Night Guards: Do They Really Help with Bruxism?

Bruxism is a common parafunctional activity characterized by repetitive jaw muscle activity, including clenching or grinding of the teeth. It can occur during sleep (sleep bruxism) or while awake (awake bruxism) and is associated with tooth wear, temporomandibular disorders, and orofacial pain.

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Among the most widely recommended treatments are night guards, also known as occlusal splints. However, an important clinical question remains: do night guards truly help manage bruxism, or do they simply protect the teeth from its consequences?

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✅ What Is Bruxism?
Bruxism is defined as a repetitive masticatory muscle activity characterized by clenching, grinding, or bracing of the mandible. It is considered a multifactorial condition, influenced by biological, psychological, and neurological factors rather than occlusal discrepancies alone.

Types of Bruxism
▪️ Sleep bruxism: A sleep-related movement disorder associated with micro-arousals.
▪️ Awake bruxism: A behavioral condition often linked to stress or concentration.

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✅ Causes of Bruxism
The etiology of bruxism is complex and multifactorial:

▪️ Psychological factors, such as stress, anxiety, and emotional tension
▪️ Central nervous system regulation, including sleep arousal mechanisms
▪️ Medications, particularly selective serotonin reuptake inhibitors (SSRIs)
▪️ Sleep disorders, such as obstructive sleep apnea
▪️ Lifestyle factors, including caffeine, alcohol, and tobacco use
Current evidence indicates that bruxism is centrally mediated, rather than caused by dental occlusion alone.

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✅ Night Guards: Definition and Mechanism of Action
Night guards are custom-made or prefabricated intraoral appliances designed to cover the occlusal surfaces of the teeth, usually fabricated from acrylic or thermoplastic materials.

Their primary functions include:
▪️ Redistributing occlusal forces
▪️ Reducing tooth-to-tooth contact
▪️ Protecting dental structures from wear
▪️ Decreasing muscle hyperactivity in some patients
Importantly, night guards do not eliminate bruxism, but they may reduce its harmful effects.

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✅ Clinical Effectiveness of Night Guards
Scientific evidence supports that night guards:

▪️ Protect teeth from further wear
▪️ May reduce muscle pain and morning discomfort
▪️ Can improve patient awareness of parafunctional habits
However, they do not consistently reduce the frequency of bruxism episodes, particularly in sleep bruxism. Their effectiveness is primarily protective rather than curative.

📊 Comparative Table: Bruxism Treatment Options

Treatment Approach	Clinical Benefits	Limitations
Night Guards (Occlusal Splints)	Protect teeth, reduce wear, may decrease muscle discomfort	Do not eliminate bruxism activity
Behavioral Therapy	Addresses stress-related and awake bruxism factors	Requires patient compliance and time
Botulinum Toxin Injections	Reduces muscle hyperactivity and pain	Temporary effect, invasive, higher cost
Pharmacological Management	May help in selected neurological or sleep-related cases	Limited evidence, potential side effects

💬 Discussion
Night guards remain a cornerstone in the management of bruxism due to their non-invasive nature and protective benefits. Nevertheless, their role should be clearly explained to patients: they manage the consequences, not the underlying neurological or behavioral causes.
Optimal management often requires a multidisciplinary approach, combining occlusal therapy with behavioral strategies, stress management, and, when indicated, pharmacological or adjunctive therapies.

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🎯 Recommendations
▪️ Use custom-fabricated night guards for better fit and compliance
▪️ Combine occlusal splints with behavioral and stress-reduction therapies
▪️ Monitor patients regularly for appliance wear and symptom progression
▪️ Address contributing factors such as sleep disorders or medication use
▪️ Educate patients that night guards protect teeth but do not cure bruxism

✍️ Conclusion
Night guards are an effective and evidence-based tool for protecting teeth and reducing symptoms associated with bruxism. While they do not eliminate the condition itself, they play a critical role in preventing irreversible dental damage. Comprehensive bruxism management should extend beyond occlusal appliances to address the multifactorial nature of the disorder.

