Common Night Guard Side Effects (and How to Prevent Them)

For many people, night guards offer relief from jaw pain, headaches, and other issues related to clenching and grinding. But can a night guard cause problems or make certain issues worse?

It may not be the norm, but for some people, night guards can exacerbate bruxism symptoms or cause new issues to develop. While this typically is a matter of wearing the wrong night guard for your needs, it is still something to be aware of. That’s why we’re taking a look at potential night guard side effects — and how you can prevent them.

A Primer on Night Guards

Bruxism — the unconscious clenching and grinding of the teeth — can lead to various health problems. From constant headaches to cracked molars, unchecked bruxism can be painful. So, how do you bring it in check?

There are multiple treatment options available, but the go-to is wearing a night guard. These removable dental appliances prevent the teeth from coming together. While you can technically still clench and grind, this barrier should stop damage to the teeth and take pressure off the jaw joints.

Night guards are not one-size-fits-all. In addition to getting better results from custom appliances (which you can get from a dentist or online), you need the right type of guard for your bruxism. The four most common types of guards are:

• Soft Night Guards: Somewhat gummy and flexible, these work for mild-to-moderate clenching and light grinding.
• Single-Layer Hard Night Guards: Because these are thin, they are great for those with daytime bruxism. They also work for light grinding at night.
• Dual Laminate Night Guards: Featuring a soft inner layer encased by a hard outer shell, this type is best for heavy grinding and moderate clenching.
• Hard Flexible Night Guards: Ideal for the most powerful clenching and grinding, these guards are strong but have slight flexibility for greater jaw comfort.

Night guards need daily care and you should replace them whenever you see signs of wear. Depending on the type you get and the severity of your bruxism, you may need to replace yours as little as every five years or as often as every three months.

Common Night Guard Side Effects

Most people who wear night guards don’t have any problems and get relief from their symptoms. But some have side effects and might even develop new issues.

One problem with wearing a night guard is that many people buy over-the-counter, generic night guards. While those appliances have their place, many can vary so much in size that it’s impossible for one size to fit all.

Remember: any appliance that doesn’t fit well doesn’t protect your teeth. In fact, the opposite is often true. Let’s explore some of the side effects people have reported.

Shifting Teeth

If your night guard isn’t custom-fitted to your mouth, your teeth might shift out of place. Using one that only covers your back teeth might cause them to shift because the force of your clenching and grinding isn’t evenly dispersed among all your teeth, only a few. In the same vein, certain specialty appliances only cover your front teeth. These appliances can cause front teeth to shift because the pressure is too much for their roots.

Irritated Cheeks, Lips, and Gums

Some night guards that aren’t made to fit your mouth can rub your cheeks or tongue, causing sore spots. If they aren’t trimmed well, they can also cut your delicate oral tissues. Most night guards only come halfway up the tooth, but if yours is too big, it might touch and irritate your gums.

Worse TMJ Symptoms

It’s important to remember that night guards don’t cure the cause of temporomandibular joint (TMJ) pain; they only help relax the muscles and protect your teeth from the damage of clenching and grinding. Sometimes, while you’re asleep and unaware, your lower jaw might jut forward and slide your bottom teeth over the front of the night guard, creating a bite like a bulldog. This strains the jaw joint and can cause pain, headaches, and difficulty chewing.

Bite Changes

If your teeth are shifting because you’re wearing a night guard that doesn’t fit, it may also change your bite. Some night guards bought online or in stores have no way to properly fit your teeth. An ill-fitting night guard can actually change your bite, causing pain in your jaw.

Gag Reflex

Some people have a strong gag reflex that makes wearing an appliance unbearable, especially a one-size-fits-all style that is designed to fit the widest variety of mouths. It’s often because they are too long or too high and cover part of the soft palate — the back part of the roof of your mouth.

Tooth Pain

Tooth pain can occur if you’ve been clenching on one side or one spot more than another. If you’re wearing a night guard, this might make a couple of teeth sore or sensitive. But sometimes, it’s the appliance itself that puts pressure on one or more teeth unevenly. This usually happens with an ill-fitting night guard but can happen with one that’s custom-made too.

Increased Clenching and Grinding

Some bruxism appliances have been found to increase clenching and grinding. In many cases, soft guards cause people to chew on them while they sleep. Many dentists have moved away from recommending upper night guards because some styles allow contact on the back teeth but create an open gap between the front teeth. This causes an uneven bite and can lead to even more clenching, grinding, and TMJ problems.

Cavities and Periodontal (Gum) Problems

As with any oral appliance, you have to take care of it (and your mouth) to keep your teeth healthy. Failing to brush your teeth for two minutes twice a day, floss once a day, and brush your night guard with a toothbrush and toothpaste daily can cause bacteria and plaque to build up. When plaque builds up, you increase your risk of getting a cavity and developing periodontal disease.

Bad Breath

Bacteria causes odors, and if you don’t clean your night guard regularly, it can get smelly fast. Brushing your night guard when you take it out of your mouth can help keep it clean and bacteria-free. Another cause of stinky night guards is not brushing your teeth well before putting it in your mouth. Food particles can get trapped inside, and without contact with saliva to rinse them away, they can grow bacteria.

Preventing Problems

Ideally, you’ll never experience any of these side effects. The good news is that quite a few of them are well within your control. For the side effects caused by that can be avoided, here are some ways to minimize your risk of developing any severe issues:

1. Take Care of Your Appliance: One of the best ways to keep your night guard clean is to brush it with a soft-bristled toothbrush and a little non-abrasive toothpaste when you take it out in the morning. Make sure you lay it on a clean, dry surface until it’s dry, and then store it in its case. Every couple of weeks, soak your night guard in water for up to 30 minutes with a denture-cleaning tablet.
2. Practice Good Oral Hygiene: Brushing for two minutes twice a day and flossing at least once a day can keep cavities and gum disease at bay. By keeping your mouth clean, you minimize transferring bacteria to your night guard, where it can stay pressed against your teeth all night. Seeing your dentist for regular cleanings and exams can also help detect small problems early, when they’re easier and less expensive to repair.
3. Make Sure It Fits Properly: By choosing a night guard that fits well, you can eliminate many potential side effects. If it doesn’t, talk to your dentist about a custom night guard that’s made to fit an impression of your teeth. Custom night guards can also be bought online. They will send you a kit and instructions to take your own impressions and they’ll make you a custom night guard, often for much less than a dental office. Make sure you choose a company with many positive reviews, like one of the ones in our guide to the five best online night guards.
4. Schedule a Consultation With Your Dentist: If you clench or grind your teeth or wake up with tooth pain, jaw pain, or headaches, we suggest scheduling an appointment with your dentist. They will be able to examine your mouth and determine the cause of your discomfort and recommend treatment options.

Final Thoughts

A night guard can be an easy way to get relief from clenching and grinding. But, it might also cause side effects that make your discomfort worse. By scheduling an appointment for an exam with your dentist, choosing a night guard that fits well, and caring for it properly, you can relax those muscles and get the rest you need.