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Why I almost always recommend lower night guards for patients that clench and grind their teeth.

worntoothI have been a tooth clencher and grinder for probably my entire life. At the University I attended we were taught to make night guard on the upper jaw. The ones that were made for me were always uncomfortable and this went beyond just having the appliance in my mouth. They always felt tight and constricting. I attended the Pankey Institute in Miami Florida and they had a different view point. The night guards were recommended for the lower jaw. I made one for myself and found it to be far more comfortable than the ones I had been trained to make in dental school. It didn’t occur to me why this was so until I took training in cranial sacral therapy with a local Osteopathic physician. (By the way I highly recommend this type of gentle manipulation of the bones of the skull and back. It is a gentle and highly effective therapy.) So in dental school we were taught that the skull ossified so the bones don’t move. But when I trained with the Osteopath, she taught that she has to feel the subtle movements of the bones but also that if bones didn’t move correctly it could cause problems with your wellness and vitality.

There are 29 bones in the head. The lower jaw is the only bone not hooked to others by sutures. The lower jaw is suspended from the skull by ligaments, tendons and muscles. I think of it like this: placing an upper night guard has the benefit of protecting the teeth from clenching and grinding. But it has the side effect of binding the bones in place. This could affect the normal cranial sacral rhythm which could effect a patients comfort and vitality. Making the night guard on the lower arch still protects the teeth from clenching and grinding but actually stimulates cranial sacral movement. To me it is a simple issue. Build it on the lower unless it would compromise the health of the upper teeth. That could happen if the upper teeth are loose or have lost bone. This is an example where the tooth is worn down to the nerve canal and the enamel is 60 % gone. This tooth is half of it’s normal size.

If you clench and grind your teeth, a night guard can really help. Night guards can also help people that suffer from headaches, TMJ, face, neck and shoulder pain and tension. This is some evidence they can even improve athletic performance.

Another amazing thing about clenching and grinding is patients may not even be aware they do it. I have asked numerous patients if they know they were doing it and most say no. It is amazing how out of touch we can be from our bodies. Ideally when you are relaxed the teeth should be slightly apart. A little space is good. An affirmation can be used to relax the jaws. “lips together, teeth apart.”

To your health and well being!

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