📚 References

✔ Lobbezoo, F., Ahlberg, J., Raphael, K. G., Wetselaar, P., Glaros, A. G., Kato, T., & Manfredini, D. (2018). International consensus on the assessment of bruxism. Journal of Oral Rehabilitation, 45(11), 837–844. https://doi.org/10.1111/joor.12663
✔ Manfredini, D., Serra-Negra, J., Carboncini, F., & Lobbezoo, F. (2017). Current concepts of bruxism. International Journal of Prosthodontics, 30(5), 437–438. https://doi.org/10.11607/ijp.5210
✔ Macedo, C. R., Silva, A. B., Machado, M. A., Saconato, H., & Prado, G. F. (2007). Occlusal splints for treating sleep bruxism. Cochrane Database of Systematic Reviews, (4), CD005514. https://doi.org/10.1002/14651858.CD005514.pub2

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How Can I Tell If I Have Bruxism? A Practical Dental Guide for Patients

✅ What Is Bruxism?
Bruxism is the habit of clenching or grinding the teeth, often without realizing it. It can occur while awake (awake bruxism) or during sleep (sleep bruxism). Over time, this constant pressure may damage teeth, muscles, and jaw joints.

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Many people live with bruxism for years without knowing it, because symptoms often appear gradually.

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✅ How Do I Know If I Have Bruxism? Common Signs and Symptoms
You may have bruxism if you notice one or more of the following:

▪️ Worn, flattened, or chipped teeth
▪️ Jaw pain or stiffness, especially in the morning
▪️ Frequent headaches, mainly around the temples
▪️ Tooth sensitivity to cold, heat, or pressure
▪️ Clicking or pain in the jaw joint (TMJ)
▪️ Ear pain without an ear infection
▪️ Poor sleep quality or fatigue on waking
▪️ Reports from a partner of grinding noises during sleep
These signs are often subtle at first but tend to worsen over time if untreated.

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✅ What Causes Bruxism?
Bruxism usually develops due to a combination of factors:

▪️ Stress, anxiety, or emotional tension
▪️ Sleep disorders, such as obstructive sleep apnea
▪️ Bite misalignment or dental interferences
▪️ Caffeine, alcohol, or tobacco use
▪️ Certain medications (e.g., antidepressants)
▪️ Neurological or muscular factors
There is rarely a single cause, which is why professional evaluation is essential.

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✅ Why Is Bruxism a Problem for Oral Health?
If left untreated, bruxism may lead to:

▪️ Progressive tooth wear and fractures
▪️ Gum recession
▪️ Cracks in dental restorations
▪️ Temporomandibular joint disorders (TMD)
▪️ Facial muscle hypertrophy
▪️ Chronic facial and neck pain
Early diagnosis helps prevent irreversible damage.

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✅ How Is Bruxism Diagnosed?
A dentist can usually identify bruxism through:

▪️ Clinical examination of tooth wear patterns
▪️ Evaluation of jaw muscles and joint movement
▪️ Review of symptoms and lifestyle habits
▪️ In some cases, sleep studies for suspected sleep bruxism
There is no single test; diagnosis relies on clinical evidence and patient history.

📊 Comparative Table: Bruxism Treatment Options

Treatment Type	Main Benefits	Considerations
Occlusal Splint (Night Guard)	Protects teeth, reduces muscle overload, non-invasive	Does not eliminate the cause, requires regular use
Botulinum Toxin (Botox)	Reduces muscle activity and pain, effective for severe cases	Temporary effect, requires trained professionals
Stress Management	Addresses emotional triggers, improves overall wellbeing	Results may take time
Physical Therapy	Improves muscle function and jaw mobility	Requires patient commitment
Dental Bite Adjustment	Reduces occlusal interferences	Only indicated in selected cases

💬 Discussion
Bruxism is a multifactorial condition that should not be viewed only as a dental problem. Successful management often requires a combined approach, addressing dental protection, muscle activity, and emotional or sleep-related factors.
Modern treatments such as botulinum toxin injections have expanded therapeutic options, especially for patients with persistent pain or severe muscle hypertrophy.

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🎯 Recommendations for Patients
▪️ Do not ignore jaw pain or tooth wear
▪️ Seek dental evaluation if symptoms persist
▪️ Reduce caffeine and alcohol intake
▪️ Practice stress-reduction techniques
▪️ Use prescribed dental appliances consistently
▪️ Follow up regularly with your dentist
Early care can prevent long-term damage and improve quality of life.

✍️ Conclusion
Bruxism is common, often silent, and potentially damaging, but it is also manageable. Recognizing early signs and seeking professional guidance allows for effective, personalized treatment. With proper care, patients can protect their teeth, relieve pain, and restore comfort.

