Protective appliances
Custom nightguards.
If you grind or clench your teeth at night, a custom-fit guard protects your enamel, jaw joints, and any dental work you’ve invested in. The fit is what makes the difference.
Most patients who grind or clench (the technical term is bruxism) don’t know they’re doing it. The first signs Dr. Agrawal usually catches are flat wear patterns on the back teeth, fine cracks in the enamel, a sore jaw in the morning, or unexplained headaches around the temples. Sometimes a partner mentions the grinding sound at night. By the time the wear is visible on the teeth, the habit has been going on for years.
The good news is that a custom-fit nightguard can stop the damage cold. Worn while you sleep, the guard absorbs the grinding force that would otherwise wear down your enamel, fracture old fillings, or chip a crown. It also takes pressure off your jaw joints, which for many patients resolves the morning soreness within a few weeks.
Signs you might be grinding, a short checklist
You may be a candidate for a nightguard if you recognize any of these:
- You wake up with a sore or tight jaw
- You get morning headaches around the temples or behind the eyes
- Your teeth look flat or shorter on the chewing edges
- You notice fine vertical cracks in your front teeth
- You have unexplained tooth sensitivity to cold
- A partner has mentioned a grinding sound at night
- Your tongue or inner cheek has small ridges from clenching pressure
Two or three of those together is usually enough for us to take a closer look at your wear pattern at your next exam.
Soft guard or hard guard, what fits you
Custom nightguards come in a few material types. Soft thermoplastic guards feel cushioned and are usually recommended for lighter grinders or first-time wearers easing in to the routine, they wear through faster but are very comfortable. Hard acrylic guards are the longer-lasting choice for moderate-to-heavy grinders and for patients who’ve cracked a softer guard before. There are also dual-laminate guards (soft inside, hard outside) that try to get the best of both. Dr. Agrawal will recommend the right one for your wear pattern at your fitting visit.
What the impression visit is like
Getting fitted for a custom guard is a single short appointment. We take a digital scan (or, in some cases, a soft impression) of your upper and lower teeth and the way your bite closes. The whole visit is usually under thirty minutes, no anesthesia, no prep work. The lab makes your guard from that scan, and we see you back about two weeks later to fit it, balance the bite, and walk you through care.
Why custom, not the drugstore kind
The boil-and-bite guards sold at the pharmacy fit roughly. They tend to be bulky, fall out at night, and don’t distribute bite force evenly, which can actually make jaw soreness worse. A custom guard is made from a precise impression of your teeth and the way your bite closes. The fit is snug, the material is durable, and the bite is balanced so your joint isn’t strained. Most custom guards last several years with occasional adjustments at your routine cleanings.
TMJ, when the joint itself is sore
If you have ongoing jaw joint pain, clicking, or limited opening, the issue may be your temporomandibular joint itself rather than the wear pattern on your teeth. Dr. Agrawal can evaluate your joint at a regular exam and talk through whether a nightguard is the right first step or whether further evaluation is needed. Often just relieving your nighttime clenching is enough to settle the joint down considerably.
A note on snoring and sleep apnea
Heavy nighttime grinding and clenching are sometimes linked to sleep-disordered breathing. If you snore loudly, wake up tired despite full nights of sleep, or have been told by a partner that you stop breathing at night, please mention it. We’ll refer you to a physician for proper sleep evaluation, treating sleep apnea matters far more than treating the grinding alone.
Frequently asked
Nightguards, common questions.
How do I know if I’m grinding at night?
Most patients don’t feel themselves grinding, by definition, you’re asleep. The signs we look for are flat wear patterns on your back teeth, fine cracks in your enamel, a sore jaw on waking, unexplained morning headaches around the temples, indentations along the side of your tongue, or a partner who hears the grinding sound. If two or three of those apply to you, ask us to check at your next exam.
What does the impression visit look like?
It’s a short single appointment. We take a digital scan or a soft impression of your upper and lower teeth and the way your bite closes. The whole visit is usually under thirty minutes with no anesthesia. The lab builds your guard from that scan, and we see you back about two weeks later to fit it and check the bite.
Soft guard or hard guard, what’s the difference?
Soft guards are made from a pliable material and are usually recommended for lighter grinders or for short-term use; they’re more comfortable initially but wear through faster. Hard acrylic guards are the more durable, longer-lasting choice for moderate-to-heavy grinders. Dr. Agrawal recommends one based on your wear pattern and the firmness of your bite, there’s no one-size answer.
How often does the guard need to be adjusted?
We see you back about two weeks after delivery to fine-tune the fit and balance the bite, then again at your next routine cleaning. After that, most well-fitting guards need only an occasional adjustment at cleaning visits. If your bite changes, from new fillings, a crown, or natural shifting, we re-balance the guard at that point.
Will my dental insurance cover a nightguard?
Many dental plans cover at least a portion of a custom nightguard, often around 50 percent, though specifics vary. We check your benefits before you commit and give you a clear estimate in writing. Virginia Dental Club members also get a discount on nightguards through their membership.
Can a nightguard fix my TMJ pain?
Often, yes, at least significantly. When clenching is the source of your jaw soreness, taking that nighttime pressure off the joint usually settles things down within a few weeks. If your TMJ pain comes from something more complex (an arthritic joint, a disc problem, or chronic posture issues), a guard helps but may not be a complete answer. We’ll evaluate and tell you honestly what to expect.
Wake up with a sore jaw?
Mention it at your next exam, or call our office to schedule a short consult about a custom guard.