Teeth grinding, or bruxism, can happen day or night. But sleep bruxism is much harder to treat since many of us don’t even know we’re doing it. The condition is often only detected when seeking treatment for symptoms like headaches, facial or jaw pain, or worn-down teeth — or if a bed partner notices the grinding sound. And ignoring it won’t make it go away. Instead, it can lead to serious oral issues, including loss of enamel, tooth sensitivity, and a proclivity for cavities, according to Dr. Rashmi Ambewadikar of Astoria Smiles Pediatric Dentistry.
If you do suspect that you’re grinding your teeth at night, the best thing to do is visit the dentist for a full evaluation. In the meantime, or if your grinding seems to be associated with periods of high stress or poor sleep, an over-the-counter (OTC) mouth guard might help. These mouth guards typically cover the upper or lower teeth to prevent them from touching and can be used as a short-term solution — our experts say two weeks to a month — but are not recommended for long-term use.
In case you decide to go the OTC route, we asked 12 dentists — including jaw-joint-disorder specialists and experts in jaw pain — what factors to consider when selecting the right mouth guard. And we tried them out ourselves to see how easy it was to set up and how comfortable they were.
Only a doctor can fit you for a custom mouth guard, but for the best-fitting OTC alternative, look for a “boil and bite” guard that molds to your teeth. These tend to be the most popular variety, since they’re comfortable and easily found in drugstores, according to board-certified pediatric dentist Dr. Danielle Lombardi. To use one, you just have to put it in hot water to soften and bite into it, which will help set it, says New York City dentist Dr. Lana Rozenberg. “When it sets, you can trim [the excess material], and now you have a semi-custom-fitted guard.” If you don’t want to boil a whole pot of water, some guards have “microwave and bite” technology, which basically works the same. In fact, Dr. Donald Tanenbaum, a board-certified TMJ and orofacial-pain specialist, prefers microwaveable ones because they are made from a “thinner, lighter, more moldable material,” which ultimately means they will be more comfortable. While microwaveable guards are undeniably more convenient, the point is that you want as good a fit as possible, and lots of boil-and-bite options offer that.
When you start your search, you’ll notice that some mouth guards cover all teeth — like one you’d imagine a hockey player wearing. Others cover just the back teeth; these are called partial mouth guards. A mouth guard that covers all teeth is safer because there is less of a chance that your teeth will shift, which is one of the risks of wearing an OTC guard long term, says Dr. Nojan Bakhtiari, a board-certified TMJ and facial-pain specialist. “Teeth are stupid,” he explains. “Teeth don’t know when to stop growing unless they touch something. One of the reasons your teeth don’t keep drifting out of your jaw bone is because they touch each other at nighttime. So when you wear partial-coverage appliances, your teeth could potentially start shifting on you.” However, there are some very specific cases where our experts have recommended partial mouth guards, which we’ll get into more below.
Mouth guards are typically designed to fit either upper or lower teeth. Which one to buy largely depends on preference. Both prevent grinding by creating a barrier between your teeth, so you can make a decision based on your dentist’s recommendation or comfort. It’s best practice to cover the teeth where you’ll likely get the best fit — i.e., your straightest row of teeth or where you don’t have existing dental work. If you think doubling up will somehow further treat your grinding, it won’t. Dr. Nojan says, “There’s no benefit to it, and the risk is, if you open up the jaw too much at nighttime so that the jaw gets accustomed to that position”—which might happen with two competing appliances—“then you might not be able to bring your teeth together after prolonged use. One is usually enough.”
However, you may need to cover both the upper and lower teeth to prevent snoring-induced grinding. Two experts we spoke to — Dr. Michael Gelb, who treats patients with TMJ disorders, headaches, and sleep disorders at the Gelb Center, and cosmetic dentist Dr. Lauren Becker — mention new research that shows an airway disorder could also cause clenching. According to Gelb, that’s why before going the nighttime mouth-guard route, it’s routine to check patients for breathing-related sleep disorders like sleep apnea or snoring, since clenching could be a symptom of those things too. There are also specific mouth guards that cover both the upper and lower teeth and prevent the tongue from rolling back to block the air passageway.
