There are so many different appliances that can boost your oral health — aligners and braces for straight teeth, mouthguards for sports protection, even dental implants for gum and bone preservation. And with so many options on the market, it can be hard to keep things straight.
Two appliances people often confuse for each other? Retainers and night guards. While they look similar in some cases, these appliances are unique in their function and design. In this article, we’re breaking down the differences between retainers and night guards so you can feel empowered in your oral healthcare decisions.
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Retainers vs. Night Guards: What’s the Difference?
How are retainers and night guards different? Let us count the ways! While we admit that aligner-style retainers and thin, rigid night guards are close to identical, when you look at the full range of options, the differences become clear. Here are the most important ways retainers and night guards differ.
Function
This is the most important difference between these two appliance types. Retainers are meant to retain tooth position after orthodontic treatment. When worn, they hold the teeth in their ideal locations, preventing them from shifting back to where they were. They can be worn 24/7 or just at night and are usually worn on both arches.
Night guards are meant to offer bruxism protection to the teeth and jaw joint. Or, put another way, they are meant for people who clench and grind their teeth, creating both a barrier between the teeth and a cushion for the jaw joint. This reduces wear and tear as well as pain. While they are called night guards, some models are also designed for daytime wear. Typically, you only wear one night guard at a time.
Types
There are three primary types of retainers: Hawley, aligner-style (Essix), and fixed.
- Hawley Retainers: Hawley retainers have an acrylic base that covers the roof of the mouth when placed on the upper arch or covers the back of the teeth when placed on the lower one. Wires attach to the acrylic base and run around the teeth, holding them in place.
- Aligner-Style Retainers: As you’d expect, these look just like aligners. In fact, if you get these retainers after aligner treatment, they should be shaped exactly like the last set you wore. The difference is that they are meant to be worn for about six months rather than 1–2 weeks so they are a bit thicker.
- Fixed Retainers: Also called bonded retainers, these are wires that are cemented to the backs of the teeth. This keeps them out of sight and ensures patient compliance but does require care similar to braces when it comes to eating, brushing, and flossing.
Like retainers, night guards also come in different styles. The four main types are:
- Soft Night guards: These have a slightly gummy texture, so they give a bit when you bite into them. They are usually around 3mm thick and are ideal for clenching or light grinding.
- Single-Layer Hard Night guards: Also known as the retainer-style night guard, these are the reason people are confused about these two appliances. They are generally 1mm thick or less and are best for mild clenching and grinding or daytime bruxism.
- Dual Laminate Night guards: These guards combine two materials to help with heavy grinding and moderate clenching. The inner layer is soft and 1mm thick while the outer layer is rigid and 2mm thick.
- Hard Flexible Night Guards: If your bruxism is severe, you most likely need a hard flexible night guard. These are about three millimeters thick. The material is dense and strong, so it is hard to bite through, but it still has enough flexibility that it is gentle on the teeth and joints.
As you can see, the only real overlap is between retainers and single-layer hard night guards. And in truth, these two can be interchangeable, depending on how severe your bruxism is and the durability of your retainer. If you already have an Essix retainer, ask your dentist or orthodontist if it can also help with your bruxism.
Cost, Insurance Coverage, & Financing
When appliances have different designs, functions, and materials, they naturally have different price points. You might also find that your insurance treats them differently. Overall, though, cost, insurance coverage, and financing are pretty similar for retainers and night guards.
Cost
The typical costs for retainers vary significantly based on type. Hawley retainers usually have a price point of $350–$600 per arch. Aligner-style retainers are generally cheaper at $150–$500 per arch. Bonded retainers are in the middle at $200–$500 per arch.
There are a few companies offering remote retainers for about half the cost of in-office options, so if you find these prices to be a bit high, you might want to look into mail-order retainers.
The mail-order night guard industry is more robust. Most companies offer between two and six different models with prices ranging from $90 to $200. Quite a few also offer subscriptions, delivering a fresh guard every 3–6 months. If you go this route, you can significantly reduce the cost per guard.
You can also get a guard from your dentist, but these tend to be quite a bit more expensive. On the low end, expect to pay around $300 but some in-office night guards cost $1,000 or more.
Insurance Coverage
With either type of appliance, insurance coverage varies between companies and policies. In general, if your orthodontic treatment was covered, at least one set of retainers should be as well. However, many policies don’t extend orthodontic coverage to adults or restrict it to cases where alignment problems were harming overall oral health. This means their willingness to pay for retainers might vary based on the age you finish treatment and if they consider your case cosmetic.
More and more policies are paying for night guards, at least partially — you might need to foot the bill for 50% or more if you have coverage. To get yours covered, you may need to be evaluated by a dental professional so they can verify that you have a medical need.
FSA and HSA Eligibility
In many cases, FSA and HSA administrators will allow you to apply your funds towards retainers and night guards. Just verify this before you buy. If you have a card associated with your account, you can use it at the time of payment. If you don’t, make your purchase and then apply for reimbursement.
