While teeth grinding, or bruxism, caused by clenched jaw muscles, does occur while you’re awake, sleep bruxism is more difficult to treat, as many patients are unaware that they even have the problem. The issue is so common, though, that New York City dentist Dr. Lana Rozenberg says one in four of her patients’ teeth show some type of wear pattern consistent with grinding. It’s also often only detected when seeking treatment for symptoms like headaches, facial or jaw pain, or worn-down teeth, or if a bed partner notices the grinding sound.
And though teeth grinding was thought to be the result of jaw or teeth misalignment, Dr. Brent Larson, director of the division of orthodontics at the University of Minnesota School of Dentistry, says, “We’ve learned that’s really not the case. People are wired to be grinders, and if they’re grinders, there are certain things that can make it worse.” Among these exacerbating factors are stress and anxiety, caffeine, alcohol, and certain medications. Dr. Michael Gelb, who treats patients with TMJ, headaches, or sleep disorders at the Gelb Center, says there is new research that an airway disorder could also cause clenching. “So now, before you make a night guard, you’re ideally supposed to check your patient to make sure that they don’t have a breathing-related sleep disorder, like sleep apnea or snoring,” he says, as clenching could be a symptom of those things too. If you do suspect that you’re grinding your teeth at night, the best thing to do is visit the dentist for a full evaluation. In the meantime, or if your grinding is a problem associated with periods of high stress or poor sleep, dentists say over-the-counter mouth guards can be used as a short-term solution — our experts say two weeks to a month — but are not recommended for long-term use.
“The intent is certainly not to treat anything of complex nature,” says Dr. Donald Tanenbaum, a board-certified TMJ and orofacial pain specialist. “If somebody has a true problem within the joint itself — a click, a pop, a lock, a profound inflammation — these devices really have no usefulness and they really shouldn’t be used.” What they can do is “diminish the impact to the teeth.” If you think this is what you need, our experts say the over-the-counter mouth guards below can provide some relief.
Best overall mouthguard
Only a doctor can fit you for a custom mouth guard, but for the best-fitting OTC alternative, look for a “boil-and-bite” guard that molds to your teeth. “Put it in hot water [to] soften it, and then you bite into it, and it sets,” says Rozenberg. “When it sets, you can trim [the excess material], and now you have a semi-custom-fitted guard.” One of her favorite boil-and-bites is this one from Oral-B, which has a pleasant, minty flavor and can also be softened in the microwave. Dr. Tannenbaum prefers the microwaveable ones to traditional boil and bite because they are made from a “thinner, lighter, more moldable material.” Dr. Brijesh Chandwani, a dentist specializing in facial pain and jaw-joint disorders, also recommends the Oral-B guard.
This mouth guard also covers all the teeth, which makes it a safer option to partial appliances, because there is less of a chance that your teeth will shift – one of the risks of wearing an OTC guard long term, says Dr. Nojan Bakhtiari, a board certified TMJ and facial pain specialist. “Teeth are stupid,” he explains. “Teeth don’t know when to stop growing unless they touch something. One of the reasons your teeth don’t keep drifting out of your jaw bone is because they touch each other at nighttime. So when you wear partial coverage appliances, your teeth could potentially start shifting on you.”
Best no-boil night guard
Because they’re ready to use right out of the box, one-size night guards, like these Plackers ones chosen by Rozenberg, are a quicker solution than boil-and-bite guards — as long as they’re a comfortable fit for your mouth. Designed to be worn on either the upper or lower teeth, these are disposable but can be cleaned with Efferdent tablets, toothpaste, or soap and water between uses. Dr. Bakhtiari says soap, water, and a soft toothbrush is preferable as “toothpaste is just gonna scratch it up and then it’s gonna accumulate bacteria faster.”
Best adjustable no-boil night guard
With a slimmer design than some of the other popular guards, Rozenberg says this DenTek model offers just as much protection while possibly feeling more comfortable. And even though you can’t boil it or warm it up in the microwave to conform to your teeth, it does come with a five-point adjustable band for a better fit. However, if you have a sensitive gag reflex, it’s best to go with a professionally-made guard, as even these low-profile OTC versions still come into contact with the roof of the mouth, which can be irritating. Also, Dr. Bakhtiari warns that a partial guard that doesn’t conform to your teeth (ahem, this one) can become dislodged during the night, and back sleepers “have a risk of it moving it around to the back of the throat.”
Best mouth guard for daytime grinding
While it’s perfectly suitable for overnight use, one of the benefits of this boil-and-bite mouth guard is that it can be worn at times during the day when you’re prone to grinding — like while playing sports or at the gym. “When people work out and lift weights, a lot of time they clench their teeth,” says Rozenberg. “As the body tenses, the jaw tenses as well because it’s one of the muscles.”
Best mouth guard for sensitive teeth
Chandwani likes this microwavable guard because it only covers the back teeth and won’t bother sensitive front teeth. The snug fit prevents the guard from moving around during the night, which can make it uncomfortable to wear and disrupt sleep.
Best boil-and-bite mouth guards for snoring
Sometimes teeth grinding and clenching is more than just a sign of stress. “There’s an association that we’ve made recently between clenching at night, and a potential airway problem or sleep disorder,” says Gelb. If you think that the cause of your bruxing might be sleep apnea or snoring, Gelb recommends a mouth guard designed specifically for that, like this SnoreRx guard, which he says “potentially gets more at the root cause for their clenching and actually that would be better for their overall health.” Unlike the others on this list, this guard covers both the upper and lower teeth “which is great so you won’t wear down your teeth.”But it also prevents the lower jaw from dropping back during the night. “When your jaw doesn’t drop back at night it maintains more of an open airway, which hopefully would also reduce the bruxism,” he says. In addition to being a boil-and-bite guard, SnoreRx is also adjustable for even further customization, which means that “if you are snoring or you are clenched in one position, it has up to six millimeters of adjustability so the patient can find the most comfortable place to sleep for their jaw.”
This VitalSleep guard works very similar to the SnoreRx. It holds your jaw and tongue forward and covers all the upper and lower teeth. It also is a boil-and-bite design, but it has even more adjustability — up to eight millimeters. Plus, it comes in both men’s and women’s sizes, giving you a better fit from the start, since the women’s guard is 10 percent smaller than the men’s. With any of these guards that aim to fix an airway issue, Gelb recommends wearing them for only a month before seeking professional help.
Best tongue retainer
This isn’t a guard exactly, as it doesn’t cover any of the teeth, but if your grinding is snoring-related, this tongue retention device will help keep your airways open. “It pulls the tongue forward at night, and by pulling the tongue forward, it opens the airway,” Gelb says. He also suggests a mouthpiece like this for people with large tongues or dentures.
Best tongue-retaining mouth guard
The Zyppah mouth guard combines both the traditional guard and the tongue retainer. “It controls the jaw and primarily the position of the tongue,” Gelb says. The guard has a tongue strap “that acts as a seatbelt and prevents your tongue from blocking your airway.” This is also customizable with boil-and-bite technology, but no further adjustments can be made.