In my dental practice we commonly  recommend 3 types of appliances for our patients:  1. night grinding guards 2. snoring/sleep apnea appliances 3. protective sports guards.  Our philosophy is to educate our patients, giving them the necessary information to make the proper decision for themselves. There are hundreds of different types of over-the-counter (OTC)  or online dental appliances that are being advertised these days.  All of these appliances are marketed as being “dentist-approved” or “custom-fit,” when in reality, this could not be further from the truth in most cases. In fact, many of these appliances can actually make your symptoms worse or cause other more serious issues.

The ease and low cost of OTC or online dental appliances make them very appealing.  Unfortunately, like many things in life, you get what you pay for.  Most of these mass produced dental appliances are ill-fitting, loose, bulky, and can be very uncomfortable.  Many patients are concerned they will have difficulty sleeping with a  custom guard that is fit precisely to their teeth taking into consideration  their jaw relationship allowing us to fabricate a perfectly fitting appliance. How uncomfortable do you think a “one-size-fits-all” appliance would be in comparison?

Why are OTC Dental Appliances less effective than custom Dental devices made by your Dentist?

1.       No proper measurements taken

2.       No proper molds of teeth are taken

3.       No monitoring of success or failure of appliance

4.       Symptoms can be significantly increased and cause other serious pain issues


1. OTC Night Grinding Guards:

One of the more popular dental appliances we recommend to people are night grinding guards, also known as occlusal guards.  At least 25 percent of the population, or 82 million Americans, clench or grind their teeth to the point of destructiveness. Studies show that almost all people unconsciously grind or clench their teeth now and then and that more than 80 percent of all bruxers (people who grind or clench teeth) are either unaware of their habit or ashamed of it.  Considering how common grinding is, and how many people are affected by it, it is important for us to protect people’s teeth before the destruction occurs. The most important qualities of an effective grinding guard are  proper fit and hardness of the material used to make the appliance.  All over-the-counter grinding guards are too soft.  It is VERY important that a proper night guard is made of a hard acrylic.  NO OTC or online night guard is made of hard acrylic.  They are all made of a softer, almost rubber-like material, that actually makes you grind more because your brain essentially registers it as food. This places huge stresses and tension on your joints and facial muscles.  We have encountered this problem way too often with patients who tried these OTC night guards to help their grinding only to result in TMJ pain, headaches, or jaw issues.

2.  Snoring and Sleep Apnea Appliances:

Another important area of dentistry that is a  focus in our office is sleep breathing disorders.  Two thirds of all Americans snore.  Even more significant, 70% of all snorers actually have sleep apnea in which breathing repeatedly stops, sometimes for 10 seconds or more, throughout the night. Sleep apnea is a serious condition that can have devastating effects on the body if it goes untreated.Your brain and heart do not receive enough oxygen as a result of sleep apnea. This generally leads to increased blood pressure and heart rate, and can put you at greater risk of heart attack and stroke.

I seriously caution against self-treatment in this area because one-size-fits-all sleep apnea appliances can hurt, not heal.  An incorrect appliance can force patients into a headache/jaw pain spiral.   We have treated patients in our practice who have been adversely affected by the use of over-the-counter, Internet ordered, or poorly made sleep appliances. When we made new, precisely measured sleep appliances based on their personal muscle physiology, their symptoms were relieved and their sleep issues improved with greater predictability.

Most importantly, there is NO monitoring or measuring of the severity of the snoring or apnea, which can be very dangerous.  It’s impossible to arbitrarily position a person’s lower jaw and put it in a proper, comfortable and physiologic position that will address a sleep breathing disorder.  In fact, we have found several cases where these over-the-counter and online sleep appliances actually increase the number of times the person stops breathing (apneas)!   Snoring and sleep apnea KILLS, are you going to trust an OTC appliance with saving your life?

3.  Protective Sports Guards :

If you have children who are involved in sports or you are playing a contact sport yourself, please take my advice and protect your teeth with a sports guard.  The common “boil and bite” guards are very popular and are quite effective in protecting your teeth.  Your dentist can make you a custom sports guard that is less bulky and more comfortable than one you buy from the sporting goods store, but if you feel that a store-bought guard is acceptable then this is the one time I will say  “go for it!”  As long as some sort of protective mouth guard  is worn, you are decreasing the risks of broken teeth or other jaw injuries associated with these sports activities.

This is your body and your overall health.  Please consider this when making the decision to either choose a custom-built dental appliance by a dental professional or a “one-size-fits-all” store-bought appliance.  In my opinion, the disadvantages of the over-the-counter appliances far outweigh the  advantages.