Some mouth guards come with different-size trays or multiple thickness options for more comfort. As mentioned above, there are also a few recommended mouth guards designed specifically for snoring. Here, we’ve mentioned any extra features that are notable.
Molding method: Microwave-and-bite | Coverage: Full | Fit: For upper teeth
Three of the experts we spoke with — Dr. Rozenberg; Dr. Brijesh Chandwani, a dentist specializing in facial pain and jaw-joint disorders; and Dr. Ambewadikar — recommend this microwaveable Oral-B guard. It also appeared on our list of best sellers a few times throughout the pandemic, suggesting that our readers turned to it when teeth grinding was exacerbated by stress. It comes with a microwave-safe case to place it in while you nuke it and to store it when you’re not using it. When I tried this out for myself, it was very convenient to set up. I just added tap water and placed it in the microwave for a little over a minute as instructed. Afterward, I drained the hot water, rinsed the guard with lukewarm water to cool it, and bit down on the impression tray for about two minutes. Then, I let it cool for about 30 minutes. Because I’m in the process of using Invisalign, I wasn’t able to wear the guard at night, but I did wear it for about an hour to see how comfortable it was. It’s definitely bulkier than my Invisalign trays I’m used to wearing, but that’s expected. I will say it wasn’t uncomfortable by any means and covered all of my front teeth snugly. I also appreciate the subtle mint flavor that tastes like I just swished some mouthwash.
Molding method: Boil-and-bite | Coverage: Full | Fit: For upper teeth
This mouth guard is a few dollars cheaper than the Oral-B, and it doesn’t come with a microwave-specific container or that minty taste, but it will give you similar results. It’s a traditional boil-and-bite style that covers all upper teeth, and you can heat up the water in the microwave to soften the guard before molding. Dr. Sharon Huang of Les Belles NYC, a holistic dentistry practice in Manhattan, recommends this guard for mild bruxers or as a very short-term solution. Huang calls it a more tolerable option for beginners, thanks to its thinness.
Molding method: Boil-and-bite | Coverage: Full | Fit: For upper teeth | Extra features: Comes with multiple sizes
Cosmetic dentist Dr. Lilya Horowitz of Brooklyn-based Domino Dental has noticed that many patients who clench or grind tend to have a lot of overall teeth sensitivity: “When enamel is lost, teeth have lost their protective layer and the nerve becomes more exposed.” It’s another great reason to find mouth guards that “cover as much of your teeth as possible,” she says, to better protect them. This guard, which she recommends, comes in a pack of four with two different sizes for a more personalized fit. From there, you can still drop it in hot water to mold it to your teeth. For even more customization, the brand recommends trimming the sides for a better fit.
Molding method: Non-moldable | Coverage: Partial | Fit: For lower teeth | Extra features: Adjustable sizing
Customizable mouth guards that cover all your teeth are the best option, but if you find them uncomfortable, a partial guard might be appropriate. This one from DenTek has a slimmer design than some of the other popular guards, and Rozenberg says it offers just as much protection as the full-fit guard while possibly feeling more comfortable. And even though you can’t boil it or warm it up in the microwave to mold it to your teeth, it does come with an adjustable band for a better fit. Just note that according to Dr. Bakhtiari, any partial guard that doesn’t conform to your teeth can become dislodged during the night, and back sleepers “have a risk of it moving it around to the back of the throat.”
Molding method: Microwave-and-bite | Coverage: Partial | Fit: For upper teeth
Another instance when you might opt for a partial guard is if you grind your teeth during the day. This guard sits behind your front teeth, so no one will see it during your Zoom meetings, which is why Dr. Horowitz recommends it for daytime use. She adds that it “will keep your back teeth apart and may prevent you from grinding into your front teeth.” Unlike the DenTek partial guard, this one is a microwave-and-bite style so you can still get a custom fit around the teeth it does cover.
