Cargotts Consulting LLC

For most people, any mouth guard, hard or soft, will induce additional clenching. A soft night guard (typical of over-the-counter types) is ideal for some because certain hard/acrylic guards (usually the custom made ones) can be just as hard, if not harder, than teeth. If they have a particular problematic tooth, or had recent surgery, etc. a hard night guard might not be an option because the pain will be too great. An OTC guard comes with many caveats, some of which are not disclosed to consumers. I will address the biggest caveat down below.

If you believe you have TMJ/TMD as a result of clenching, as opposed to grinding, or any other cause, there is no night guard that will stop you from clenching. Some may help with clenching, but they are not going to “cure” you. A night guard will, however, protect your teeth and that is important. Ideally, a night guard should be used while you address the root cause of your clenching (again, assuming your TMJ/TMD is caused by clenching). Most clenching (day and night) is stress related and you must therefore deal with the root cause of your stress. Barring that, there are very few ways to stop clenching at night. One of them is the Cargotts Method.

The most comfortable over-the-counter night guard that I have tried is the Oral B Nighttime Dental Guard. This product is definitely more comfortable than others, and works as far as protection, etc., HOWEVER, if you have some or all of your wisdom teeth (the “third molar”) you should not use this product for more than 6-9 months. Like most over-the-counter night guards, the Oral-B Nighttime Dental Guard does not cover the “wisdom teeth.” It and almost all other over-the-counter night guards do not extend that far back. As a result, over time, one can experience supereruption of the posterior teeth. Essentially, the front teeth are suppressed by the guard and the clenching, while the back teeth are left to erupt. Eventually your whole bite will change to the point where you are only closing on either 2 or 4 back teeth (depending upon whether your wisdom teeth have been removed from both sides or not). I personally experienced this problem and thus learned the hard way. Why don’t the manufacturers disclose this small, but crucial fact? I have no idea. I guess they feel comfortable hiding behind the disclaimer that says “consult your dentist first”. Or perhaps they wrongly assume that everyone has had all of their wisdom teeth removed? Either way, it is my hope that some of you reading this will benefit from my mistake and misfortune. After experiencing supereruption, it was recommended that I stop using any type of night guard and to just let the back teeth grind down on their own (to become level again with the others). Now of course comes my disclaimer- Everyone reading this should ideally consult their own dentist as everyone’s case is different. I will say that if all wisdom teeth have been removed, the Oral B Nighttime Dental Guard should work well even over the long term, but obviously monitor your bite and consult with a reputable dentist.

So for some, an over-the-counter night guard is a great alternative to an expensive ($500-$900) custom night guard, depending upon whether or not you have all of your wisdom teeth. Even for those who do have some of their wisdom teeth, an over-the-counter night guard may buy some time (up to 6 months) to get their clenching under control, to the point where they no longer need a night guard. That, really, should be everyone’s goal anway. Not all over-the-counter night guards feel the same, and some are downright harmful to your bite. Do your research first before purchasing one (if you decide to go that route).

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