📚 References

✔ Lobbezoo, F., Ahlberg, J., Glaros, A. G., et al. (2013). Bruxism defined and graded: An international consensus. Journal of Oral Rehabilitation, 40(1), 2–4.
✔ Manfredini, D., Winocur, E., Guarda-Nardini, L., Paesani, D., & Lobbezoo, F. (2013). Epidemiology of bruxism in adults. Journal of Orofacial Pain, 27(2), 99–110.
✔ Al-Moraissi, E. A., et al. (2020). Botulinum toxin for the management of bruxism: A systematic review. Journal of Oral Rehabilitation, 47(7), 856–864.
✔ American Academy of Sleep Medicine. (2014). International Classification of Sleep Disorders (3rd ed.).

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Bruxism in Children vs. Adults: Key Differences, Risks, and Evidence-Based Treatments

Bruxism, defined as repetitive jaw-muscle activity characterized by clenching or grinding of the teeth, presents differently in children and adults. Understanding these distinctions is essential for appropriate diagnosis and treatment.

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While pediatric bruxism is often self-limiting, adult bruxism is usually multifactorial and chronic, demanding targeted intervention.

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✅ Bruxism in Children: Characteristics and Causes
Pediatric bruxism is commonly sleep-related and may occur during tooth eruption, mild airway disturbances, stress, or parasomnias. In most cases, it decreases spontaneously with age.

Key features
▪️ Frequent in children aged 4–12
▪️ Often physiological and self-limiting
▪️ Less associated with chronic pain
▪️ May correlate with occlusal changes, ADHD, sleep-disordered breathing, or anxiety

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✅ Bruxism in Adults: Characteristics and Causes
Adult bruxism often involves both awake bruxism (AB) and sleep bruxism (SB) with stronger association to stress, anxiety, sleep apnea, substance use (caffeine, alcohol), or medications (SSRIs).

Key features
▪️ More likely to cause muscle pain, TMJ disorders, and tooth wear
▪️ Strong stress-related component
▪️ Associated with sleep fragmentation
▪️ Typically chronic unless underlying cause is treated

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✅ Clinical Differences: Children vs. Adults

▪️ Etiology: Children—parasomnias and development; Adults—stress, medications, airway issues.
▪️ Symptoms: Adults experience greater pain and damage due to stronger bite forces.
▪️ Progression: Children often improve with age; adults tend to worsen without intervention.

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✅ Evidence-Based Treatments for Children

1. Behavioral and Preventive Approaches
▪️ Sleep hygiene
▪️ Stress reduction strategies
▪️ Management of airway issues (ENT evaluation when needed)

2. Occlusal Splints in Children
Used cautiously and usually short-term to avoid affecting jaw growth. Soft splints may reduce wear in severe cases.

3. Dental Monitoring
Regular evaluation of wear, mobility, restorations, and TMJ health.

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✅ Evidence-Based Treatments for Adults

1. Occlusal Splints (Hard Acrylic Night Guards)
Most effective non-invasive treatment to reduce tooth wear and protect restorations.
Types: Full-arch stabilization splints, Michigan splints, and mandibular advancement devices (when sleep apnea is involved).

2. Physiotherapy and Muscle Rehabilitation
Exercises, manual therapy, and thermal therapies help reduce myofascial pain.

3. Stress & Behavioral Management
CBT, relaxation therapy, biofeedback devices.

4. Pharmacologic Therapy (Selective Cases)
Low-dose muscle relaxants or clonazepam for severe sleep bruxism—but not recommended long-term.

5. Botulinum Toxin (BTX-A)
Used in chronic or refractory cases to reduce masseter hyperactivity.

📊 Comparative Table: Consequences of Bruxism (Children vs. Adults)

Aspect	Advantages	Limitations
Tooth Wear (Adults)	Early detection allows restorative planning	Severe enamel and dentin loss, fractures
Tooth Wear (Children)	Helps identify parafunctions early	May affect eruption patterns and vertical dimension
TMJ Disorders (Adults)	Indicates need for physiotherapy or splints	Chronic pain, clicking, limited mouth opening
TMJ Symptoms (Children)	Allows monitoring of joint development	Less common but may cause headaches or jaw fatigue
Muscle Hypertrophy	Useful diagnostic marker	Facial asymmetry, masseter hypertrophy
Dental Hypersensitivity	Encourages preventive remineralization therapy	Can affect eating and oral hygiene behaviors
Restoration Failure	Detects weak areas early	Chipping, crown failure, implant overload
Sleep Disturbances	Early identification supports sleep evaluation	Fragmented sleep, fatigue, behavioral issues in children
Headaches	Prompts differential diagnosis	Can become chronic migraines or morning headaches
Behavioral Consequences (Children)	Supports early psychological or pediatric referral	May be associated with anxiety, ADHD, or stress disorders
Gingival Trauma	Indicates maladaptive bite forces	Recession or soft tissue abrasion
Cracked Tooth Syndrome (Adults)	Early diagnosis improves prognosis	Pain on chewing, restoration loss, complex treatment needs

