Custom nightguard to fit over my braces

[Mylene]

Does anyone else have a nightguard for night grinding? I have had really bad bruxism for over 20 years - root canals, cracked teeth, worn down teeth, you name it. Thousands of dollars later and years of excruciating pain and lack of sleep later, my dentist told me that one reason I may have bad grinding is because of poor alignment. I was also getting chipped front teeth because my upper and lower teeth weren't meeting properly, due to alignment issues. To save my teeth from being chipped off, I decided to get braces. It's so frustrating, because I do anything possible to preserve my teeth, but I have this unconscious habit that destroyed them in my sleep... I had been wearing nightguards the past couple of years, but I swear they make me grind even more.

During the consult, my ortho told me that, since my custom-fitted nightguard wouldn't work once I had braces put on, I wasn't going to have one at all. I insisted on having one, since even one bad grinding session can crack a tooth, and I wasn't going to risk something that painful and permanent just because he didn't think I needed it... So he caved and custom-fitted a nightguard for me. It's really uncomfortable; the big wires fit up over my top braces, and the middle "bite" part keeps my front teeth from touching, which doesn't allow the back molars to touch. I have heard bad things about that type of nightguard (permanent jaw misalignment), but at this point, since I'm seeing my ortho monthly, he's monitoring my progress and at least I don't go to sleep afraid I'll break a tooth grinding it. Last month I also bought a SleepGuard biofeedback headband, which has really scaled back my grinding, so I'm not even waking up in pain anymore. (I'm publishing the results of my trial if anyone wants to check out my blog: http://www.sevinsense.com.) So, I'm wearing the custom nightguard and biofeedback headband; I basically look like an alien when I go to bed at night now. My teeth are being saved, but I sure look weird.

Does anyone else have a custom-fitted nightguard that goes over your braces? I'm wondering if there's a "better" design that would be more comfortable that I could recommend to my ortho...

Thanks!

[Jerseygirl]

I'm a grinder - have lost two bottom molars to a bad bite and I guess possibly grinding.

Prior to being braced I saw many orthos for consults as well as general dentists about my TMJ and I spent thousands on splints/guards etc.

Never did anyone suggest I could get a guard while being braced - I'd ask and they all said nope. Interesting about yours and great someone found a solution for you!

[Mylene]

I'm a grinder - have lost two bottom molars to a bad bite and I guess possibly grinding.

Prior to being braced I saw many orthos for consults as well as general dentists about my TMJ and I spent thousands on splints/guards etc.

Never did anyone suggest I could get a guard while being braced - I'd ask and they all said nope. Interesting about yours and great someone found a solution for you!

Hi Jerseygirl,
Isn't it hard when medical professionals don't respond to your concerns? They didn't want me to have one, I INSISTED on it, or I wasn't going to cough up the $4100 for the braces - then all of a sudden it became a possibility. It's uncomfortable, but hey, if I'm going to spend that much on my teeth I might as well keep them, right?

Fortunately, with the SleepGuard headband I'm even sleeping through the night and not grinding as much as I used to - hopefully over time it will get to the point where I won't feel the need to wear a nightguard anymore... crossing my fingers!

[Jerseygirl]

Good luck - that is GREAT it is working so well for you!!!! Yes - sometimes we have to be our own best advocates! Please keep us posted on how well you continue to do!

[Mylene]

In case you're interested, here are the different posts I have written about my trials:

http://sevinsense.com/blog/bruxism-a.k. ... 8gx4rBDyrk
http://sevinsense.com/blog/sleepguard-s ... 8gx97BDyrk
http://sevinsense.com/blog/sleepguard-s ... 8gyCLBDyrk
http://sevinsense.com/index.php/blog/sl ... 8gyGbBDyrk

I'll keep updating on my blog. I wish I had the SleepGuard System 20 years ago - I would have saved tons of $$$ and even more grief...

[Jerseygirl]

Very interesting about the biofeedback headband. Your bruxism and grinding sounds more involved than mine - it's great that you've found relief with the combo treatment! Good for you!

[Mylene]

Thanks, jerseygirl!

[Mylene]

OK so now I'm super and

At my second adjustment last week, my ortho looked at my bite and told me that I can't wear the nightguard anymore - my bite is so screwed up by the nightguard that a number of my teeth can't touch anymore. I had heard about the dangers of a nightguard that blocks the front teeth from touching, that sometimes they damage a bite, but since I was being seen monthly, I trusted my ortho would be able to identify if there's a problem early on... anyway...

Now I'm worried my bite is permanently damaged. Does anyone have any words of advice?!?

[kreyFL]

So sorry to hear of your bite guard issues! I am a grinder too - which is the whole reason I got braced in the first place.

