Advice needed about teeth grinding

Parent Cafe
1

<p>I have a problem with cracked teeth. My husband tells me I have always tapped my teeth at night (gee, wish he’d told me this earlier). The dentist said I have a bite problem that causes the grinding and thus the cracks. I have 2 choices.</p>

<li><p>I can get a night guard. This costs $500. It will prevent me from clenching/grinding/tapping my teeth at night.</p></li>
<li><p>I can get a splint, which is $1,400. This is a diagnostic tool. I’m not sure exactly how this works, but I see the dentist once a week for about a month, he makes adjustments in the splint, and this helps him figure out how to fix my bite. While this is happening, I wear the splint constantly (except when eating) – night and day.</p></li>
</ol>

<p>The most basic fix is a “simple” equilibration, which costs another $800. This involves filing down teeth so the bite improves. However, I may need much more – like breaking and resetting the jaw and putting in crowns and bridges, etc. If I decide against using these more extensive (and expensive) treatments (which I would), I can use the splint at night, which will serve the same purpose as the guard.</p>

<p>I don’t have headaches or muscle aches – just cracked teeth.</p>

<p>My inclination is to get the splint, do the diagnostics, but possibly don’t do anything immediately other than wear the splint at night. I figure this is a middle ground – if my bite continue to cause problems, at least we’re halfway to fixing it. If I get the night guard and then still have problems, then we are back at square one. </p>

<p>But, OTOH, I wonder if spending $900 less makes perfect sense and would solve my problem. (Insurance covers nothing – and I don’t have dental insurance anyway.)</p>

<p>So, I am turning to the vast wisdom here on CC, to find out if anyone here has experience with this issue and can advise me on the splint vs. night guard decision (or $1400+ vs. $500 decision).</p>

2

<p>While I don’t have any cracked teeth, I was having some achiness in my jaws from clenching during sleep. Got a night guard fitted several years ago, and it has helped tremendously. I miss it when I fall asleep somewhere other than my bed too soon, and don’t put it in when I get up and go to bed. I notice the difference in the morning. </p>

<p>You certainly want to take care of the cracked teeth, though, and that WILL run some big money for crowns.</p>

3

<p>My S used to grind his teeth. He got a night guard. No cracked teeth.</p>

4

<p>DW and D both had night clenching problems. Night guards helped both, and no further dental work was required. Five hundred bucks sounds a bit steep. Not much to them, kinda like a wimpy clear athletic mouthguard.</p>

5

<p>$500 is the usual patient share of one crown. Well worth it and the noise is horrible to hear when you are trying to sleep. Worse than snoring. Get it now.</p>

6

<p>I agree with NewHope33 – try a simple athletic mouthguard you can purchase in any sports store. They’re clear & plastic, and you get them to mold to your teeth by first softenting them in hot water.</p>

7

<p>Gosh, my dentist told me to go get a regular sports mouthguard and use that, and that worked. Way less than $500!</p>

8

<p>I cracked two teeth by clenching/grinding at night and had to have crowns made. Ouch. I then ha night guard made and have had no further problems, but I did wear through it in about four years, which shows the extent of my clenching, I guess. Since insurance didn’t cover night guards, I have gone almost a year without one – but when I woke up with achy teeth last week I got an appointment to have an impression made for a new guard. This one (managed care practice) will cost $280. I swear when I inquired about the price a year ago they quoted $400, but I wasn’t about to mention that when they charged me $280 this time.</p>

9

<p>I’ve gotten 2 crowns plus a root canal in the last year, so I am quite aware of the cost. Right now my other teeth aren’t bothering me to get them crowned.</p>

<p>Just to be clear – I am definitely doing something. That is a given; I don’t have to be convinced. The question is whether anyone feels I should spend the $1400 on the splint/diagnostic treatment, or if that’s excessive and just the dentist trying to create work for himself.</p>

10

<p>Where did you get your DDS? I’d go with the dentist…the money is insignificant, compared to potential problems…</p>

11

<p>I don’t have any expertise to offer, just personal experience. The splint option was never presented to me and I’m not familiar with it. The night guard was helpful. I have several friends who also have night guards, but no one has ever mentioned the splint. The dentist did do some grinding of tooth surfaces to improve my bite when I went in to have the new night guard impression taken the other day. The grinding just took a few minutes and didn’t seem like a big deal, but I have a sense that my bite is “better” now. Any alignment problems were minimal, though, so your situation could be quite different.</p>

12

<p>Sounds like you have a diligent dentist. Only a small percentage of general dentists feel comfortable offering splint therapy and equilibration. This is a somewhat controversial area that I’ve studied quite extensively (I am a restorative dentist). I have been making full nightguards and bite splints and equilibrating bites for almost twenty years. Equilibration will help balance the forces on your teeth making them less likely to crack, but no guarantees that it will stop your nocturnal grinding. A few years ago,I switched to the NTI plus for most of my bruxism (clenching & grinding) and TMD patients. I also use it as a diagnostic appliance for bite analysis. You can read more about it here: [HeadAchePrevention.com</a> - How it works](<a href=“http://www.headacheprevention.com/index.php?option=com_content&task=view&id=13&Itemid=29]HeadAchePrevention.com”>http://www.headacheprevention.com/index.php?option=com_content&task=view&id=13&Itemid=29)</p>

<p>Sorry to throw some additional complexity into the mix. To specifically answer your original question: If you went with the splint, would you be motivated to wear it 24/7 (except while eating)? If yes, it may be worth it. If no, just go with the nighttime appliance.</p>

