Over one million Americans wake up each morning in significant pain from nighttime teeth grinding and clenching (bruxism). Does the fact that these people remain in pain every day mean they all don’t have dentists? No, actually most of these people have dentists. Unfortunately, while most dentists are expert at preventing tooth damage and repairing damaged teeth, they are taught little or nothing in dental school about the psychology of habits, and most long-term tooth grinding and clenching is a habit most people would very much like to kick.

So what does to for a person to rid himself or herself of the habit of nighttime teeth grinding and clenching? As you might suspect from thinking about like smoking, drinking, over-eating, or nail biting, different things work for different people. The “solution” most often recommended by dentists is a custom-made mouth guard.

There are many variations of the custom mouth guards that dentists recommend, most costing between $500 and $800. Different dentists disagree strongly on which is the “best” type of mouth guard to use. Some are thin plastic, made by vacuum-molding a hot thin sheet of plastic over a plaster replica of your upper teeth. Some are hard plastic cast in a mold made from an impression of both your upper and lower teeth.

Lots of people take their dentist’s recommendation and plunk down between $500 and $800 for a custom-made mouth guard. Once you have paid for yours, you get to find out if you are someone whose nighttime clenching gets worse or better when you wear a mouth guard.

“Now just a minute” you might say, “are you telling me my clenching problem could actually get worse?” Yes, unfortunately it could. The problem is that although mouth guards keep your tooth enamel from being worn away, they don’t necessarily make you clench less. Some people’s teeth grinding and clenching habit is such that when they are asleep, a mouth guard feels like an annoyance to be chewed through rather than a reminder to relax.

Most mouth guards are made to sit between your upper and lower molars, and spread the load if you clench your teeth, the idea being that even if you keep clenching, the mouth guard will help you do less damage. Sometimes this may work. Sometimes the damage done becomes much worse with a mouth guard.

Some brands of mouth guards (for instance the “NTI”) are made to snap on to your front teeth and keep your molars from touching when you bite. The theory here is that such a front-teeth mouth guard will feel so different when you bite on it that your mind will know (even subconsciously) that something is not right when you bite, so you will not bite down hard. There are cases where that seems to work. Unfortunately, for the cases where it does not work, biting down on a front-tooth-only guard such as the NTI can cause serious damage.

Fortunately, there are a lot more possible ways to interrupt a habit than just sticking a mouth guard in your mouth. Some of them are free to try, some are moderately expensive to try, and some are very expensive to try. Some have money-back guarantees, and some do not. Various methods that people have successfully used to kick the teeth grinding and clenching habit include: biofeedback, hypnosis, changing sleep surface, changing pillow, soothing sound machines, chiropractic work, massage, diet changes, meditation, and other positive psychology practices.

Interestingly, the mouth guards sold by dentists are not only among the most expensive possible solutions you can try for teeth grinding and clenching, they are also among the options with no free trial, and no guarantee whatsoever. This is a great deal for your dentist, but not a great deal for you. Trying an over-the-counter mouth guard from a pharmacy that you can mold yourself may be a better first step.