Mouth Guards: Everything You Need to Know

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Having healthy, beautiful teeth for a lifetime is on everyone's wish list. But for many people, maintaining strong teeth may involve more than just brushing, flossing and visiting the dentist every six months. Even though tooth enamel is harder than bone, it still needs protection from wear and accidental breakage. That's why dentists recommend mouth guards for their patients who grind their teeth at night, are active in contact sports or have temporomandibular joint (TMJ) problems or sleep disorders. If your dentist has recommended a mouth guard, here's what you need to know.

Types of Mouth Guards

Mouth Guards for Grinding

When your dentist asks questions about your sleep habits, it may be because your tooth enamel is showing signs of wear. Some of your teeth and fillings could even be chipping or cracking. These signs are frequently the first indications that you grind or clench your teeth at night. Other signs that you may notice are waking up with dull headaches, sore muscles in your jaw or damage to the inside of your cheeks from biting.

Grinding or clenching, also known as bruxism, is often caused by stress, sleep disorders, a misaligned bite, acid reflux or as the side effect of some medications. Smoking and drinking alcohol or caffeine beverages also increases the likelihood of grinding at night.

It is important to determine the cause and address this habit early on, since long-term grinding can eventually wear through the enamel into the softer dentin layer of the teeth. Exposed dentin can put you at risk for sensitivity and tooth decay.

Besides repairing any broken fillings and making any necessary bite adjustments, if you are grinding or clenching your teeth, your dentist may recommend you wear a custom-fitted mouth guard (sometimes referred to as a night guard or splint) while you sleep. The night guard separates your teeth and acts as a barrier to protect them from any further wear and breakage, and it may also help you break the grinding habit.

Night Guards for TMJ Problems

Discomfort while chewing or moving your jaw or a limited ability to open your mouth are common symptoms of TMJ problems. Popping or clicking sounds accompanied by pain or dull headaches are also signs that you may have a complication involving your TMJ.

TMJ problems can stem from arthritis, misaligned teeth or jaw injuries, notes Merck Manuals, but they can just as commonly arise from muscle tension and stress. Although pinpointing the exact cause of TMJ discomfort is difficult, the first line of treatment is wearing a custom-made splint or mouth guard that fits over the upper or lower teeth at night. This allows the jaw muscles to recover and protects the teeth from wear.

In severe cases the splint may also need to be worn during the day to keep the muscles relaxed and the bite stable, which may help reduce discomfort. Day splints are usually only worn for about eight weeks or until the symptoms subside. Daytime grinding can also happen as a result of diseases, such as Parkinson's. In these cases, your doctor and dentist may work together on a treatment plan.

Because of the complexity of TMJ issues, splints are always custom-made by the dentist who is treating the TMJ problem. The night guards you can pick up at your local drugstore are not as strong as the plastics cast in a dental lab and may not adequately protect your tooth enamel.

Mouth Guards for Sports

Whether you are a weekend warrior soccer fanatic or your kids just joined the hockey team, protecting your family's teeth from injury is critical. Most mouth-related sports injuries involve broken or chipped teeth (most often the central incisors), fractured tooth roots and cuts to the lips and tissue inside of the mouth. But the risk of a sports injury is greatly reduced when wearing a well-fitting mouth guard. The soft absorbing material that they are made from helps cushion any hits to the face or teeth. According to the Academy of General Dentistry, a custom-made mouth guard may even protect against a concussion.

If you or your child has braces, you are especially vulnerable to soft tissue injuries from the impact on a mouth full of metal. A mouth injury can also cause damage to your orthodontics if you aren't wearing a mouth guard made to fit over braces. This type of guard is designed to be a bit wider to provide protection for your braces as well as your teeth and gums.

Most athletic mouth guards are designed to protect the upper teeth, but some sports require a mouth guard for both the upper and lower arches. Always check with a coach or league referee to determine their requirements before making your dental appointment. You will also find that guards made for sports activities usually need to be replaced after each season since wear and tear can make them less effective over time. Because the mouths and teeth of children and teens are still growing, more frequent replacements may be necessary for your child's sports guard.

It's always a good idea to have your dentist take a look at your mouth guard during your six-month checkup to evaluate if the guard is still fitting properly, effective or in need of a replacement. Your mouth guard is just as important as any other piece of athletic equipment.

