An occlusal guard is a removable dental appliance, often called a night guard, designed to fit over the upper or lower teeth. Fabricated from durable plastic or acrylic, the device creates a physical barrier to minimize or eliminate contact between the dental arches. Worn primarily during sleep or periods of stress, its purpose is to absorb and distribute the intense, involuntary forces generated by jaw muscle activity, protecting the underlying dental structures.
The Primary Role of Occlusal Guards
The most common reason for using an occlusal guard is to mitigate the damaging effects of bruxism, the involuntary grinding or clenching of the teeth. Bruxing forces are intense, leading to significant wear on the tooth enamel over time. The guard provides a sacrificial surface, absorbing this excessive pressure and preventing direct tooth-on-tooth contact that causes fractures, chipping, and premature wear.
For individuals experiencing temporomandibular disorders (TMD), the guard promotes a more relaxed jaw position and reduces muscle hyperactivity. Introducing a stable bite plane helps alleviate strain on the temporomandibular joint and surrounding masticatory muscles. By reducing muscle tension, the guard can interrupt the pain cycle associated with TMD, which often manifests as chronic headaches, jaw soreness, or facial pain.
The appliance also protects existing dental restorations, such as crowns, veneers, bridges, or large fillings. These restorations can be compromised or fractured by the intense, repetitive force of grinding and clenching. Wearing a guard ensures the longevity of these restorations by shielding them from mechanical stress. Dispersing stress across a larger surface area prevents the concentration of force on individual teeth, reducing the risk of micro-fractures and sensitivity.
Distinguishing Between Types of Guards
Occlusal guards differ significantly in their manufacturing process, material composition, and quality of fit. The most effective option is a custom-made guard, fabricated by a dental laboratory after the dentist takes a precise impression of the patient’s teeth. These guards offer the highest level of protection and comfort because they are perfectly contoured to the individual’s unique bite and dental anatomy.
Custom guards are often made from hard acrylic or a dual-laminate material, which combines a soft inner layer for comfort with a hard outer layer for durability. Hard acrylic guards are frequently recommended for patients with severe grinding or those who require specific changes to manage TMD symptoms. The superior fit of the custom appliance ensures it remains securely in place throughout the night.
Alternatively, over-the-counter (OTC) options, such as stock guards or “boil-and-bite” guards, offer a temporary or less precise solution. Stock guards are pre-formed and non-adjustable, providing a poor, bulky fit that can be uncomfortable and interfere with sleep. Boil-and-bite versions are softened in hot water and then molded to the teeth, providing a semi-custom fit that is inferior to a professionally fabricated appliance.
While OTC guards are more affordable, they are often less durable and may wear out quickly under heavy grinding pressure. Their less precise fit can lead to jaw discomfort or, in rare cases, prompt unwanted tooth movement if worn incorrectly. Patients with moderate to severe bruxism or TMD symptoms should select a custom guard, as the tailored design is necessary for adequate protection and therapeutic benefit.
Caring For and Using Your Occlusal Guard
Maintaining proper hygiene ensures the longevity of the occlusal guard and prevents the buildup of bacteria and plaque. Immediately after removal, rinse the appliance thoroughly with cool or lukewarm water to remove saliva and debris. Gently brush the guard using a soft-bristled toothbrush and a mild, non-abrasive soap or specialized cleaning solution. Traditional toothpaste should be avoided as it can scratch the material.
The guard requires a deeper cleaning at least once a week, involving soaking it in a solution of denture cleanser or a diluted mixture of white vinegar and water. Following any soaking, the appliance must be rinsed well to remove all cleaning agents before use. Avoid exposing the guard to hot water or extreme heat, such as direct sunlight, which can cause the material to warp and compromise the fit.
When not in use, store the guard in its protective case, which should have ventilation holes for air circulation. Before storage, the guard must be completely dry to prevent a moist environment that encourages the growth of mold or bacteria. While the device is typically worn nightly for protection, a dentist may prescribe wearing it during the day for TMD management.
Patients should bring their occlusal guard to routine dental check-ups for professional cleaning and inspection. The guard will eventually need replacement, with signs including cracks, holes, or significant thinning due to grinding. Depending on the material and the severity of grinding, the lifespan of a custom guard ranges from one to five years.