Mouth Guards for Sleep

As we all know, mouth guards are widely used in sports to prevent mouth-related injuries, but certain types are also used to help some people to get a good night’s rest. Also known as dental guards, night guards, or occlusal splints in the dental world, these appliances are used to alleviate unconscious teeth grinding and clenching that occurs during the night. 

The medical term for this is known as bruxism, which is classified as a sleep-related movement disorder. While mild bruxism can typically be managed without a night guard, more severe cases usually need them to manage the symptoms that can interfere with a good night’s sleep and cause a variety of health issues. 

Why wear a mouth guard for sleep?

Night guard for teeth grinding

Bruxism is a common condition that affects about thirty to forty million children and adults in the United States. It can be identified with symptoms[1] such as: 

  • Rhythmic clenching of the jaw muscles.
  • Headache.
  • Chronic facial or jaw pain.
  • Swelling in the face or jaw.
  • Teeth that are sensitive, worn down, fractured, or chipped.
  • Limited jaw movement.

Untreated bruxism also tends to co-occur with temporomandibular jaw disorder, or TMJ, which can cause pain in the jaw joints, limited jaw movement, and misalignment of the upper and lower teeth. 

Mouth guards separate the front teeth and bottom teeth to prevent them from grinding together and wearing out the chewing surface of the teeth. They can also help prevent clenching which can cause injuries to the jaw joints and result in facial pain upon waking. 

Certain medications and high levels of stress and anxiety can give rise to bruxism, but one of the biggest risk factors is having sleep apnea. 

Dental night guard for sleep apnea

Obstructive sleep apnea is a sleep disorder that occurs in more than 18 million adults in the United States. It causes a person to temporarily stop breathing during sleep. This occurs when the muscles in the back of the throat relax, restricting airflow despite efforts to breathe. It’s a potentially serious disorder that when left untreated, can increase the risk of heart disease and stroke. 

Sufferers tend to have daytime sleepiness, poor sleep quality, and often snore during their sleep. Additionally, approximately 25% of people with sleep apnea grind their teeth at night, since temporary breath loss tends to stimulate teeth grinding.

People that have sleep apnea will commonly use a CPAP (continuous positive air pressure) machine, which increases air pressure in the throat and prevents the airway from being obstructed. A custom-made sleep apnea mouthguard is used for more mild cases of sleep apnea where a CPAP isn’t used.

Mouth guards for sleep apnea adjust the position of the tongue and/or push the lower jaw forward. This helps keep the airways open while sleeping, thereby preventing snoring and alleviating teeth grinding in the process. 

For sleep apnea, mouth guards are typically classified as either mandibular advancement devices (MADs) or tongue retaining devices (TRDs). Later on, we will recommend one of the best anti-snoring sleep apnea mouth guards.

How mouth guards are fitted

Night guards can be fitted different ways. For sleep use, they typically come in 1mm, 2mm, or 3mm sizes and rarely weigh more than ten ounces. 

Stock mouth guards

These “one-size-fits-all” mouth guards are the lowest cost option and may be effective for mild cases of teeth grinding. These come pre-formed out of rubber or polyvinyl and ready to wear out of the box. They tend to be bulky and the least comfortable out of the three. 

Since everyone has a different jaw size, it’s not too uncommon for these to fall out during the night and disrupt sleep. Stock mouth guards come in small, medium, and large sizes. Many of them just cover the top teeth, and it may be difficult to talk while wearing them.

Where to buy stock mouth guards

Stock mouth guards are available at many sporting goods stores and drugstores, including CVS, Walgreens, and Walmart. They can also be purchased online from Amazon. These mouth guards run anywhere from one to $15. 

Boil-and-bite mouth guards

This is one of the more common mouth guards available and they are typically made out of a thermoplastic. They come in one size and are fitted by boiling them in water, letting them cool for a few seconds, and biting down to make your own impression. 

While they are quite a bit cheaper than custom mouth guards, they tend to be less comfortable. They are usually not recommended as a long term solution, because they may become weaker and brittle over time. In general, they are used for short-term relief from mild to moderate bruxism or jaw clenching and are not effective for sleep apnea. 

Where to buy boil-and-bite mouth guards

Like stock mouth guards, boil-and-bite mouth guards can be found over-the-counter in most drugstores or bought online. These mouth guards are available for $30 or less. 

Custom mouth guards

Custom mouth guards are usually the most expensive but have the most comfortable fit since they are individualized for each person. They are also by far the best choice for anyone suffering from bruxism and sleep apnea, especially moderate to severe cases. 

These are made by taking a dental impression of your teeth, which is used to create the mouth guard tailored specifically to the structure of your teeth and jaw. Custom mouth guards are the least likely to dislodge while sleeping, and tend to be slim and the most comfortable to wear. Custom mouth guards are more resilient than the other two and will typically last for more than a year with repeated use.

Where to buy custom mouth guards

Custom mouth guards can be fitted at the dentist’s office for a price usually between $400-800. Thankfully, many dental insurance plans will cover some or all of the price tag. 

