Occlusal splint – Dental splint therapy for teeth grinding, TMJ disorders, sleep apnea, and snoring

An occlusal splint commonly called a dental guard is an occlusal orthodontic device that relieves symptoms of teeth grinding, TMJ disorders, protects muscular and anatomical structures, and even improves sleep problems like snoring or sleep apnea.  

It’s an appliance that fits over the dental arch (usually the upper one) and prevents the chewing surface of the upper teeth from making direct contact with the chewing surface of the lower teeth.

It also guides the muscles and mandibular joint into an adequate rest position, helping facial structures to relax and relieving muscular tension and pain caused by a clenching jaw or grinding teeth. 

You can wear occlusal guards at any time you need them, but since most people wear mouthguards for sleeping, it is common to call them nighttime mouthguards.

OTC (over-the-counter) dental guards are highly affordable, however, if you are diagnosed with TMJ disorders or bruxism, it is best to use custom-made mouth guards prescribed by a dentist since the inappropriate use of occlusal guards can be counterproductive.

Below we will explain in detail what type of occlusal splints exist, how they work, what is the healthiest option, the benefits and risks of wearing a night guard, and when to acquire one.

Occlusal splint types

There are 3 types of occlusal splints:

  • Custom dental night guards.
  • Boil and bite night guards.
  • Over-the-counter night guards.

Custom-made occlusal splints

These are occlusal splints made by the dentist, they fit perfectly in your mouth and have personalized features to address the specific circumstances of each patient. 

This is the ideal type of occlusal splint for people with clinical conditions such as bruxism and temporomandibular joint disorders.

They are way more comfortable than any other type of dental splint, but you must go to a clinical check-up to get one, and depending on your particular needs, a custom-made night guard might be expensive.

Boil and bite night guards

Boil and bite mouthguards are over-the-counter, partially customizable dental guards, they are made of a thermoplastic material that can be softened by submerging the dental guard in boiling water.

Once the material is soft enough, you should place the guard on your mouth and bite it firmly until your teeth make an impression on the material, after that, carefully remove the guard and submerge it in cold water to harden the thermoplastic material.

Once the mouthguard is completely hard, you’ll have a slightly customized occlusal splint. 

This type of occlusal splint is good for athletes and contact sports practitioners since it provides good protection against blows and crashes, but it’s not recommended for teeth grinding or TMJ problems.

Over-the-counter night guards

OTC mouthguards are standard appliances designed to fit almost all types of dentures, you can find them in drugstores and even supermarkets, and they are fairly affordable. 

However, they might not be the best option since, by not being customizable, they won’t fit properly and might cause discomfort. 

They are also not recommended for teeth grinding since they are made of soft materials that could stimulate the chewing impulse worsening bruxism and jaw clenching.  

TMJ occlusal splint

TMJ splints are special appliances designed to guide the jaw joint and chewing muscles into a determined position depending on each patient’s needs. 

They considerably reduce the symptoms caused by TMJ disorders and help reeducate the maxillofacial structures to function properly.

Types of TMJ splints

  • Stabilization Splint: Also called permissive splint, prevents harmful contact between upper and lower teeth while also stabilizing the jaw joint by guiding jaw muscles into a relaxing position and hence, dissipating muscular tension.
  • Repositioning Splin: Also called non-permissive or directive splints, has customized indentations to prevent the teeth from sliding side to side and, therefore, make it possible to reposition the jaw joint into its natural place by aligning the anatomical structures.
  • NTI-tss device: (Nociceptive Trigeminal Inhibition Tension Suppression System) This appliance consists of a special splint that only fits over the front teeth (both lower and upper simultaneously) and should only be used during short periods, mainly to alleviate migraine episodes caused by severe grinding or clenching. NTI-tss should not be worn during sleep.

Teeth grinding guard

Occlusal splint therapy is the best treatment option for mild, moderate, and severe cases of bruxism since besides preventing damage to the anatomical structures, it also inhibits the chewing impulse that makes you grind your teeth while you are asleep.   

Types of night guards for bruxism

  • Hard mouth guard: This type of dental guard is made of acrylic, a hard material that highly protects the chewing surface of the teeth, it’s the best option for those with severe teeth grinding due to its protective qualities and durability.
  • Hybrid mouthguard: It is made of 2 plates, an inner plate made of soft material that makes it more comfortable to wear, and an external plate made of rigid material that prevents teeth contact. This type of occlusal splint is ideal for moderate to severe bruxism.
  • Soft mouth guard: This dental guard is completely made of soft material and is ideal for mild cases. It is not recommended for moderate to severe since the soft material could stimulate chewing impulses. 

Mouthguard for sleep apnea

Sleep apnea is a disease where breathing stops spontaneously while the person is sleeping, there are various treatments for this condition, and dental splint therapy is one of the best support treatments to reduce symptoms.

This is possible since occlusal splints adjust the jaw, tongue, and chewing muscles to their natural position and keep the airways open, improving breathing.

When it comes to sleep apnea night guards, you should only wear FDA-approved, custom-made guards provided by a specialist. There are currently 2 different types of mouthguards for sleep apnea:

  • Mandibular Advancement Devices: This is a splint that covers both the lower and the upper teeth and works by moving the jaw forward in order to open the airway, they are custom-made, and they will move the jaw more or less depending on each patient’s needs. 
  • Tongue-Retaining Devices: These work by keeping the tongue in its place in order to prevent it from falling back into the airway once you fall asleep, they are not a main treatment option but an alternative for people who can’t use a mandibular advanced device.

