clenching – Tooth Be Told

As a dental hygienist, guiding my patients to improve their oral health and protect the integrity of the teeth, gums and jawbones are my top priority. I often discuss using night guards to prevent damage to the teeth and gums with my patients. Usually, they ask me if using over-the-counter store-bought dental night guards are okay to use, including Brux's product. Brux night guards should not be used because the appliance is used only on the anterior (front) teeth. Brux usage can lead to over-eruption of molars, resulting in bite issues, potentially causing gum disease advancement, cavities, cracked, chipped and broken teeth, tooth loss, and speech problems. In this post, I dive into why purchasing an over-the-counter dental night guard like Brux should be avoided at all costs! I also advise which dental night guards are okay to buy over-the-counter. That will cause the least worry to us dental professionals if having one made professionally is not an option. Brux nightguards can cause over-eruption and tooth issues Brux night guards should be avoided no matter what. I am so passionate about preventing this dental product because it will cause serious dental issues! Brux night guard only fits on the front teeth, as you can see in the photo below. By only having contact with the front teeth, the space between the back teeth increases, resulting in significant problems for the back teeth. This photo is a screenshot of the Brux website, showing their night guard appliance. It depicts an image of the device, which only covers the front teeth. Let me explain; Teeth always want to come together when you bite. If the night guard only covers the front teeth, a significant gap is left between the top and bottom back teeth! This opening will allow the top and bottom back teeth to start over-erupting, with the goal to touch together when biting. This video presented by Michael Nugent DDS perfectly shows how teeth can over-erupt if they are not touching together! Like he says in the video, "teeth like to be social and like to be together"... I love that! The video shows what happens if there are no opposing teeth, but the same happens if there is a large gap left between the teeth every night if you are wearing a Brux night guard. https://www.youtube.com/watch?v=aARsA297ysA Over time, if the back teeth over-erupt too much, they will come closer together, preventing the front teeth from coming together. Over-erupting back teeth will start to create a gap between your front teeth. This will not happen overnight, but with continuous wear, it can, and if it were me, I would want to know this risk before putting it in my mouth. If this occurs, you will need orthodontic treatment and possibly oral surgery to fix the problem that a cheap night guard cost. Prices to fix/correct the damage inflicted can extend past $5,000! If you have any dental work on your front teeth, wearing this device will compromise that dental work. Here is a quote from the Brux website; "*DO NOT use the Brux Night Guard if you have missing FRONT TEETH or wear braces, caps, crowns, veneers, implants, dentures, retainers or other external surface devices on your FRONT TEETH." Again, serious complications can come from these over-the-counter night guards. A personal story; I will be the first to admit that I didn't take the advice of my dentist I had in my teenage years. He recommended that I get a night guard because there was evidence that I was clenching and grinding my teeth. Because both the dentist and dental hygienist did not take the time to explain the importance of wearing a night guard or explain the consequences of not wearing it, I didn't value the importance of getting one and I did not want to shell out hundreds of dollars to get one. Because of the lack of explanation, it cost me dearly. I have ground down my molars so they are essentially flat, and I have both cracked and chipped my teeth. In my first year of dental hygiene school, I realized the importance of having a night guard and wearing it to prevent tooth damage and long term issues. That is why I am so passionate about taking the time to explain the importance of wearing a high quality night guard made by a dentist, and what consequences there are by wearing one that is inadequate and will cause long term damage. Have a night guard professionally made by a dentist There is a reason why dental professionals make night guards. PLEASE do not take the cheaper route, because not only can it be detrimental to your bite, your overall smile appearance, it can cause cracking, chips, dental abscesses, and so many other dental issues! A properly made dental night guard should cover all the teeth, and when biting down, all opposing teeth touch the night guard. It is imperative to provide an even distribution of clenching and grinding forces. I'm not too fond of Brux night guards, especially when they claim to be better than a professionally made night guard by a dentist who has gone to school for many years to provide the best quality treatment to the patient. Also, I don't particularly appreciate how they claim that night guards are not covered by dental insurance. In Canada, most insurance companies will cover night guards because they play a vital role in preventing more severe and more expensive dental procedures (that the insurance will have to pay out). What we do at our office is send an estimate to the patient's dental insurance, who will evaluate the estimate and tell the patient how much will be covered by them, so the patient will know how much they will need to pay out of pocket. Read Now: Perfect Bite: How Teeth Should Line up and Come Together Scientific case report of inadequete coverage of night guard This article from the British Dental Journal depicts a case study of a patient who had significant bite issues after wearing a night guard that didn't have the proper coverage on all teeth. Her teeth did not touch equally on the night guard, resulting in over-eruption of teeth, causing an open bite, where the teeth could no longer bite fully together. Any device (including a night guard) that will be used for a prolonged amount of time must cover all the biting surfaces, and when the teeth bite together, all teeth are touching and applying equal force. "the selective over-eruption of posterior teeth not incorporated in the appliance can lead to the development of an anterior open bite"https://www.nature.com/articles/sj.bdj.2011.46 What is the best night guard for teeth grinding? I have patients who sit in my dental chair and recommend a night guard, but they too do not want to shell out the money for one because they do not see the value. The best night guard for teeth grinding covers all occlusal surfaces, and when biting down with opposite arch, all teeth come into contact with the night guard with equal pressure forces. A professional made night guard at the dentist is the best option Having a dentist make a night guard for you takes all steps to ensure you are getting a properly made dental appliance. Moulds of the teeth are taken, or a scan of your teeth will propagate a digital 3D model of the teeth (that is how I got mine made). These models, be it physical or digital, are used to create an exact cast of your teeth that the night guard will be made on. This allows the night guard to be an extremely accurate match to your mouth and be firm in place when placed in the mouth. When the night guard has been made, the dentist will bring you in for an appointment to try in your night guard. The dentist should check that all teeth hit the night guard at equal pressure. They may even use articulating paper (think graphite/carbon paper but safe for the mouth) to check the bite and make slight adjustments with a dental drill. Read Now: How Dental Hygienists Clean Teeth! What You Need to Know! They will also give you tailored advice depending on the material used to make the night guard, which is priceless! Maintaining the night guard will allow it to last for a long time. But what if a professionally made night guard isn't an option for somebody. Sometimes there are issues with access to care, and money is a factor. The best over-the-counter night guard for teeth grinding The best over-the-counter night guard for teeth grinding is one that will cover all the teeth on either the bottom or top arch and all opposing teeth touch when biting. It should be moldable to the teeth, providing a custom fit. Boil and bite are the best because they cover these criteria. I have patients who cannot afford a professionally made night guard, and I get them to bring in their over-the-counter night guard at their hygiene appointments to check for defects or issues that may need to be brought up with the patient. I still want them to have the best they can get! The over-the-counter night guard that I recommend to my patients can be found on Amazon. It is the DenTek Professional-Fit, Maximum Protection. This night guard is FDA registered device, BPA free and made in the USA! It comes with a patented fitting tray, an antimicrobial storage case, and a moldable night guard. No matter what night guard you are using, you must regularly see a dental professional and check it for defects that could lead to dental issues. Some medical conditions like sleep apnea might also contraindicate the use of a night guard. Check with your doctor and dentist to discuss any medical conditions you have. I hope this information finds you well, and I have helped you find the information you were looking for! Have a wonderful day, Holly :)