Molding method: Boil-and-bite | Coverage: Full | Fit: For upper and lower teeth | Extra features: Adjustable sizing, designed for snoring
Sometimes teeth grinding and clenching is more than just a sign of stress. “There’s an association that we’ve made recently between clenching at night, and a potential airway problem or sleep disorder,” says Gelb. If you think the cause of your bruxism might be sleep apnea or snoring, Gelb recommends a mouth guard designed specifically for those concerns, like this SnoreRx guard, which he says “potentially gets more at the root cause for their clenching and actually that would be better for their overall health.” Unlike the other mouth guards on this list, this one covers both the upper and lower teeth, “which is great so you won’t wear down your teeth,” says Gelb. It also prevents the lower jaw from dropping back during the night; “When your jaw doesn’t drop back at night, it maintains more of an open airway, which hopefully would also reduce the bruxism,” he says. In addition to being a boil-and-bite guard, the SnoreRx is adjustable, which means that “if you are snoring or you are clenched in one position,” says Gelb, you have six millimeters of adjustability to noodle with to find the most comfortable fit.
Molding method: Boil-and-bite | Coverage: Full coverage | Fit: For upper and lower teeth | Extra features: Designed for snoring with tongue retainer
The Zyppah mouth guard combines the traditional mouth guard with a tongue retainer, which pulls your tongue forward at night and keeps your airways open. “It controls the jaw and primarily the position of the tongue,” Gelb says, by way of a tongue strap “that acts as a seat belt and prevents your tongue from blocking your airway.” For someone who has previously used a tongue retainer to help with snoring, but is also experiencing grinding, this Zyppah mouth guard serves as an all-in-one tool. It’s moldable with boil-and-bite technology, but no further size adjustments can be made.
Molding method: Boil-and-bite | Coverage: Full | Fit: For upper and lower teeth | Extra features: Multiple thickness options
Teeth grinding can affect all age groups, and it’s especially complicated for teens and tweens, who might still have baby teeth and braces to contend with. Mouth guards are generally safe for tweens and teens, but parents should talk to a dentist and an orthodontist before buying one, advises Lombardi. The good news is that while bruxism is fairly common in kids, it’s usually “self-limiting and does not persist into adulthood,” Lombardi says. For the tween or teen who insists on one, Ambewadikar recommends this pack of five mouth guards from ConfiDental. “This pack comes with different thicknesses for varying degrees of grinding, so one can pick the one that is most comfortable for their individual mouth,” she says. But adults can use them, too, Ambewadikar says. Horowitz likewise recommends these guards for adults since they can protect teeth well. Their single-digit price and 37,000 Amazon reviews also make the ConfiDental a tried and true affordable option.
• Dr. Rashmi Ambewadikar, pediatric dentist at Astoria Smiles Pediatric Dentistry
• Dr. Nojan Bakhtiari, board-certified TMJ and facial-pain specialist
• Dr. Lauren Becker, cosmetic dentist
• Dr. Brijesh Chandwani, facial pain and jaw-joint-disorder specialist
• Dr. Michael Gelb, TMJ, headache, and sleep-disorder specialist at the Gelb Center
• Dr. Sharon Huang, founder of Les Belles NYC, an integrative, holistic dentist office in Manhattan
• Dr. Lilya Horowitz, founder of Brooklyn-based Domino Dental
• Dr. Brent Larson, assistant dean for graduate education at the University of Minnesota School of Dentistry
• Dr. Danielle Lombardi, pediatric dentist at Park Smiles NYC Pediatrics
• Dr. Lana Rozenberg, celebrity cosmetic dentist
• Dr. Donald Tanenbaum, board-certified TMJ and orofacial-pain specialist
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