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Which is better a hard or soft nightguard?

Published: April 17, 2011
Author: Dr. Mike Williams ( Michael Williams )
Tagged: teeth grinding, nightguard

Image: Which is better a hard or soft nightguard?

Which material is better for a nightguard? Is a hard nightguard better than a soft night guard? Is a combo dual laminate a better nightguard?

There is some debate even among dentists as to whether a hard nightguard (night guard) or soft nightguard is better to use for the nighttime clenching also known as bruxism or grinding your teeth at night.

Who should wear a nightguard?

You should consider wearing a nightguard if you awaken with sore jaw muscles. A general term for this condition is referred to as TMJ or TMD which stands for Tempro-Mandibular Joint Dysfunction.  A nightguard or night guard is a horse shoe shaped mouthpiece worn over the teeth during sleep.  The nightguard is used to prevent damage to the teeth and relieve symptoms caused by excessive teeth grinding and clenching. If you have some of the following symptoms you could try a nightguard.

Symptoms of Night TMD:

Ear pain
Pain in the face
Pain in the jaw muscles
Difficulty sleeping
Neck pain
Jaw clicking or popping
Difficulty with opening or closing your mouth
Sensitive teeth
Worn, sharp, or  short and flat teeth
Teeth or dental work that is frequently breaking
What causes the nighttime teeth grinding? 
This pain is usually caused from emotional stress, sleep breathing disorders, or a bad bite.

Emotional difficulties prevent sound sleeping. The worrisome daytime events can be carried over into the sleep process and as the mind processes these events muscular contractions, spasms and teeth clenching can occur.

Difficulty breathing during sleep including snoring and obstructive sleep apnea is sometimes associated with the body’s attempt to improve breathing by clenching. This clenching can activate a tiny muscle (tensor veli palatini) in the jaw which can increase the size of the airway.
Bad Bite: If the bite location and jaw position is not physiologically correct, the body attempts to make corrections during sleep by self-adjusting  which often results in teeth grinding. Some situations involve all three conditions.
What causes the pain?

Over time the constant grinding causes the jaw muscles and supporting joints and ligaments to fatigue. Certain chemicals accumulate within the fatigued muscles which cause the pain.  The supporting ligaments, tendons and jaw joint components are stressed by this extreme muscular activity and damage begins to occur resulting in pain and possible permanent joint damage.  The teeth actually wear away sometimes exposing the nerve and become more sensitive as the jaw muscles stress the teeth in their bony sockets.

How can a Nightguard help?

The nightguard can work in several different ways.

Simply explained, the nightguard prevents full jaw muscle contraction since the maximum force cannot be created because the jaw cannot be fully closed due to the thickness of the nightguard.  This particular nightguard thickness can help relieve jaw muscle pain.  Covering the teeth with the protective acrylic or vinyl type material also eliminates further teeth damage and wear can be stopped.

When the problem is caused by a bad bite, the properly fitted nightguard can realign the jaw to a more physiological position thereby relieving the pain.  These bad bite situations are best treated by a dentist specializing in TMJ disorders. Some of these dentists are called neuro-muscular dentists.

Emotional stresses may require professional help but the symptoms can be temporarily helped by using a nightguard.

Sleep breathing disorders such as snoring and sleep apnea have been successfully treated by wearing a mouthpiece designed for those situations. these mouthpieces may also stop the grinding.

Which Nightguard is for me?

Nightguards are currently being fabricated in one of three types: Soft Nightguard, Hard Nightguard and a Combination Nightguard (also known as dual laminate) which is soft on the inside and hard on the outside.

Benefit of a hard Mouthguard

These nightguards are very durable and are made from hard acrylic material.  This could be considered by a person with extreme clenching.  Extreme clenchers may also need treatment from a TMJ dental specialist.  If you are looking to self-treat your condition, you could obtain a laboratory custom fit device by making your own dental impression and sending it to a dental lab.  By carefully following the directions you may get benefit from this alternative at least as a diagnostic effort and perhaps a good treatment alternative until you have adequate resources to obtain a professional solution.

Benefit of a Soft Mouthguard

Generally this nightguard is considered for first time users and those with minor or moderate clenching habits.  The soft nightguard is usually quite comfortable, economical and may satisfactorily treat the condition.  However, the soft material is subject to more deformation and for extreme clenching conditions will not give a long lasting service.  Some experts say that more serious clenchers are more likely to chew through their soft guards and these guards may actually promote increased clenching especially for those who's clenching is caused from with bite problems. However, for some people these economical nightguards may help with the pain completely or help them decide if a custom nightguard may help better long term. To determine which nightguard is safest, you could start with a soft night guard, and if you find you are still clenching and grinding, move on to a better more costly hard night guard available online or from your dentist.

Benefit of a Combo Nightguard

A third alternative combines both the comfort of the soft guard and the durability of the hard acrylic. The interior of the nightguard is made from a soft material for maximum comfort and adaptability while the exterior is a hard acrylic. The hard exterior is designed not to chip, crack or break, and can help protect teeth and maintains its shape under stress.  For serious TMJ dysfunction cases the additional thickness required for the combo nightguards may not be tolerated.  This is best determined by a TMJ dental specialist. However, for the moderate nighttime clenchers the combo dual laminate guard seems to offer the best in comfort and durability.

All three of the nightguard types are available from dental specialists and many are available directly online or from online dental laboratories who fabricate your nightguard from a custom dental impression made by the user.  The dental professional can offer the best solution. However, in an effort to save costs and time many persons have successfully managed  their night time clenching pain with nightguards obtained from the Internet.  Selection of the nightguard material type can be made according to the cause and severity of the nighttime clenching condition.

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