13

<p>My DH got the nightguard for around $400. It looks like invisalign orthadontia, very small, fits right over your teeth and clear. An athletic mouth guard would be bigger & bulkier and maybe a bit inclined to cause you to gag?? It would be better than nothing.</p>

<p>I cannot speak to the splint, no experience, but with my pocketbook, I would likely try the less expensive option.</p>

14

<p>I had a teeth grinding appliance made … $300, but that was “back in the day”… it does work and wasn’t hard to get used to.</p>

<p>For some reason I lost or broke it… went without for a while. The dentist that suggested I get it retired and the new dentist didn’t mention my teeth…but now about a year ago, I lost a corner from teeth grinding sooo…</p>

<p>I went to Longs (local pharmacy) paid $20 for a fit it yourself dental appliance (you put it in hot water, then bite it)… and it works exactly as well as the expensive one from the dentist. AND I like it better because it is softer, rubberier and the dentist one is hard, like a retainer.</p>

<p>So I’d suggest trying out the cheap one first for sure. FYI, in both cases, it took about ONE week to get used to it (for me) to fall asleep just like usual. </p>

<p>Did crack DH and I up tho’ because I’d leave my “dentures” on the night stand for …er… certain nights, so I could pop them in …er…later. Felt very very old…</p>

15

<p>Thanks audiophile. It’s good to know that someone out there thinks my dentist is “diligent.” It’s hard to know if I’d wear the splint 24/7 until I actually get it. And I’m curious – what makes this “controversial”? My dentist sent me to [Pankey</a> Institute : Continuing Dental Education](<a href=“http://www.pankey.org%5DPankey”>http://www.pankey.org), which I guess is where he trained. </p>

<p>I may decide to get a second opinion. I will go get an over-the-counter device as a stop-gap measure to use before I get whatever I get from the dentist.</p>

16

<p>I had a feeling your dentist went to the Pankey Institute from your description of the process. I am also a Pankey trained dentist, having spent a total of more than seven weeks there, starting in 1987 where I had the honor of meeting Dr. Pankey himself before he passed away. “The Pankey Philosophy” involves being a continual student and providing excellence in both diagnosis and treatment to your patients without regard to personal gain. Going to “The Institute” involves so much more than just learning new techniques. It is a significant educational commitment for your dentist to make and speaks highly of him (can you tell I’m biased?). </p>

<p>The controversy is not with the nightguard, but with the different splint designs. You should see the fights on the dental discussion boards about this! Most splints placed with attention to detail will work, it comes down to what your dentist has had success with. </p>

<p>I don’t think there’s any comparison between an OTC guard and one carefully adjusted and placed by a dentist (can you tell I’m biased there too?). I have encouraged my patients who are skeptical or can’t afford one of mine to try a boil and bite. I typically find that they only wear it for a few weeks, if that, whereas the ones I make can be successfully worn for years.</p>

17

<p>I had a nightguard many years ago. Eventually, I stopped grinding my teeth. I think the presence of it in my mouth worked like a behavior modification device (in my non professional opinion.)</p>

18

<p>Grinding, also known as bruxism, can lead to extensive damage of your teeth. I should know–I grinded (ground?) my teeth for many years, and wore down the contact surfaces and broke several in the process. I had extensive dental work about 8 years ago that included gum surgery to lower/raise the gum line and crowns on almost every tooth in my mouth (maybe $30,000, most not covered by insurance). Since then I have worn my dentist-provided night guard religiously (no exceptions) and everything seems to be stable.</p>

<p>I always found the cheap athletic teeth guards too bulky to wear comfortably at night (I’m a light sleeper), and even some of the ones I got from dentists were not comfortable, so I didn’t wear them (big mistake). The one I have now cost about $300-400 (probably because of taking the impressions), but is fairly thin and comfortable–well worth the investment, given the alternative.</p>

<p>According to my prosthodontist (the guy who put in all my crowns), grinding at night is just a way that some people relieve stress, so it’s not uncommon to do it for your entire life. He also said the number one occupation for people with grinding damage, in his experience–lawyers!</p>

<p>So I consider myself a poster child for teeth grinding. My advice–get on top of the problem, have your teeth fixed, and then wear a comfortable night guard every night, without exception.</p>

19

<p>I had a night grinding/clenching problem for years. Each time my dentist checked my teeth, he would tease me about my “working mom stress” and suggest a night guard to protect my teeth. After having five crowns over a period of three years (only 50% covered by my dental insurance) I finally decided to have one made for me. One appointment to get my tooth impressions done and the other to fit it on me and make sure I knew how to put it on and take it off. I don’t know why I waited so long. I think I kept putting it off because I envisioned the night guard to be something like an athletic mouth guard and did not like the thought of something so big in my mouth at night. Instead, it ended up being a small clear plastic device that was custom molded to snap onto four of my top front teeth. It took me a few days to get used to it - early on I actually took it off in my sleep a couple times and tossed it. Lots of fun the next morning on hands and knees looking on the floor and under the dresser for it ! But I got used to it quickly and have been wearing it for a couple years now. No more cracked teeth. I did have to have the dentist refit it recently as it got a bit loose- apparently my front teeth were “working on it” as the dentist put it and I wore down the custom fit of the plastic. </p>

<p>I have dental insurance which picked up a good deal of the cost but I remember looking at the itemized charge on my dental invoice and know it was not as much as $400. And it beats continuing to lose my teeth to grinding and clenching.</p>

20

<p>By all means buy the night guard. $500 is cheap to properly preserve your original tools into your 90s or later. :)</p>

<p>*Don’t forget to floss.</p>