water to remove saliva and debris. A soft-bristled toothbrush and a mild, non-abrasive soap or specialized appliance cleaner should be used to gently scrub the guard. Avoid using toothpaste, as its abrasive particles can scratch the surface, creating microscopic areas where bacteria can accumulate.
The guard should never be cleaned or soaked in hot water, which can cause the material to warp and compromise its precise fit. When not in use, it must be stored completely dry in a sturdy, ventilated case to prevent the growth of mold and bacteria. The typical lifespan for a custom hard acrylic guard ranges from two to five years, while OTC guards often require replacement every six to twelve months due to material degradation.