Over one million Americans wake up each morning in significant pain from nighttime teeth grinding and clenching (bruxism). Does the fact that these people remain in pain every day mean they all don’t have dentists? No, actually most of these people have dentists. Unfortunately, while most dentists are expert at preventing tooth damage and repairing damaged teeth, they are taught little or nothing in dental school about the psychology of habits, and most long-term tooth grinding and clenching is a habit most people would very much like to kick.

So what does it take to kick the nighttime teeth grinding and clenching habit? As you might suspect from thinking about habits such as smoking, drinking, over-eating, or nail biting, the answer is different for different people. The “solution” most often recommended by dentists these days is a custom-made mouth guard.

The custom mouth guards that dentists recommend come in many varieties, most costing between $500 and $800. There is strong disagreement between dentists on which is the “best” type of mouth guard to use. Some are made by vacuum-molding a hot thin sheet of plastic over a plaster replica of your upper teeth. Some cast acrylic, made in a mold made from an impression of both your upper and lower teeth.

Lots of people follow their dentist’s recommendation and spend between $500 and $800 for a custom-made mouth guard. Once you have spent your money, you get to find out if you are someone whose nighttime clenching gets worse or better when you wear your new mouth guard.

It’s not unusual for people to follow their dentist’s advice and plunk down between $500 and $800 for a custom-made mouth guard. Once you put out the big bucks, you get to find out if you are someone whose nighttime clenching gets worse or better when you wear your custom mouth guard.

Most mouth guards go between your upper and lower molars, preventing upper tooth enamel from touching lower tooth enamel, and spreading the load if you clench your teeth. The load-spreading idea is that if you keep clenching, the mouth guard will help you do less damage. Sometimes this may work. Unfortunately in some cases the damage done can be significantly worse with a mouth guard.

Some brands of mouth guards (for instance the “NTI”) are made to snap on to your front teeth and keep your molars from touching when you bite. The theory here is that such a front-teeth mouth guard will feel so different when you bite on it that your mind will know (even subconsciously) that something is not right when you bite, so you will not bite down hard. There are cases where that seems to work. Unfortunately, for the cases where it does not work, biting down on a front-tooth-only guard such as the NTI can cause serious damage.

Fortunately, there are many ways to kick the teeth grinding and clenching habit other than sticking a mouth guard in your mouth. Some methods don’t cost anything to try, some are moderately expensive to try, and some can be rather expensive to try. In some cases the cost is less of an issue because of a money-back guarantee, but unfortunately some of the expensive things to try have no such guarantee. Different methods that people have successfully used to get themselves out of the teeth grinding and clenching habit include: massage, diet changes, biofeedback, hypnosis, changing to a new pillow or mattress pad, using a soothing sound machine, chiropractic work, meditation, and other positive psychology practices.

Interestingly, the mouth guards sold by dentists are not only among the most expensive possible solutions you can try for teeth grinding and clenching, they are also among the options with no free trial, and no guarantee whatsoever. This is a great deal for your dentist, but not a great deal for you. Trying an over-the-counter mouth guard from a pharmacy that you can mold yourself may be a better first step.