Types of night guards: digital vs traditional workflow

types of night guards

Sleep bruxism—the grinding, clenching, and gnashing of one’s teeth at night—likely affects between 5% and 8% of the population. And temporomandibular joint disorder (TMJD)—pain and inflammation in the jaw joints—is estimated to affect 5–12% of people.

What do these conditions have in common (besides being fairly common)? For both, night guards can make a difference. When you keep your clients from teeth grinding or clenching their jaw, you help protect their enamel in the long term and avoid any unnecessary muscle tension.

Whether you call them dental guards, bite splints, or night guards, there are several kinds to choose from—and there’s more than one way to make them, too. In this guide to nighttime mouth guards, we’re exploring the different types of night guards and the processes—both digital and traditional—involved in producing them.

5 different types of night guards

All night guards act as a barrier between the top and bottom teeth, keeping patients from exacerbating their dental issues. However, as you may already know, there are multiple types of night guards with varying purposes.

1. Hard night guards

These custom-fit night guards are made from a firm acrylic material that won’t bend or give. Because they’re sturdy, hard night guards are ideal for patients with more pronounced teeth grinding or teeth clenching habits.


2. Soft night guards

Soft night guards are custom-fit appliances made from a more pliable plastic or rubber material. They’re better suited for clients with mild to moderate bruxism or a minor TMJD.

Soft night guards have a slightly “gummy” feel in the mouth, which may encourage some patients to chew or play with them. As such, they may not last as long as hard night guards.

3. Dual-laminate night guards

Also known as hybrid night guards, these best-of-both-worlds custom appliances have a soft, pliable inside and a firm outer layer. Dual-laminate night guards combine the comfort of a soft guard with the durability of a hard guard.


4. Flat plane occlusal guards

Flat plane occlusal night guards can be hard, soft, or hybrid. However, they differ from standard custom-fit night guards in that they have a flat occlusal plane.

So, while your average upper night guard accounts for the top teeth and the opposing bottom teeth, a flat plane occlusal guard only molds to the top teeth; the bottom teeth rest against a flat surface. These night guards work well for patients with disclusion or malocclusion (bad bite).

5. Over-the-counter night guards

Unlike the other types of night guards listed, this class of night guards does not require input from a dental professional. Instead, OTC night guards are available at most pharmacies and sporting goods stores. They typically come in one of two forms:

  • Boil-and-bite night guards – These drugstore guards are first boiled to soften the material. From there, the patient bites into the guard, forming it to their teeth.
  • One-size-fits-all guards – These guards don’t allow for any customization. Patients can wear them to keep their upper and lower teeth apart, but due to size and shape discrepancies, they may be uncomfortable or even unwearable.

While OTC night guards offer an affordable alternative for patients, they don’t last as long as custom night guard options.


Comparing night guard production processes: traditional vs. digital

Aside from over-the-counter mouth guards, all high-quality night guards are manufactured by dental professionals. There are two ways to prepare and produce a night guard: Traditionally and digitally.

The traditional process

As with all dental appliances, night guard production starts with a consultation. Once you and your patient determine that a night guard is the solution, you’ll take a traditional impression of your patient’s lower and upper teeth.

This step involves sticking trays full of dense, sticky material (usually alginate) into the patient’s mouth and waiting a few minutes for the substance to firm up. The molds then sit and dry for around 30 minutes before they’re ready for handling. At this time, the patient can return home and wait several weeks for the final product.

Meanwhile, the impression is mailed to a dental lab for the production process to begin. The lab techs use the negative copies of the teeth to create a cast. From there, they’ll take your chosen night guard material—hard, soft, or hybrid—and form it around the cast to produce the night guard.

After any necessary adjustments, the finished night guard is shipped back to the dental office for pick up and final fitting (or, in some cases, directly to the patient).

The digital process

The rise of digital dentistry and new dental technology has made the digital process of producing nightguards more accessible. The steps are similar to the traditional method, but there are a few notable improvements.

Following the consultation, you’ll take an impression of your patient’s teeth. However, when it comes to digital impressions vs traditional impressions, instead of placing unwieldy trays into the patient’s mouth to create a physical impression, you’ll use an intraoral scanner to produce a digital impression. Once the impression-taking is complete, you’ll instantly send the scan to the dental lab.

Switching from a traditional impression to a digital one saves time in several different places:

  • Chair time – Patients no longer have to sit with a mouth full of alginate for minutes at a time. Instead, most intraoral scans take under a minute.
  • Wait time – There’s no need to wait for the impression to dry and harden—digital scans are ready the moment you finish scanning.
  • Shipping time – Digital scans take seconds to reach the dental lab, whereas physical impressions may take a week or more to ship.

After the impression is made and sent to the lab, the process again takes a turn. Instead of making the night guard from a cast, the lab techs can simply use the digital scan as a model—once again cutting down on production time. Thanks to CAD/CAM dentistry technology, the lab team can make minute adjustments to ensure proper spacing and alignment for an impressively accurate fit.

Finally, once the night guard is finished, it’s sent back to your office (or to the patient) for any final adjustments and information sessions.


If you go digital, go for Dandy

Overall, the digital process for producing night guards can offer a more streamlined experience for your patient and your entire staff. Impressions take less time, shipping costs are cut in half, and the finished guards are more accurate.

If you’re ready to try a digital approach to dentistry, try Dandy. From night guards to dental implants and everything in between, our fully digital dental lab makes better appliances in a fraction of the time. We’ll provide the intraoral scanner and the training you need—all you have to supply is your passion for cosmetic dentistry.

Ultimately, the faster your nightguard appointments go, the sooner you can see your next patient—and the more likely your last client will tell their friends about their efficient, stress-free day at the dentist.

Sources: 

National Center for Biotechnology Information. Sleep Bruxism-Tooth Grinding Prevalence, Characteristics and Familial Aggregation: A Large Cross-Sectional Survey and Polysomnographic Validation. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5070759

National Institute of Dental and Craniofacial Research. Prevalence of TMJD and its Signs and Symptoms. https://www.nidcr.nih.gov/research/data-statistics/facial-pain/prevalence

My Community Dental Centers. Mouth Guards, Night Guards, and Bite Splints. https://www.mydental.org/dental-services/night-guards/ 

Dental Update. The bilaminar (Dual-Laminate) protective night guard. https://www.researchgate.net/publication/319040938_The_bilaminar_Dual-Laminate_protective_night_guard