An occlusal guard is a removable dental appliance, often called a night guard or bite splint, that fits over the biting surfaces of the upper or lower teeth. Constructed from durable medical-grade plastic or acrylic, the guard acts as a protective barrier, preventing direct contact between the upper and lower teeth. The primary purpose of this appliance is to shield the teeth, jaw joints, and surrounding muscles from potentially damaging habits.
Primary Reasons for Using an Occlusal Guard
The most frequent reason for prescribing an occlusal guard is to manage bruxism, the involuntary habit of grinding or clenching the teeth. This habit can occur both during sleep (sleep bruxism) and while awake (awake bruxism). Without a guard, the forces generated during bruxism, which can be several times greater than normal chewing forces, lead to excessive wear, chipping, and fracturing of tooth enamel and existing dental restorations.
The guard works by positioning a smooth, resilient surface between the arches, absorbing the impact and preventing tooth-on-tooth abrasion. This protective function preserves the long-term structural integrity of the teeth and prevents sensitivity that arises from enamel loss. By distributing the substantial forces across the guard’s surface, it shields the teeth from the destructive pressure of clenching.
Occlusal guards also mitigate symptoms associated with Temporomandibular Disorders (TMD), a condition affecting the jaw joints and surrounding musculature. The appliance reduces strain on the temporomandibular joints (TMJs) by keeping the teeth slightly separated, allowing the jaw muscles to relax. This reduction in muscle tension alleviates symptoms like chronic jaw pain, facial muscle soreness, and frequent tension headaches. For TMD, some splints are designed to subtly reposition the jaw, promoting a relaxed resting position and reducing joint inflammation.
Understanding the Different Types and Materials
Occlusal guards are categorized by how they are manufactured and fitted, which directly impacts their efficacy and comfort. The gold standard is the custom-fitted guard, which a dentist fabricates using a precise impression or digital scan of the patient’s teeth. These guards offer a superior, snug fit that conforms perfectly to the dental arch, ensuring maximum comfort and protection. Custom guards are typically made from highly durable materials, such as hard acrylic for severe bruxism or dual-laminate materials featuring a soft interior for comfort and a hard exterior for resilience.
In contrast, over-the-counter (OTC) options include stock guards and “boil-and-bite” guards, which are widely available at pharmacies. Stock guards are pre-formed and offer a one-size-fits-most solution, providing the least accurate fit and comfort. Boil-and-bite guards are softened in hot water and then molded by biting into them, resulting in a semi-custom fit that is often bulkier and less precise than professional alternatives.
OTC guards are often made from softer, more pliable plastic or vinyl, which may wear down quickly under heavy grinding forces. Because they lack the precise fit of a custom appliance, they can sometimes cause discomfort, interfere with the bite, or require constant clenching to keep them in place. For individuals with moderate to severe bruxism or existing jaw joint issues, the long-term protection and stability provided by a dental-grade, custom-fabricated appliance is recommended.
Essential Care and Maintenance
Proper daily cleaning of an occlusal guard is necessary to prevent the accumulation of bacteria, plaque, and unpleasant odors. Immediately after removing the guard, it should be rinsed thoroughly under lukewarm water to wash away saliva and loose debris. The guard should then be gently scrubbed using a soft-bristled toothbrush and a non-abrasive cleanser, such as mild soap or specialized appliance cleaner. Abrasive products like most toothpastes should be avoided, as they can scratch the surface of the guard, creating microscopic areas where bacteria can thrive.
Periodic deep cleaning is also beneficial, often involving soaking the guard in a solution of specialized denture cleaning tablets or a diluted mixture of water and non-alcoholic mouthwash. After cleaning, the guard must be allowed to air-dry completely before being placed into its protective case. Storing the guard in a clean, ventilated case when not in use is important, as an airtight environment retains moisture and encourages bacterial growth. It is also important to keep the guard away from high heat sources, like direct sunlight or boiling water, as extreme temperatures can cause the material to warp and compromise the fit.