Night Guards for Sleep Disorders

A mouth guard may also help alleviate sleep disorders, according to the National Sleep Foundation. This group of disorders includes obstructive sleep apnea, a condition that the National Sleep Foundation explains causes you to stop breathing periodically while asleep. Poor quality sleep and waking up throughout the night can leave you feeling groggy and tired during the day and interfere with your ability to concentrate. Some people with sleep apnea have difficulty staying alert enough to drive.

The main reason someone with sleep apnea stops breathing during the night is because their tongue falls back into their throat. By wearing a mouth guard called a mandibular advancement device on the lower arch, the tongue and jaw are repositioned so that the airway is kept open. People who snore loudly or have nighttime bruxism may also find that this device helps considerably.

Choosing a Mouth Guard

Whatever the reason you need a mouth guard, you'll want one that fits well and is comfortable, durable and tear-resistant. In addition, your mouth guard should not interfere with talking or breathing.

It's possible to buy an inexpensive stock mouth guard at your drug store or online. The sizes of these guards are usually limited to small, medium and large, so getting a good fit is a challenge. You may also find that they are uncomfortable and bulky or that even a properly fitted one can impede your breathing and speaking.

A boil-and-bite mouth guard can be purchased at sporting goods stores, online or at drug stores. This type of mouth guard is preformed, but when you boil it in hot water and bite into it while warm, you can get a more customized fit for your mouth. The fit is better than an non-molded mouth guard, but you need to follow the directions carefully to avoid an ill-fitting mouth guard that won't protect your teeth.

The most comfortable and effective guards for protecting your teeth are those that are custom-made by your dentist or a professional laboratory. They can be expensive, but your dentist or dental insurance may provide some coverage to help with the cost.

How Your Dentist Makes a Mouth Guard

A custom-made mouth guard, whether for sports, grinding or TMJ issues, usually involve two dental appointments. During the first appointment, your dentist will take a dental impression of your teeth and make a model. The model is sent to a laboratory where the actual mouth guard is fabricated for a custom fit.

After your mouth guard comes back from the lab (often a process of several weeks), your second appointment will involve checking to see that your mouth guard fits properly. Your dentist will file down any rough edges and make any necessary adjustments.

Sleeping With a Night Guard

If your dentist prescribes a night guard, you may be concerned about the distraction of sleeping with a piece of plastic in your mouth. Like anything new, you may need to be patient to get used to it. But if you have sleep apnea or bruxism, the reduced interruptions from using a night guard might give you a better night's sleep faster than you think.

If your mouth guard is comfortable and fits well, it shouldn't take long to get used to. This is why dentists recommend custom-made guards. They are less bulky than stock guards and conform to your mouth better, making wearing one less intrusive. If you are keeping your mouth guard clean, it will also be much more pleasant to put it in your mouth.

To really make wearing your guard a nightly habit, you need to wear it consistently for at least a month. Sporadic use won't help you adjust to it and certainly won't help the problem that you are trying to correct.

If you have tried wearing your night guard, but it's just too uncomfortable or doesn't fit correctly, let your dentist know right away. They can evaluate the problem, fix it and help you get back on the road to regular wear.

Caring for Your Mouth Guard

Just like you have to clean your teeth every day to remove the bacteria, it should be no surprise that you will need to clean and sanitize your mouth guard after wearing it. Leaving it by your bedside in the morning or throwing your sport guard in your gym bag until next week's game is not only gross — it's a health risk. Bacteria, yeasts and molds can contaminate your mouth guard, exposing you to infection. The good news is that keeping your mouth guard clean is easy.

You should brush your guard with a toothbrush and toothpaste after wearing it. This will clean off any debris that has built up and remove the bacteria you can't see. Rinse it well, and take time once every week or two to soak it in an antimicrobial solution, such as diluted mouthwash or denture cleaner. To keep it clean when not wearing it, you should store it in its protective case, making sure that it is dry and the case is ventilated to prevent any bacterial growth. Scrub the case regularly, too!

Keep an eye on your mouth guard for any breaks, cracks or fissures that trap bacteria, and look for any rough edges on the guard that could potentially irritate your gum tissue. When your mouth guard shows signs of wear, ask your dentist about a replacement.

Do You Need a Mouth Guard?

There are numerous reasons why someone may benefit from using a mouth guard. Before you decide whether or not a night guard is the answer to your particular problem, be sure to consult your dentist to weigh all of your options.

Remember: your mouth guard is not going to keep your tooth enamel from wearing away or alleviate discomfort from a TMJ issue if you sleep with it gathering dust on your nightstand every night. You need to make the commitment and conscious effort to wear it regularly. And for you sports enthusiasts — don't leave home without it!

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