Financing
Some dental offices and online retailers may offer third-party financing or allow you to divide the cost of retainers and night guards into a few equal payments. If this is essential for you, verify your options in advance.
How Long Do They Last?
They say nothing lasts forever, and that applies to retainers and night guards as well. So when you are looking at costs and comparing these two appliances, lifespan is something to keep in mind.
Retainers
How long a retainer lasts depends on a few things: the material it’s made of, how well the appliance is taken care of, and how much it’s used.
A Hawley retainer can last 5–10 years if you clean it regularly and take it out every time you eat. If it does have minor damage, your dentist or orthodontist might be able to repair it.
Essix retainers are a little more delicate in that they can’t be repaired. So if you break one, it’ll need to be replaced. If you take care of your clear retainers and follow your doctor’s instructions, a clear retainer will typically last 6–12 months.
A fixed retainer is the longest-lasting because it’s cemented into place. This makes it hard to break or damage. But, that also means it’s the most difficult to keep clean. If you don’t clean around the retainer at least once a day, plaque can build up around it and your teeth and cause cavities. As long as it’s kept clean, a fixed retainer can stay in place for decades with no problems.
Night Guards
No matter what type of night guard you have or what company you order it from, you can expect that it will last five years or less. In fact, if you have severe bruxism, you might need to replace yours every 3–6 months — that’s part of what makes subscription services so appealing. In general, thinner night guards need to be replaced sooner than thicker ones and hard or hard-flexible options last longer than soft ones.
Care & Maintenance
Removable retainers and guards worn during the day need to be taken out every time you eat or drink anything besides water. You should brush and floss your teeth well before you put your appliances back in.
You should brush your retainers and night guards once a day with a non-abrasive toothpaste and soft-bristled brush to remove any food particles. To help prevent bacteria and plaque from building up on your retainers and night guards, you should soak them in a glass of water with a dissolved denture tablet for about 30 minutes every couple of weeks.
Are They Interchangeable?
If you have had orthodontic treatment and also have bruxism, the idea of using one appliance for both cases is appealing. The question is if it’s possible. There’s a bit of nuance here, so let’s dig into this a bit.
Some retainers can be worn as night guards — but the reverse isn’t true. If you have an aligner-style retainer to keep your teeth in place, this can be used to reduce or eliminate bruxism as well if your clenching and grinding is suited to thin, rigid night guards. With one retainer per arch, you should get about 2mm of separation between the teeth, which is better than a single retainer-style night guard would offer. Hawley and fixed retainers don’t cover the teeth so they can’t be used as a night guard.
Night guards cannot replace retainers because even the retainer-style options aren’t meant to hold the teeth in place; while some online providers advertise this, what they are actually selling is a retainer. Night guards fit looser than retainers, so tooth retention isn’t a secondary feature they offer.
Final Thoughts
Retainers and night guards can be very similar in design but not necessarily in function. Failing to use each device as they’re intended can break your appliance and might even hurt your teeth or jaw.
Before you use a retainer or night guard for anything other than their intended purpose, you should check with your dentist.
Frequently Asked Questions
How long each day do I have to wear my removable retainers?
To prevent your teeth from shifting, you should wear your removable retainers for at least 22 hours a day at first. Then, over time, you will reduce this to just at night, and then every other night. Follow the plan your doctor gives you.
Will I have to wear a retainer for the rest of my life?
Most people wear their retainers every other night once they are about 6–12 months post-active treatment.
My removable retainer keeps breaking. What can I do?
If you keep breaking your retainer, your dentist might suggest a fixed retainer instead.
Can I buy retainers and night guards online?
Yes! Some online retailers have the same high-quality appliances as a dental office but at half the cost (or less). Check with your dentist before you buy them online just to be sure it’s the correct style.
I know I clench my teeth. Can my dentist just make me a night guard that doubles as a retainer?
Probably! Your dentist might be able to make you a night guard that’s thin and discreet for day wear yet strong enough to withstand your clenching and grinding.
What if I only clench my teeth during the day?
Your dentist or online retailer can make sure your appliance is durable enough for daytime wear.
Can I wear the same appliance during the day that I do at night?
Most people need a separate night guard for nighttime wear since bruxism tends to be more severe when sleeping.
Is bruxism curable?
As of now, no, bruxism isn’t curable. But we can use night guards to effectively manage the symptoms and even prevent us from bruxing while we’re wearing one.
My dental insurance only covers one night guard but it broke. Will my medical coverage cover it?
Possibly. If your dentist and doctor determine that you need another appliance but your dental insurance doesn’t cover them, your medical plan might pick up a portion of the cost.
My dental insurance doesn’t cover a replacement retainer. Will my medical insurance cover it?
It’s doubtful. Most medical plans don’t offer any orthodontic coverage.
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