Should I use a TMJ night guard?

Night guards are a custom-made appliance to be worn while sleeping to protect the teeth
and the temporomandibular joint from the damages caused by bruxism (teeth grinding). There
are standard size night guards and “boil-and-bite” night guards available in drugstores and
supermarkets, along with custom night guards used under the supervision of a dental practitioner.
We strongly recommend patients only use custom-made night guards made in a reputable dental
laboratory. Standard night guards may be mass produced at a low marginal cost, but they are
usually not a good fit for patients because every patient’s dental impressions are different. Dr.
Federman also does not recommend patients use the “boil-and-bite” mouth guards because they
will not fit as precisely as a customized night guard and may actually cause a shifting in the
occlusal positioning of a patient’s teeth and exacerbate TMJ symptoms.

Symptoms of bruxism include teeth grinding noises, enamel wear, chipped teeth, and
increased tooth sensitivity. If Dr. Federman believes you are experiencing a TMJ disorder
resulting from bruxism, he may recommend a night guard to alleviate the symptoms. Before a
night guard is made, the practitioner should thoroughly evaluate the patient’s dental records and
overall dental hygiene. The process begins by taking a physical dental impression of the patient’s
mouth. Using the patient’s dental impression, the mouth guard material is professionally fitted
over the mold and the rough edges are cut, trimmed, and polished. Once the material is made in
the dental lab, the patient will return for a follow-up appointment to be fitted with the device.

The practitioner may make minor adjustments and trim sharp edges to make the appliance more
comfortable for the patient. Night guards should not be confused with Essix (plastic) or Hawley (metal) retainers
following the completion of orthodontic treatment. Essix retainers are not meant to be used
solely for treating TMJ conditions, and patients with bruxism may exert greater wear on the
retainer appliances because they cover the biting surfaces. In contrast, Hawley retainers do not
cover the biting surfaces of the teeth while retaining tooth positioning. Orthodontists should take
proper precautions for patients with TMJ conditions to ensure that the bite positioning is properly
adjusted during orthodontic treatment to minimize the possibility of enamel wear resulting from

It is important to note that night guards are not the same as mouth guards, which are
customized appliance used by athletes in contact sports to minimize the possibility of facial
trauma, concussions, and TMJ injuries. Night guards only need to cover the biting surfaces of the
teeth to prevent bruxism, while mouth guards may cover the teeth and even cover part of the
gums. If you have a tendency to grind your teeth, please contact Dr. Federman’s office to
schedule an evaluation so he can determine if a night guard can help alleviate TMJ symptoms
caused by bruxism. We are committed to fully evaluating each patient’s condition and our
laboratory technicians use the most advanced technology available to make customized night
guards and other dental appliances on behalf of our patients.