Sleep mouth guards for snoring

Snoring is caused by a partial obstruction of the superior airways, it occurs during sleeping hours when your throat relaxes causing it to close a bit, making it difficult for air to circulate normally.

Wearing a mouthguard for sleeping can improve snoring by keeping the airway open, the types of occlusal splints used for snoring are the same used to treat sleep apnea: the mandibular advancement splint, and the tongue-retaining splint.

Sports Mouth Guard

These mouthguards cover your teeth and gums in order to keep you safe from suffering injuries while practicing contact sports like boxing, wrestling, or hockey. 

They can be custom-made at the dentist’s office for a better fit, but in this case, over-the-counter mouthguards are efficient at keeping your teeth safe.

Benefits of wearing an occlusal splint

Wearing an occlusal splint, especially while sleeping, offers a large number of benefits for our general health:

  • It dissipates excessive tension by stimulating muscles and jaw relaxation.
  • It reduces head, neck, and back pains significantly.
  • The muscles have a property called “muscle memory”, the constant use of the splint allows the chewing muscles to “remember” the correct relaxation position.
  • It prevents occlusal wear and dental enamel injuries such as fractures.
  • Sleep quality is significantly improved by wearing a dental guard for sleeping.

Risk of wearing a night guard

Custom-made night guards are fairly safe, however, OTC night guards might cause some serious problems since these are not indicated or supervised by a professional, some of these problems include:

  • Worsening teeth grinding symptoms.
  • Headaches.
  • Neckaches.
  • Jaw pain.
  • TMJ disorders.

Night guards cost

Custom-made occlusal splints by the dentist cost around 200$ and 1.000$, it will vary depending on the severity of your symptoms.

Slightly customizable night guards like the boil and bite guards cost around 20 to 200$.

Over-the-counter night guards (one-size-fits-all) cost from 5$ to 50$.

Night guard cost with insurance

Some insurance covers all or a part of the price of custom-made dental guards by the dentist, but others will not cover it, so you should check it up directly with your insurance company.

In case you don’t have coverage for occlusal splint therapy, you can ask the clinic for payment plans.

Frequent questions

Do upper night guards increase bruxism?

They will not, as long as they are made from the right material that should be rigid or semi-rigid, however, using soft mouth guards for bruxism might increase the teeth grinding.

Can I use Invisalign as a night guard?

No, Invisalign is an orthodontic tray (clear aligner), it is designed to align your teeth and even if you have to wear the aligner while sleeping, they are not capable of stabilizing the jaw and chewing muscles, if you are suffering from bruxism or TMJ disorders, you should treat them before starting an Invisalign treatment.

Do lower teeth mouthguards exist?

Yes, you can opt for a lower teeth night guard if you wish, or your dentist might suggest one if it is necessary, the thing is that most patients choose the upper teeth dental guard since it’s more comfortable to wear at nighttime.

Do daytime mouthguards exist?

Yes, you can wear a dental guard anytime you need it, they are called “night guards” just because most people experience symptoms of bruxism or TMJ disorders while sleeping.

Can I use a night guard if I’m wearing braces?

Yes, you can wear a mouth guard if you are wearing braces, but keep in mind that you’ll need a custom-made occlusal guard made by your orthodontist so it fits perfectly over your teeth and braces.

Can I buy Brux night guards on Amazon?

Yes, over-the-counter night guards and boil-and-bite night guards are available on Amazon, just keep in mind that the best occlusal splints for bruxism are custom-made by a dentist. 

What can I do if my night guard is not helping TMJ?

Night guards for TMJ disorders are highly effective, if your condition is not improving after a few days you should contact your dentist to check the dental guard and make any necessary adjustments. 

Are silicone occlusal splints useful for bruxism?

No, silicone is a soft material that stimulates the impulse of biting, worsening the grinding of teeth.

Although splints made of soft materials can be useful in other situations when it comes to treating bruxism, splints must be rigid.

How long do I have to wear the occlusal splint?

Occlusal splints are usually worn while sleeping since sleep bruxism is usually the most common and also the one that produces the most intense symptoms.

However, in cases of severe bruxism, the dentist may suggest its use during the day until the symptoms decrease.

Where do I put the occlusal splint, top or bottom?

Guards for bruxism are usually placed in the upper teeth, but they can also be placed on the lower teeth if this is more comfortable for the patient and the dentist deems appropriate.

How long does an occlusal splint last?

An occlusal splint lasts an average of 5 years, although this varies a bit depending on the severity of each case. 

If you stop using the splint for a long time, it is possible that it no longer fits perfectly when you want to use it again.

How do I clean the occlusal splint?

You should wash it daily using a soft bristle brush and neutral soap, never with toothpaste.

You should avoid using other types of cleaners such as denture disinfection tablets as these can deteriorate the splint material.

Is a rigid or semi-rigid occlusal splint better?

Both types of splints are made in the dental clinic and are equally effective, although the adaptation process is more comfortable with the semi-rigid splint.

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