💬 Discussion
Although bruxism appears in both children and adults, the pathophysiology, severity, and management differ significantly. Children generally need monitoring and minimal intervention, whereas adults require multimodal, long-term management to prevent complications.
Emerging evidence links bruxism, especially sleep bruxism, to neurophysiological arousal and sleep disturbances, highlighting the need for interdisciplinary evaluation.

✍️ Conclusion
Bruxism in children is usually temporary, whereas adult bruxism is commonly chronic and more destructive. Early identification, individualized management, and preventive strategies are essential for reducing long-term consequences. Dentists should tailor treatment based on age, etiology, and symptom severity, integrating behavioral, dental, and medical approaches.

🔎 Recommendations
▪️ Evaluate for airway issues in children with bruxism.
▪️ Use occlusal splints only when necessary in children.
▪️ For adults, prioritize night guards, stress management, and physiotherapy.
▪️ Refer to sleep specialists when sleep apnea is suspected.
▪️ Monitor tooth wear regularly and consider minimally invasive restorative approaches.

📚 References

✔ Lobbezoo, F., Ahlberg, J., Raphael, K. G., Wetselaar, P., Glaros, A. G., Kato, T., ... & Manfredini, D. (2018). International consensus on the assessment of bruxism. Journal of Oral Rehabilitation, 45(11), 837–844. https://doi.org/10.1111/joor.12663
✔ Manfredini, D., Winocur, E., Guarda-Nardini, L., Paesani, D., & Lobbezoo, F. (2013). Epidemiology of bruxism in adults: A systematic review. Journal of Orofacial Pain, 27(2), 99–110.
✔ Ramos-Jorge, J., Ferreira, M. C., Rodrigues, C. N., et al. (2011). Association between bruxism and behavioral problems in children. Journal of Oral Rehabilitation, 38(11), 859–864. https://doi.org/10.1111/j.1365-2842.2011.02212.x
✔ Okeson, J. P. (2019). Management of Temporomandibular Disorders and Occlusion (8th ed.). Mosby.

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Occlusal Splints: Types, Benefits, and Who Needs Them

Occlusal splints, also known as bite guards, night guards, or dental orthotics, are removable dental devices that cover the occlusal (biting) surfaces of teeth. They are used to manage conditions such as bruxism (teeth grinding), temporomandibular joint disorders (TMDs), and excessive dental wear.

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A. Purpose of Occlusal Splints
Occlusal splints serve several key functions:
° Protecting Teeth from Wear: They act as a protective barrier between the upper and lower teeth, preventing enamel erosion and fractures caused by grinding.
° Reducing Jaw and Muscle Pain: By repositioning the jaw and alleviating pressure on the TMJ, they help relieve pain and muscle tension.
° Preventing Further Dental Damage: Patients with bruxism or TMD can experience cracked or worn-down teeth; splints help mitigate this risk.

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B. Types of Occlusal Splints
There are different types of occlusal splints, depending on the patient’s needs:
° Stabilization Splints – Also called flat-plane splints, these are used to prevent bruxism and relieve muscle tension.
° Repositioning Splints – These are designed to reposition the lower jaw to relieve TMJ discomfort.
° Soft Splints – Made of a softer material, these are typically used for mild bruxism cases.
° Dual-Laminate Splints – A combination of hard and soft materials, offering comfort and durability.

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C. Materials Used in Occlusal Splints
Occlusal splints are typically made from the following materials:
° Hard Acrylic Resin (PMMA - Polymethyl Methacrylate): The most common material, it is highly durable and provides excellent stability.
° Thermoplastic Materials: Softer and flexible, these materials offer more comfort but are less durable.
° EVA (Ethylene Vinyl Acetate): Used in softer night guards, providing a balance between comfort and protection.
Dual-Layered Materials: Some splints combine a hard outer shell with a soft inner lining for both protection and comfort.