I went to a new dentist one day with terrible lock jaw type pain and found out I had been a long term sufferer of bruxism. Here I just thought I had a lot of tension and bad pillows, lol. I was fitted for a night guard and had immediate and instant relief. I never realized how bad it was until I got my night guard and saw the improvement of my quality of life - without the pain, tension, muscle spasms, chewed up tongue, etc. My dentist recommended I get braces. I had been grinding so bad with an ill fitting crown that I had created an open bite (pretty massive one too).

I was really worried about having braces and no bite guard. My dentist told me that he would construct something for me if it was "absolutely necessary" but that he advised against it. He said that my teeth would be moving so much that I may experience some discomfort every so often, but not like I had before my bite guard and that the braces would ultimately help with my grinding. Here I am, almost 2 years in and he was right.

Look, I had mornings in the beginning where life was miserable. Chewed tongue, sore neck and jaw and thought this is BS. But after about 6 months it literally went away. It would start happening only about 2 weeks after an adjustment, and only for a day or two. Now I hardly ever have jaw pain anymore and my tongue is becoming less and less of a victim of my night time chomping.

Once my ortho introduced rubber bands (which was about 7 months in for me) then I REALLY saw and felt a difference.

Everyone is different, and so is each case of bruxism. All I can suggest is to stick with the braces and NO bite guard, try and find little things to help relieve you until your braces really start to change things for you. If you are not on elastics already - try and find out when they will be incorporated and maybe ask that they be put on immediately.

The bite guard WILL affect how your ortho can address your bite - but nothing has been done that cannot be corrected so try not to be too upset about it.

I am opting for the Essex retainer (Invisalign style) solely because it will help with my bite issues and kind of serve as a night guard. Ortho says I will probably have to replace it every year as I may bite through it, but it will kill 2 birds with one stone.

Good luck to you - please keep us all posted.

[Mylene]

Thanks for replying.
What is the purpose of elastics?
How will my bite be fixed? Do you know?

[cavomington]

I'm in about the same situation. I'm 25, my teeth never looked bad enough on the outside to get braces even though my parents implored me to due to alignment issues. I've done terrible damage to my teeth via anxiety induced grinding, including losing one of my back molars to a root canal. I'm finally getting braces on Monday to try and keep my teeth healthy, but I know that my current grind guard won't fit then.

[Mylene]

So sorry to hear that! I have experienced huge relief with the sleepguard biofeedback headband, I grind/clench much much less now.

[kreyFL]

Thanks for replying.
What is the purpose of elastics?
How will my bite be fixed? Do you know?

Elastics help with the overall fit of your bite. YouTube has some great animated videos of how elastics can move open bites, over bites, re-alignment, etc. It really is neat to see.

Your nite grinding will subside the more your bite actually fits how it should. And I also felt that the elastics helped me keep my mouth shut - which kind of trained my brain to just keep it still I guess. The tension of the elastics really helped me, IMO.

[TMJJill]

I totally understand your worries.

I've worn various customized nighttime orthotics for over a decade. Originally they were to protect my teeth when I brux, then they were to keep me from bruxing at all (upper splint with beak in front and wedge behind my lower teeth), and now I've been wearing a lower mandibular repositioning splint for TMJD. I've had upper braces for 10 months with the lower splint. At night in addition to the splint, I've been wearing elastics from my lower back molar to my upper canine to hold my lower jaw forward while I sleep.

I'm finally getting my lower braces in a few weeks. I'm very nervous about the bruxing returning since I've had it under control for almost 2 years. The last 2 splints were very much like a safety blanket for me. My tmj orthodontist told me the good thing about the full set of braces is that he can use the elastics to help me with this. I'm putting a lot of trust in him for this.

I figure I'll need to pay a few visits to my PT as I transition. She is great at working my facial and neck muscles (myofacial pain) and doing orofacial trigger point releases. If you haven't ever heard of the trigger point releases, it might be worth looking into. The releases that have really helped me are the ones for the pterygoid and masseter muscle areas. Also, my orthodontist will also do as many ultrasound treatments as I want... I just have to take a couple hours off work and drive 45 minutes each way.

I'm wishing you well in getting your bite back in place. I know I still have a ways to go for mine, but I'm on the road for success.....

[Jerseygirl]

Your nite grinding will subside the more your bite actually fits how it should. And I also felt that the elastics helped me keep my mouth shut - which kind of trained my brain to just keep it still I guess. The tension of the elastics really helped me, IMO.

This is so very true and makes a great deal of sense!

I spent THOUSANDS of dollars on repositioning splints, nightguards etc - - and I used highly reputable doctors. But - in the end I look back and see much of what I spent as a big waste of money for my situation. And they all said we could try this or that but there really is no one specifiic treatment for all TMJD patients.

For me, my TMJD pain was attributable to stress but I also believe correcting my bite will help a great deal too! I was also told that some people with horrible bites never suffer with TMJD pain and others with perfect bites do have TMJD. So I guess it varies. I was never offered an option for a nightguard with my braces.

Bottom line for me, I am already getting relief from my TMJD (and not grinding as much) with my braces. I hope you find the same happens with you.