1) Mouth Guards
Mouth guards are one of the two most direct pattern interrupts which for some people reduce or eliminate bruxism (the other being biofeedback). When you put a mouth guard in your mouth, it does more than just keep your upper and lower teeth from contacting each other when you clench. It changes the entire sensory experience of clenching. Thus, part of the entire pattern of neural activity in the habitual clenching cycle changes. As you might guess, for some people this makes them clench less , and for some people this makes them clench more.
If you are lucky enough to find that you clench less with a mouth guard (perhaps so much less that pain symptoms which were previously experienced each morning subside) you have cause to celebrate. If your mouth guard only cost you $15 at CVS, you can also celebrate your genius at selecting an inexpensive solution. If your mouth guard was made by your dentist and cost $700, you might at least gratefully justify the investment.
If you are one of the unlucky people who clench more with a mouth guard than without, you probably won’t be so happy. In fact, you may feel trapped, knowing that if you don’t wear your mouth guard, you will wear away your teeth if you are a grinder, and you have a higher probability of cracking your teeth if you are a hard clencher. The other half of the trap being that if you wear your mouth guard and it makes you clench more, you may have more jaw pain, migraine headaches, and tooth pain than if you don’t. Fortunately, there are a lot more ways to interrupt a neurological pattern than just wearing a mouth guard.
Types of Mouth Guards
The two main groups of people who buy mouth guards are athletes (who buy mouth guards to prevent damage if they get bashed in the jaw or teeth in a sporting event), bruxism sufferers (who buy mouth guards to prevent tooth wear from grinding, cracked teeth from clenching, and (if they are lucky) to reduce their clenching). Mouth guards specifically marketed to bruxism sufferers are also sometimes referred to as night guards.
Some mouth guards are flexible and some are rigid. Some mouth guards are thin and some are thick. Most mouth guards are designed to fit between your entire set of upper teeth and lower teeth. One mouth guard (the NTI “tension suppression” device) is in a class by itself, being custom-made to attach to and sit between the front teeth only.
Some dentists believe that thick mouth guards are bad unless they are custom molded such that they are thicker in the front than they are in the back, to match the natural way your front teeth come further apart than your back teeth do when you open your mouth. Rigid cast-acrylic mouth guards can be made with such a custom taper. This type of mouth guard is one type offered by many dentists.
Other dentists believe that what is best is a thick mouth guard which does not taper so much, and thus “off-loads” the temporomandibular joint (jaw joint). The only thing almost everyone seems to agree on is that it would be better if you didn’t clench on your mouth guard.
Mouth guards purchased through dentists are usually custom fit to your teeth. This is typically done in a four-step process. The first step consists of taking an impression of your teeth with a polymer impression material. This is typically done in a dentist’s office. The second step typically involves making a three-dimensional replica of your teeth (typically out of a plaster or polymer material) using the previously-taken impression as a mold. This second step may be done by a technician in the dentist’s office or at a dental lab.
The third step typically involves either casting a custom (thick) mouth guard (rigid or flexible) around the replica of your teeth, or vacuum-forming a thin plastic mouth guard over the replica of your teeth. This step is usually done by a technician and may be done at a dental office or a dental lab.
The fourth step typically involves making final fitting adjustments to the mouth guard. This step is typically performed in the dentist’s office.
Mouth guards purchased over the counter (at pharmacies or over the internet) are available made from thermo-moldable material, so that you can heat the mouth guard until the material becomes moldable, then put it in your mouth and bite on it to make it take on the shape of your teeth.
Costs of Various Mouth Guards
In a recent survey of over 100 dentists in the Boston area, it was found that the prices charged by dentists for custom-made mouth guards varied from a low of $200, to a high of $700, for essentially the very same mouth guard. Since the materials cost to make a custom mouth guard is less than $20, and the lab fee is often significantly less than $200, you can see that the main difference in price comes from how much profit a given dentist believes that he or she deserves to make on a mouth guard.
Over-the-counter mouth guards such at “The Doctor’s” brand typically sell for about $20 and are available at pharmacies, Wal-Mart, and on the Internet. Home-moldable mouth guards sold for athletic use are available at Wal-Mart for less than $2.
Choosing Between Mouth Guards
Perhaps the reason there are so many different types of mouth guards is because different types work better for different people. People keep inventing new types. The most economically sensible approach is to start by trying an inexpensive mouth guard or two, and then try a more expensive one if you don’t get good results with the inexpensive one.
If you wind up deciding to buy a mouth guard which is custom-fit by a dentist, you might want to call a few dentists first and see what prices they charge. It could save you a bundle.