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D. Who Needs an Occlusal Splint?
Patients who may benefit from occlusal splints include:
° Bruxism Sufferers – Those who grind or clench their teeth, especially at night.
° Patients with TMD – Individuals experiencing jaw pain, clicking sounds, or limited movement of the jaw.
° People with Dental Restorations – Those with veneers, crowns, or implants that need extra protection from excessive force.

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Conclusion
Occlusal splints are essential devices for protecting teeth, managing jaw disorders, and preventing long-term dental complications. Their effectiveness depends on proper diagnosis and professional customization by a dentist.

References
1. Crout, D. K. (2017). Anatomy of an occlusal splint. General Dentistry, 65(2), 52-56. AGD
2. Okeson, J. P. (2014). Management of Temporomandibular Disorders and Occlusion (7th ed.). Elsevier.
3. Jagger, R. (2003). The effectiveness of occlusal splints for sleep bruxism. Evidence-Based Dentistry, 4(2), 39-40.
4. Wright, E. F. (2014). Occlusal Appliance Therapy. In Manual of Temporomandibular Disorders (pp. 149–222). Wiley-Blackwell.
5. Clark, G. T., & Minakuchi, H. (2006). Oral Appliances. In Laskin, D. M., Greene, C. S., & Hylander, W. L. (Eds.), Temporomandibular Disorders: An Evidence-based Approach to Diagnosis and Treatment (pp. 377–390). Quintessence Publishing.

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Bruxism: What are the symptoms? How is it diagnosed?

Bruxism is a parafunctional and multifactorial activity that consists of abnormal contact of the teeth (clenching or grinding), resulting in pain and alterations in the chewing muscles, temporomandibular joint, and teeth.

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Watch the video 🔽 What are the consequences of bruxism? ... In many cases, the patient does not know that he suffers from bruxism, and is detected when he attends the dentist motivated by another consultation

Bruxism can occur at any age, and must be diagnosed and treated in time to avoid its serious consequences and complications. Treatment is sometimes usually multidisciplinary.

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We share a review article on the symptoms of bruxism and its current concepts on the diagnosis and treatment of this pathology.

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📌 Read and download the article in PDF:

👉 "Diagnosis and treatment of bruxism: Concepts from past to present" 👈

Dr. Hema Kanathila, Dr. Ashwin Pangi, Dr. Bharathi Poojary, Dr. Mallikarjun Doddamani. Diagnosis and treatment of bruxism: Concepts from past to present. Int J Appl Dent Sci 2018;4(1):290-295.

📌 Watch video "Symptoms of Bruxism"

Youtube/ Dr. Gorbatov Dentistry

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Online Video library - Bruxism: Definition, diagnosis and treatments

Bruxism is a parafunctional pathology, which can occur day or night, and affects both adults and children. The presence of bruxism affects the teeth, orofacial muscles, and the temporomandibular joint.

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Bruxism is evidenced when the patient grinds or clenches his teeth. The origin of bruxism is multifactorial, for which an interdisciplinary treatment is recommended.

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🎯We share an interesting list of videos dedicated to this pathology, so that it can be shared in the dental community.

► Bruxism: A medical or dental issue?

► Can children suffer from bruxism?

► What are the symptoms of clenched teeth and how can we fix it?

► Bruxism - A Major Cause of Gum Recession

► What are the consequences of bruxism?

► Everything you need to know about bruxism

► Bruxism: Why do you need a dental splint?

What are the consequences of bruxism?

Bruxism is a parafunctional habit that consists of clenching or grinding the teeth. This event can be day or night and affects both children and adults. The consequences of this pathology not only affect the teeth, but also the temporomandibular joint and the chewing muscles.

We invite you to our English-only dental publishing groups

🎯 WhatsApp Group All Odontology
🎯 Telegram Group All Odontology
🎯 Facebook Group All Odontology

In many cases, the patient does not know that he suffers from bruxism, and is detected when he attends the dentist motivated by another consultation. In other cases, the patient attends another specialty motivated by headaches and ends up being referred to dentistry.

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We share a simple but didactic explanation of the serious consequences of suffering from bruxism. Thanks to the Osmosis channel.

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Bruxism: A medical or dental issue?

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Source: Youtube/ Ósmosis