I have a night guard and my jaw still hurts. What now?

That is worth a proper evaluation rather than a new guard. Either the appliance is not addressing what is actually driving your symptoms, or the diagnosis it was made against was incomplete.

Are drugstore night guards safe?

For short-term tooth protection they are usually harmless. Worn nightly for long periods, they can allow unwanted tooth movement and can increase muscle activity through uneven contact. They are not appropriate for treating jaw pain.

What is the best mouthguard for grinding teeth at night?

The best one is the one designed for the reason you grind. A thin, hard, custom-fitted upper guard is a reasonable default for simple wear protection; a soft drugstore guard often increases clenching; and if grinding is a response to airway obstruction, the right device is a mandibular advancement appliance rather than a guard at all.

Can a night guard make TMJ worse?

Yes, particularly soft or bulky over-the-counter guards, which give the muscles something to squeeze, and any guard that changes where the jaw rests without accounting for the joint. A guard should reduce muscle activity and joint load, and if it does not you should be re-evaluated.

Do I need a night guard or a sleep apnea appliance?

They look similar and do opposite things: a guard separates the teeth; a sleep appliance holds the lower jaw forward to keep the airway open. If you grind and also snore, wake tired or have been told you stop breathing at night, get the airway assessed before choosing.

How long does a custom night guard last?

Typically several years, depending on how hard you grind and how well it is maintained. A guard that wears through, cracks, or no longer seats is a sign either that it needs remaking or that the underlying grinding is not being addressed.

Night Guards and Mouthguards for Grinding Teeth

A night guard and a therapeutic orthotic are not the same device, even though they look similar and both go in at bedtime. Conflating them is one of the most common reasons people arrive saying they already tried a guard and it did not help — or made things worse. What the guard is protecting against — clenching and grinding — often has an airway cause that a guard alone leaves untouched.

What a protective guard actually does

A standard night guard is designed to protect teeth from wear. It puts a layer of acrylic between the arches so grinding damages the appliance instead of enamel. That is a legitimate and useful job. What it does not do is change where the jaw sits, unload the joint, or reduce the muscle activity driving the grinding.

What a therapeutic orthotic is for

An orthotic is designed and adjusted to hold the jaw in a specific position — one chosen to take load off the joint and let the muscles release. It is fitted to a diagnosis, adjusted over time as the muscles change, and its position is a clinical decision rather than a byproduct of the impression. That is why it requires a workup first.

How the wrong appliance makes things worse

Over-the-counter boil-and-bite guards are the clearest example. They are bulky, they contact unevenly, and an uneven contact gives the muscles something to push against — which can increase clenching rather than reduce it. Guards that cover only some teeth can also allow unopposed teeth to move over months of nightly wear. A guard that has never been adjusted after fitting is worth re-evaluating.

When a simple guard is the right answer

If your only issue is tooth wear from grinding, with no pain, no joint noise, no limitation and no morning headache, a well-made protective guard may be exactly what you need. The problem is not guards. The problem is using a protective device to treat a joint disorder.

Getting a mouthguard for grinding made in New York

A guard that is right for you is made from a diagnosis: is the grinding a habit, a response to an unstable bite, or a sign of an airway problem during sleep? The answer changes the design, and it is why the same appliance can help one person and worsen another. In this practice appliances are designed and adjusted in-house, so refinement happens week to week as your muscles and joint respond. New York patients begin with a virtual consultation with TMJ specialist in New York City; if grinding is accompanied by snoring, gasping or unrefreshing sleep, the airway is evaluated first — see sleep apnea dentist in New York City.

Common questions

I have a night guard and my jaw still hurts. What now?: That is worth a proper evaluation rather than a new guard. Either the appliance is not addressing what is actually driving your symptoms, or the diagnosis it was made against was incomplete.
Are drugstore night guards safe?: For short-term tooth protection they are usually harmless. Worn nightly for long periods, they can allow unwanted tooth movement and can increase muscle activity through uneven contact. They are not appropriate for treating jaw pain.
What is the best mouthguard for grinding teeth at night?: The best one is the one designed for the reason you grind. A thin, hard, custom-fitted upper guard is a reasonable default for simple wear protection; a soft drugstore guard often increases clenching; and if grinding is a response to airway obstruction, the right device is a mandibular advancement appliance rather than a guard at all.
Can a night guard make TMJ worse?: Yes, particularly soft or bulky over-the-counter guards, which give the muscles something to squeeze, and any guard that changes where the jaw rests without accounting for the joint. A guard should reduce muscle activity and joint load, and if it does not you should be re-evaluated.
Do I need a night guard or a sleep apnea appliance?: They look similar and do opposite things: a guard separates the teeth; a sleep appliance holds the lower jaw forward to keep the airway open. If you grind and also snore, wake tired or have been told you stop breathing at night, get the airway assessed before choosing.
How long does a custom night guard last?: Typically several years, depending on how hard you grind and how well it is maintained. A guard that wears through, cracks, or no longer seats is a sign either that it needs remaking or that the underlying grinding is not being addressed.

Not sure where to start?

Request a virtual consultation with Dr. Samadian. In-person visits are by appointment in New York.

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Patients of Dr. Samadian

Written by patients treated across the Dion Health practices.

“I found myself dealing with a number of medical issues that I had no idea were so directly tied to my sense of oral wellbeing. The professionals at Dion Health helped me resolve my clenching and grinding, leading to better sleep and a more enjoyable lifestyle.”
Dianne M.

“When I'm dealing with a run-of-the-mill dental issue—or need something more serious like an implant, bridge, or crown—I know I can trust the Dion Health network to provide me with the most advanced techniques, for results that last.”
Kesha W.

“Showing off a glowing smile has me feeling more confident than I've ever felt in my life. Dion Health has fully rehabilitated my smile, resolving all my cosmetic issues with long-term solutions and helping me enjoy the self-esteem I deserve.”
Justin A.

Real patient stories

Patients Dr. Samadian has treated describe their experience in their own words.

Lindsay — TMJ patient
Olivia — TMJ patient
Chihiro — TMJ patient

Testimonials reflect the experiences of individual patients. Individual results vary.

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