Night guards

by Clara Kirlis
(California, USA)

Hello. I would like to know if most night guards are for the upper or lower teeth. I spent a fortune on a mouth guard that I'm supposed to wear at night and it goes on my bottom teeth. In the morning, I wake up with my jaw feeling stiffer than it ever does and I can barley open my mouth at all for the first few hoursof the day . Do you think that the mouth guard I have should go on my upper teeth instead of my lower teeth? Is it normal to wake up with such stiffness in the morning?
Thank you very much.

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Upper and Lower Mouthguards
by: Dr. Spainhower

Hello Clara,

Thank you for posting your comment about Upper/Lower Night Guards. This is a good question, one that I haven't thought about writing about, in fact I think I'll continue this topic after I answer yours on my "case studies" page.

The question of..."if you should be wearing an upper night guard vs. a Lower night guard?" is not probably the issue here.

The problem most likely lies in the adjustment of the splint. I would call the Dentist immediatley and report to him/her that "I'm worse". Report that the Splint is making you more miserable.

I don't know if your Dentist will charge you again for adjusting the splint again, but Reporting your concern or problem like this will help you in not getting charged again to correct it.

I would not report to him/her that the problem is an upper or lower splint problem. Because that will rarely be the case.

So, mostly likely the posterior part of the splint needs to be adjusted so that there are very light contacts or even no contacts.

If you are having "TMJ pains", which is probably the case if you found this website (some people just want to protect their teeth at night), then you might benefit from having the splint adjusted with only the anterior teeth contacting.

If the Splint does not have the front teeth contacting, then you might want to ask your Dentist to adjust it so that that is the case.

That is the best possible case for "pain Relief". But, you've got to be carefull with this type of adjustment. You cannot wear the splint/nightguard more than 12 hours per day. If you do, then your back teeth can start to supererupt (kind of like growing out of your jaw bone). And that will mess your bite up permanently.

If the Splint does not have enough acrylic on the splint for your upper front teeth to contact the lower splint, the Dentist can send the night guard back to the lab and request that the lab put more acrylic on so that the upper front teeth contact on the lower splint. This usually requires that additional impressions will be taken for the lab to make these adjustments.

I have to do this every now and then, I just send the splint back and have the lab add more material on so that there is "anterior contact". The lab usually won't charge me to add or improve the splint.

You might even want to copy this webpage and take it with you if the Dentist would like to read my suggestions. Usually we Dentists aren't comfortable with others (like myself) directing their Dental treatments on their patients, but with TMJ, I think most Dentists will gladly like some second opinions about treating their TMJ patients. It's a tough topic to treat.

Good luck, and please feel free to keep me posted with updates and questions. This will help many others that read your question as well.

And you probably want to NOT wear your guard until it is adjusted again.

Dr. Spainhower

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