I don't think I grind my teeth. Why do I need a night guard?
The short answer
Most people who grind don't know they do it, because it happens while they're asleep. Dentists usually spot it from what it leaves behind: flattened or chipped teeth, cracks, worn fillings, or sore jaw muscles. Often a bed partner hears it first.
Signs your dentist looks for
- Flat, worn edges on teeth that should have points or bumps, especially the eyeteeth
- Chips, cracks, or broken fillings with no other clear cause
- Large, firm jaw muscles at the angle of the jaw
- Ridges on the inside of the cheeks or a scalloped edge on the tongue, from pressing against the teeth
- Wear on an existing night guard, crown, or filling
Signs you might notice
- A sore or tired jaw, or a dull headache, when you wake up
- Teeth that feel sensitive
- Someone who sleeps near you hears grinding or clicking. Clenching makes no sound, so sore muscles may be the only clue.
- Catching yourself clenching during the day, at the computer or while driving
Grinding while you sleep and clenching while you're awake are related but different habits. Both can wear and stress teeth.
Wear isn't always from grinding
Teeth can also wear from acid (from foods, drinks, or reflux) or from brushing too hard. These look different up close, and they're treated differently: a night guard won't help acid wear. If you're told you grind, it's fair to ask what tells your dentist it's grinding and not something else.
Some plans don't pay for fillings or crowns on teeth damaged by wear. See how plans handle worn teeth.
Is grinding a problem in itself?
Not always. Experts now describe grinding in otherwise healthy people as a habit rather than a disease. Lots of people grind a little with no harm. It becomes a reason for treatment when it's doing damage (wearing or breaking teeth, cracking fillings or crowns) or causing symptoms like jaw soreness.
That's why the most convincing reason for a night guard is something your dentist can show you: wear, a crack, or damage that's getting worse over time. Comparing photos or models from one visit to the next is a good way to see it.
Grinding and sleep
Grinding while you sleep is sometimes linked with sleep problems, including breathing problems during sleep. If you also snore loudly, wake up tired, or someone has noticed you stop breathing at night, mention it to your doctor. A night guard protects teeth, but it doesn't treat a sleep problem.
Questions to ask
- Can you show me the wear or damage you're seeing?
- How can you tell it's grinding and not acid or brushing wear?
- Is the wear getting worse? Do you have older photos or X-rays to compare?
- What could happen if I don't wear a guard?
- Should I mention my sleep or snoring to my doctor?
- Before we schedule, can I get my cost in writing? (A predetermination if I'm using insurance, or a good faith estimate if I'm paying myself.)
When a second opinion makes sense
Reasonable if a night guard is recommended and you can't see any wear or damage yourself, and you have no jaw soreness or other symptoms.