TMJ Not Improving With Night Guard?

Some of our patients come to us and say, “I have a custom night guard but it’s not helping with my TMJ symptoms”. If you are wearing a night guard and your problem is not improving or worsening, it is probably because the appliance is not right for the situation.

I have patients that have had a night guard custom made by their general dentist in order to address morning jaw soreness, sensitive teeth, or excessive wear on their teeth. I am sometimes asked if I can use their existing night guard in my treatment of their TMD or TMJ problem. Unfortunately the answer is usually not.

Here’s why.

Custom night guards are made to fit your teeth very precisely. The “biting surface” is typically smooth and adjusted to precisely fit your unique bite. Non-custom night guards are those that are bought in a store and softened in hot water to fit over the teeth. They are not designed to help a joint problem, just to protect teeth and help calm muscles in an otherwise healthy TMJ system.


TMJ orthotics are designed to treat the jaw joint, that is the joint just in front of the ear. Just as a teeter-totter moves slightly different on each side because of the “fulcrum”, a TMJ orthotic has a special design on the biting surface based on the diagnosis of your condition. This allows the position of the jaw joint to be changed at the back end of the jaw which effects the muscles, in an effort the stop pain or unlock a stuck jaw.

If your night guard was made to relieve pain and it doesn’t help or makes you feel worse, there is a good chance you have a condition that is more complex than a night guard can treat. Because the surface of the existing night guard has been designed for a different purpose, it usually won’t work for a Temporomandibular Disorder. However, I will assess your reaction to the night guard to help us understand the underlying problem.

If you are using a night guard but not experiencing any relief or things are getting worse, perhaps it is time for another evaluation. For some people the first line of defense works and for others it does not. I have dedicated my practice to helping patients find lasting solutions to TMJ disorder and Sleep Apnea.

Give us a call to schedule your evaluation.


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