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.

There are many variations of the custom mouth guards that dentists recommend, most costing between $500 and $800. Different dentists disagree strongly on which is the “best” type of mouth guard to use. Some are thin plastic, made by vacuum-molding a hot thin sheet of plastic over a plaster replica of your upper teeth. Some are hard plastic cast 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.

“Now just a minute” you might say, “are you telling me my clenching problem could actually get worse?” Yes, unfortunately it could. The problem is that although mouth guards keep your tooth enamel from being worn away, they don’t necessarily make you clench less. Some people’s teeth grinding and clenching habit is such that when they are asleep, a mouth guard feels like an annoyance to be chewed through rather than a reminder to relax.

Many mouth guards fit between your upper and lower molars, and spread the load if you clench your teeth. The load spreading is supposed to help you do less damage if you clench. Sometimes this works OK. Other times the damage done is much worse with a mouth guard.

Some mouth guards (such as the “NTI”) are made to attach to your front teeth and prevent your molars from touching, even if you try to clench. The theory is that biting on a front-teeth-only guard will feel so different than a normal bite that you will know (even subconsciously) that something is wrong, so you won’t bite down. For some people this works out OK. Unfortunately, for the people who bite down anyway, the results unusual forces generated can misalign the jaw and 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.