Get the guard before the crown

Maybe, people say, and it does not change the arithmetic. Many people put the sum plainly: several hundred for a guard against thousands for the crowns, root canals, implants or jaw treatment that untreated grinding leads to; some people describe decades of grinding ending in the loss of nearly every natural tooth; some people report cracked teeth and crowns before they got protection, some say ignoring it cost them root canals and extractions, and more than one wishes they had started earlier. Some people say the outcomes include cracked teeth, infections and extractions. The suspicion is real too: people say dentists upsell, some people say guards are pushed for revenue — one person was suspicious when the whole family was prescribed one in the same week — and one person warns a trustworthy provider is hard to find. People’s own answer to the suspicion: one hygienist says wear and early recession in a twenty-three-year-old are sound reasons for a guard even if the patient distrusts the dentist; one person says to get a second opinion from a dentist unconnected to the first, who does not know what was recommended; one says a dentist who only tells you to be less stressed has not helped you. The signs people say a professional should be checking — flattened teeth, jaw soreness or headaches on waking, a partner who hears it, clenching you catch yourself doing in the day — are the NHS’s list too. One point narrows the sale: the expensive part of a dentist’s guard is the fitting and the adjustment so it does not change your bite, one dentist says, which is what the cheaper routes leave out.

People have this argument across some discussions on each side, and it is rendered below with both sides. In the other discussions people had, it runs the same way and never settles, the extreme positions included. The shop side says a boil-and-bite guard costs a fraction, works for the grinders here who wear one if it is moulded properly, and is easy to replace; some people have used one for years without a cracked tooth, one dentist says shop guards work for most of their patients, and one says a shop guard is better than none if a custom one is unaffordable. The custom side says shop guards fall out — some people woke up without theirs — are made of the wrong stuff, and can alter the bite: some people warn an ill-fitting guard can worsen clenching or move the jaw, one person warns long-term wear of a poorly fitted one can misalign the bite permanently, and one person needed clear aligners to undo what a shop guard did. One dentist says that if you cannot afford a custom guard, do not wear a shop one at all — and some people answer that any guard beats tooth on tooth, which people leave open. The decider people give: the severity of the grinding — light against heavy — the alignment of your bite, and your tolerance for the fit. The warnings that both sides accept are in the safety line: hard, not soft; full coverage, not back teeth only; and none of it without a dentist if the jaw joint hurts.

Yes, some people say: a mail-order dental lab sends an impression kit, you take the mould at home, and a custom-fitted guard comes back for well under what a surgery charges — people’s own US figures run from around a hundred to two hundred dollars against four to seven hundred at the dentist, which one person says is high but not unusual in an expensive city. Others say the fit is comparable and the protection real, and one dentist says a well-fitting online guard is often as good as an in-office one. The warnings: one dentist points out the surgery’s price buys the adjustment that keeps your bite right, which a lab working from your own mould cannot do; one person warns a badly taken impression can produce a guard that shifts teeth; one person says older kits were thicker and today’s thinner ones wear faster. People argue over exactly this — the cheaper custom against the dentist’s — and people’s deciders are the severity of the symptoms, any existing jaw problem, and whether insurance pays. On money, others say: ask the dentist directly about a cash discount or a payment plan, and if the shop guard is what you can afford, buy the hard kind and replace it when it wears — one person warns waiting until there are holes in it puts you back to tooth on tooth.

Not only stress, some people point out, though stress is where the dentists start. The NHS lists stress and anxiety as the most common cause, then sleep problems including snoring and sleep apnoea, some medicines for sleep, depression and anxiety, smoking, and heavy alcohol or caffeine. Some people say a dentist added the bite itself — teeth that do not meet properly — and another added stimulant medicines; others add low iron, pregnancy, and one person warns some antidepressants can increase grinding. Some people say the grinding turned out to be a sign of sleep apnoea, and that treating the apnoea reduced or stopped it — which is a sleep study, and the page on this site about asking for the ferritin carries how people got one. Some people say a guard does not stop the habit; it takes the force. So people also work on the cause: one person found and removed a trigger — caffeine, a stressor — and one says meditation, journaling and exercise ended theirs; some people take magnesium to relax the jaw, with cautions — ask a doctor first if you have any condition, start low because high doses upset the gut, and one person’s statistic about how common a shortage is was corrected by its own author. Some people mention botulinum-toxin injections into the jaw muscles as a recognised treatment, which is a prescriber’s conversation and not this page’s. Some people speak for the reader whose dentist said ‘be less stressed’ and nothing else: people found that dismissive, and the answer they give is to ask for the specific signs to be checked and, if the dentist will not, to find one who will. What people did not provide: which cause is yours — the NHS gives the dentist and the GP as the two doors.

Soap and water, or a denture tablet, and never toothpaste — some people point out toothpaste is abrasive and wears the plastic, and some people warn the same of a toothbrush scrub; people argue whether tablets every few days are needed or warm water is enough, and the decider is your nose against the cost of tablets. Some people say a guard worn without cleaning grows bacteria you then sleep with for eight hours, so the routine is not optional. Lifespan is argued too: some people say fifteen to twenty years, some people say three to six, and the decider people give is how hard you grind and what the guard is made of — one person warns heavy grinders chew through even a custom one inside a year, and one person switched to a guard over the front teeth after destroying the back-teeth kind. One person warns to take the guard with you to any dental work so it can be adjusted then, because a separate adjustment appointment may cost. Many people say that after a few strange nights they could not sleep without it, and more than one misses it when they forget; some people warn if it causes tooth pain or a sore jaw in the morning even after adjustment, stop wearing it and go back, and one says a night without it can bring back the jaw pain and sensitivity at once. Some people say the guard eased the neck pain and headaches that came with clenching — which is the page on this site about the tennis ball. What people did not provide, and this page names as gaps: whether insurance ever pays and how to ask, how to choose between a hard and a soft custom guard, jaw exercises, whether an old orthodontic retainer can stand in — one line from some discussions: keep wearing the retainer you were given after braces, or the teeth move — and what to do if the guard breaks in the night.