Hello, I'm Dr. Mehrdad from Yalda Dental. Today, I'd like to speak about a very important and very general topic in dentistry, which is mouth guard or night guard—different terms that we use for this appliance.
What is a mouth guard and why might someone need one?
Mouth guard, or known as night guard, is a shell that sits on the teeth, mostly on upper teeth, sometimes on the lower, based on different conditions. We have different mouth guards: they are soft, they are hard, and they are a combination of both. Most of them are made out of acrylic and almost always clear acrylic to be cleansable. When acrylic is clear, if it gets stained or has calculus or any kind of debris, we can see and clean them properly.
What are the most common types of nightguards?
Most of the dentists design and give their patients hard nightguards, but it varies based on different situations. If my patient has multiple implants, I prefer to have a mouth guard designed with half soft, half hard. In other words, the inner surface that sits on the teeth should be softer, and the other surface, to break the stress and pressure of clenching or grinding, should be hard.
How can a mouth guard help with TMJ disorders?
Let's talk briefly about TMJ disorders. TMJ is the most complicated joint in our entire body. It's the only joint where both have to work together. You can move your one arm or elbow and not the other one, but that's impossible when opening your mouth by moving just one TMJ; they have to work together. They need to be synchronized like an orchestra and should be healthy. Dislocation of the TMJ part, the bony part, and the disc part happens quite frequently. A well-designed, specifically designed mouth guard moves the TMJ to the right location and keeps it there, playing a significant and important role in correcting TMJ problems.
What are the benefits of a night mouth guard for sleeping?
It's a very good question. A brief explanation before that: we live in a very stressful world. We are in media all the time, we use smartphones, we have computers, and we over-focus on many topics. We live in a world where lifestyle is going very fast and very stressful. All these things will cause grinding and clenching. The right terminology is bruxism, and the person who has bruxism is a bruxer, not a boxer. Bruxer means a person who grinds and clenches. A very common misunderstanding about this topic is that most people, including many dentists, consider grinding or bruxing only in sleep. That's not true. When you are a grinder, you are a clencher too. When you clench, you grind too; it comes like a package together. When we are a grinder, we grind all the time, day and night. I've had so many patients over the past many years that when I found the clinical signs of grinding on their teeth and told them, they were surprised and shocked. Many times, they kind of argued with me that, no, I'm not grinding; I am not a grinder, I don't clench. My answer was, okay, now when I pointed it out to you, you will realize it. With no exception, after a short while, they come back and say, yeah, I caught myself clenching when I was driving or working on my computer or in many other situations. The treatment of grinding and clenching is very important and advanced. So, in my opinion, which backs up the great opinion of the University of Pennsylvania periodontal process department, when I have a grinder patient, I need to give them an appliance called a night guard for their sleep and another appliance or appliances, we call them day guards, so they have to use it during the day to stop the clenching and grinding and deteriorating the TMJ, the teeth, the jaw, the alveolar bone, and many other things.
What is a sleep apnea guard and how does it help with breathing during sleep?
It's a very good question. Sleep apnea appliances are not night guards. Sleep apnea appliances don't guard anything; they don't protect your teeth. Maybe as a side job, they kind of do, but the main purpose is enhancing breathing and opening the airway. The main reason for snoring and having sleep apnea is congestion of the throat and the airway while we're sleeping and trying to breathe. Most of them advance the lower jaw forward, and based on that, the tongue moves forward and makes the airway open. That's the general idea of having a sleep apnea appliance. We have many designs for every individual with different conditions, so a dentist who treats sleep apnea and makes appliances for sleep apnea needs to do a very comprehensive and thorough exam on the patients and their airway. Many times, we need to take a CT scan to evaluate everything: the type of face, the figure of the face, specifically the lower jaw, the size of the tongue, and many other elements.
What is the difference between a custom mouth guard and a store one?
The difference is very significant and very important. If you look at a dental office lab and just take a quick glance at different models taken from different patients, you see every arch, every mouth is different from the other. We cannot have just three or four sizes of night guard that fit everybody. That's why custom-made is strongly recommended. It is designed for the very specific person, considering the size of the arch, shape of teeth, thickness of the guard, and everything. The quality of a prefabricated and a custom KN guard are significantly different.
How do you properly clean a mouth guard and how often it should be replaced?
We shouldn't use a toothbrush on our night guards because most of the night guards are made of acrylic. Using a toothbrush, regardless of how gentle, starts creating scratches over time—very thin scratches. When using the night guard, we have saliva, biofilm, and bacteria in our mouth, regardless of how good our home care is. Those are going to stick in the scratches, fill them, and make the night guard look not nice, stainy, and, the worst part, smelly. Obviously, nobody wants to have a bad-smelling night guard in their mouth every night they sleep. The best way of cleaning it is just rinsing it and, every once in a while, putting it in a small ultrasonic cleaner. There are small ultrasonic machines for cleaning dentures, night guards, Invisalign trays, and everything, available at very reasonable prices. Everybody can buy them through Amazon or other sources. If patients don't like to have a personal ultrasonic cleaner for any reason, almost every dental office has one. The moment we see the stain or discoloration on the night guard, that's the time to clean it. It might happen after two weeks or after a year. The second part of the question was how long a night guard lasts. It depends on how strongly you grind on it or clench on it. Patients who are severe grinders might cause deep slots and gouging and scratch lines on the night guard after a few months. Sometimes a night guard might last a few years. So, for every individual and every patient, it varies how long it lasts.
Are there risks or side effects associated with using a mouth guard?
If dentists design the night guard properly, there is no side effect and no harm in having a night guard.
When should someone consider using a mouth guard for sports like football or boxing?
When should someone consider using a mouth guard when doing sports like football, boxing, karate, hockey, baseball, and all kinds of sports which have a possibility of trauma or injury to the head and neck? The answer is for all of them. When we do sports that have a possibility for any kind of trauma to the head and neck, I would say it's a must to use a mouth guard.
Thank you for listening. I hope this information is helpful and encourages you to consider the importance of using mouth guards for dental and overall health.