The Troubling Trend of DIY Night Guards – More Harm Than Good?

DIY night guards may seem like a cost-effective option, but without proper instruction and guidance, they could lead patients to further dental issues.

By Sharon Boyd, MA, RDH, with Dr. R. Anthony Matheny, author, speaker, and coach

First, there are mail-order orthodontic aligners. Now, people are getting night guards off the internet without visiting their local dentist. The appeal is that patients can save hundreds of dollars by taking their own dental impressions and requesting a "custom" mouth guard shipped directly to them from a third-party lab. But why do these seemingly inexpensive appliances wind up actually costing patients in the long run?

Poor Quality Materials

Many mail-order night guard companies fail to point out that their guards require semi-regular replacement due to the worn-out materials. In comparison, a custom night guard created at the dentist's office will typically last much longer. In fact, these third-party manufacturers often have quarterly or annual subscription memberships to consistently ship replacement guards, as they expect the materials to last no longer than a matter of months.

According to Dr. R. Anthony Matheny, author, speaker, and coach, "The guards they make are essentially like a thin bleaching tray [that]…tend to wear these out very fast, grinding holes in them, causing them to have to be remade. That is why they offer you a subscription plan to make new ones every six months, whereas the professional night guard often can last years."

What seems like an inexpensive custom night guard ultimately costs consumers more money over time. Especially after the mail-order night guards are consistently replaced more frequently than one delivered by a personal dentist. The custom-fitted appliance offers the best return on investment for most patients.

Failing to Address Why People Grind Their Teeth

Dr. R. Anthony Matheny
Author, Speaker, and Coach

Most people order online night guards because they experience symptoms related to teeth clenching and grinding, such as worn enamel or headaches. In addition, conditions such as bruxism may be attributed to anything from stress to TMJ disorder to bite misalignment. However, simply addressing the symptoms of pain caused by clenching or grinding may be inadequate for the patient, especially in malocclusion cases.

"Most patients clench and grind their teeth due to their bite not being as balanced as it should be or they have a lot of tension building up in their jaw muscles from stress," says Dr. Matheny. "With a professional custom-fit night guard through a dentist, we can make a thicker, stronger night guard that we can adjust in your mouth to balance your bite at night. It keeps you from grinding your teeth, but also, very importantly, it relaxes your jaw muscles, so during the day, when you are not wearing the guard, you are more comfortable and not clenching, taking pressure off your teeth."

A combination of therapies, such as night guards paired with occlusal adjustments and orthodontic appliances, may be needed to prevent nighttime bruxism. But when patients use mail-order appliances, they lack the professional insight of having these conditions diagnosed by their dentist. As a result, they cover up their symptoms or co-existing situation over time.

Advanced Resources Aren't Necessary (But a Professional Fit Is)

Many dental providers have a misconception that patients will be noncompliant with traditional impression techniques required to create a custom appliance. But given that DIY mail-order guards and aligners are gaining so much popularity—and they need self-impression kits—this isn't necessarily the case. A poll with the ADA Clinical Evaluators Panel found that 88% of dentists provide removable appliances other than dentures daily or at least a few times a week. In 7 out of 10 cases, the dental assistant took the impressions or created the models. While intraoral scanning is certainly advantageous, it's not mandatory.

Dr. Matheny reiterates, "With the less costly guards you get with the do-it-yourself impressions at home, the impression you make at home is not as good as what we make in the office, causing the fit to be unbalanced."

Patient Education is Key

Until dental patients understand the poor quality of mail-order nightguards and the reason behind their bruxism, holistic treatment will continue to take a seat on the back burner. These lower-quality materials can also cost patients more over time, both monetarily and with their oral health condition(s). Dentists and their staff should continue to educate patients on the symptoms and risk factors of nighttime clenching and grinding and the benefits of choosing a custom-fitting oral appliance.

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As part of DOCS Education's Elite Learning Series, Dr. R. Anthony Matheny will be presenting a free webinar, "How to Overcome Patient Objections WITHOUT Being Pushy, Aggressive, or High Pressure!" on Wednesday, March 15, 2023, at 5:00 PM PST / 8:00 PM EST. Click HERE to learn more about this presentation and to sign up for the free webinar.

This webinar is free to attend. We offer 1.5 CE hours for DOCS Members and Trial Members who attend the live presentation.

If you are not yet a DOCS Education Member but would like to earn the 1.5 CE for attending, as well as experience the many benefits of DOCS Membership, consider joining as a Trial Member for only $1.* There is no obligation or risk; cancel anytime.


Author: Sharon Boyd, MA, RDH, has over 20 years of experience in the dental industry and is the founder of DentaSpeak, LLC. In addition to being a registered hygienist, she serves as a full-time patient education professional with a special interest in strategic dental communications. She often works as a liaison between practitioners and patients, bridging the gap between care needs and patient concerns. Sharon is an Ironman, band mom, and enjoys volunteering at her family's church.

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