However, they can also be ordered online from a private dental lab for much cheaper. In this case, the lab will send a kit that is used to take the mold impression of your teeth. After sending it back, they will create the mouthguard based on the structure of your teeth and mouth. 

The different types of mouth guard materials

A variety of different mouthguard materials are available, depending on the needs of the individual person. 

Soft mouth guards

These mouth guards are typically made of soft, rubber-like EVA plastic or medical-grade silicone. They are recommended for people with mild or occasional teeth clenching and grinding. In moderate to severe bruxism, soft mouth guards can produce a “chew toy” effect and actually exacerbate the problem. 

They may therefore be more effective for clenching, acting as a cushion for the jaw muscles. Soft mouth guards tend to be the least pricey, but also don’t last as long as the harder types. 

Dual layer laminated (soft/hard hybrid) mouth guards

Dual layer mouth guards are made with a special machine that fuses together the soft interior material and hard exterior material into one dual-layer. The hard material is made out of the same material that the fully hard mouth guards are made of. 

The soft, gel-like material in the interior comfortably sits against your teeth while the hard exterior takes the force of the teeth gnawing from the bruxism. This type of material is recommended for moderate to heavy teeth grinding, and tends to last longer than the soft mouth guards.

Hard mouth guards

Hard mouth guards are made from hard acrylic, methyl methacrylate (MMA), urethane methacrylate, or stearyl acrylate. Since they are the most rigid and durable, these are recommended for heavy to severe teeth grinders. 

Hard mouth guards snap on and stay in place, which makes them less likely to dislodge during the night. It’s possible for hard mouth guards to be too tight, or cause gum irritation from the sharp edges. For this reason, they are more uncomfortable than softer mouth guards but tend to last the longest. 

Recommended night guards for sleep apnea and teeth grinding

Based on an analysis of the available mouth guards, these are the best mouth guards for teeth grinding and sleep apnea based on the quality of the materials and customer reviews. 

Best over-the-counter mouth guard for teeth grinding

SleepRight No-Boil Dental Guard 

The SleepRight mouthguard for sleeping is an affordable mouthguard that is designed with five bite pad positions for a more customized fit. This mouthguard is made of a thin, soft, plastic that will last for several months of repeated use. 

It is made in an FDA inspected facility and contains no BPA, silicon, latex, phthalates or other harmful chemicals. The SleepRight comes with a three month warranty. 

Best custom mouth guard for teeth grinding

JS Dental Lab Custom Dental Guard

The JS Dental lab custom mouthguard is a comfortable, custom-fitting mouthguard. The manufacturer will send a putty impression kit for an easy five-minute mold of the teeth. 

It is FDA-approved, and BPA, latex, and vinyl-free. It offers the night guard in soft, semi-hard, and hard material depending on the needs of the user. 

Best anti-snoring mouth guard for sleep apnea

The VitalSleep is a sleep guard and mandibular advancement device (MAD) used to alleviate snoring and the symptoms of sleep apnea. This option uses a custom molded impression for the most individualized fit. It works by advancing the lower jaw forward to relax the muscles that constrict air flow during sleep apnea episodes.

The mouthguard has a low profile design, a large opening for adequate airflow, and is adjustable up to 8mm. It’s made of FDA-approved materials with no latex, BPA, or other harmful chemicals. The company offers a 60-day money back guarantee and a one year warranty. 

The possible risks of night guard use

Some people experience undesirable teeth shifting from long-term use of mouth guards for sleep. If the mouthguard doesn’t fit well, it’s possible for the teeth to move and cause bite alignment problems. When using a mouthguard in the long term, it’s always a good idea to have it checked regularly by a dentist. 

It is also worth mentioning that sports mouth guards should not be used for sleep-related issues like bruxism and sleep apnea. While they are often made of the same materials, they tend to be thicker and less well-fitted, which could potentially lead to jaw joint issues, headaches, and facial pain down the road.

Night guard maintenance

It’s a good idea to brush and floss your teeth before wearing a night guard. Mouth guards can be washed with soap and cool water, or cleaned with a soft bristle toothbrush and toothpaste. Night guards will last the longest when they are stored in a well-ventilated plastic storage box when not being used. 

Be sure to follow the manufacturer’s instructions before using mouth guards that are tailored to your individual mouth.

The bottom line

Teeth grinding during sleep has the potential to cause severe dental and jaw injuries, but thankfully night guards offer an effective and relatively inexpensive solution. 

While custom mouth guards tend to be the most expensive, they are the best option for sleep apnea and bruxism, and can potentially save a lot of money on dental bills caused by unprotected teeth grinding.

If you’re still deciding which mouthguard to use, be sure to talk to a dental professional to assess which mouthguard may be the right fit for you. 

References

  1. Shetty, S., Pitti, V., Satish Babu, C. L., Surendra Kumar, G. P., & Deepthi, B. C. (2010). Bruxism: a literature review. Journal of Indian Prosthodontic Society, 10(3), 141–148. doi:10.1007/s13191-011-0041-5