While doctors recommend mouthguards for bruxism, they’re only a band-aid-fix. Considering bruxism is grinding teeth while we sleep, suggesting mouthguards makes some sense. They protect the teeth from scraping, cracking and breaking caused by night grinding. But mouthguards don’t cure bruxism itself and here lies the main issue.

Dentists and doctors who wholeheartedly suggest mouthguards as the universal solution to our problems are, in the long run, not helping bruxism sufferers. Because one problem solved does not solve all problems of bruxism.

While our teeth may be saved by mouthguards, the muscular and joint pain caused by bruxism continues to intensify. This pain can lead to further discomfort, starting with constant headaches during the day. Or long term jaw stress and discomfort as time goes on.

And mouthguards only reduce teeth grinding temporarily. When inserted, our body treats the mouthguard as a foreign object. So, grinding comes to a halt. But the more we use it (every night) the more comfortable our body becomes. With that, the grinding starts anew plus we still suffer from additional pain caused by bruxism.

As the accompanying literature review recounts, for a few weeks the splint (and most other intraoral devices) may be truly successful in stopping bruxism, but this is a temporary effect that may lull patients and dentists alike to the virtual uselessness of the splint over the long term (see also Harada et al., 2006) In particular, while the splint may provide some protection for the teeth, it does not stop bruxism nor such grave potential consequences as hearing loss and TMJ syndrome. Moreover, the splint itself may cause health problems (.e.g., "complications from long-term use of splints, however, can be severe and irreversible"--Widmalm, 1999).

Dr Moti Nissani’s bruxism page

Over-the-counter vs. Custom-made mouthguards

Anthony, from the Bruxhackers Mailing list, discusses the importance of using a custom-made mouthguards instead of over-the-counter mouthguards. “Over the counter mouthguards are fine as a temporary solution, but you really want a professional one, fitted by your dentist,” Anthony explains. “They are expensive, but insurance will occasionally pay for them. Either way, it’s worth the cost.”

Over-the-counter mouthguards are designed to fit the mouth of millions. They can be clunky, oversized, and a bad fit for your teeth. If they are, your teeth will not be protected during nightly grinding. What actually happens is the grinding continues but around the material that poorly fits your teeth.

The type of mouthguard material plays a role too. While a custom mouthguard will fit your teeth like a dream, the material it’s made from can lead to problems. A chewy material could worsen your bruxism; it can actually encourage teeth grinding. Which is the last thing we want from an expensive mouthguard.

Some have linked bruxism to sleep apnea. Our brain pushes our jaw forward each time we stop breathing during sleep. So by grinding our teeth, we open our airways. If you’re a nightly teeth grinder, chances are you have trouble breathing, which could be sleep apnea.

But mouthguards can pose a problem here: It can prevent the jaw from moving forward. So your airways can’t be opened, and you can’t breathe while you sleep. This causes your brain to try harder and force your jaws to work harder and grind more.

Ouch.

Why dentists push mouthguards as a solution to bruxism

Some dentists treat bruxism as purely a dental issue. Which is why they suggest mouthguards as the solution to the problem: it’s a clear way to protect our teeth from aggressive nightly grinding. But only protecting our teeth causes the dentist to ignore other issues of bruxism, such as muscle and jaw pain.

It’s quite a predicament when you have to educate your doctor about this connection. Carlos, from the Bruxhackers mailing list, wanted to research sleep studies related to bruxism then show the connection to his doctor. But he feared his doctor wouldn’t listen. He explains, “I think my doctor will stand with the mouthguard stuff and say that it’s the only way to deal with [bruxism].”

Dentists also tend to be quite dismissive of acknowledging the connection between teeth grinding and joint pain.

Also from the Bruxhackers mailing list, Lucy suffers from joint pain and wondered if she may have developed Temporomandibular Disorder (TMD), a disorder linked to teeth grinding and bruxism. “[My dentist] ignored my asking about TMD for several visits until finally I outright said, “I want a mouthguard.” Ironically, he loved explaining to me what the problem was but when it came to helping me, he made me feel there wasn’t much to be done.”

This is the problem with doctors and dentists ‘treating’ bruxism. They give the illusion only one product can help (i.e mouthguards) and, if they don’t work, we feel powerless to our bruxism symptoms. And if our doctors can’t see how bruxism causes more than just damage to our teeth, we can’t get proper treatment.

But we can bring research, medical journals, and other expert opinions to our health care professional. And we ought to do this whenever we can, especially if it seems they’re not listening to what we’re saying. Bruxism isn’t an inside-the-box illness so we have to get our doctors to think outside of it.

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