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Molly Maloof, MD

Director of Clinical Content

which is better for a nightguard, grinding, clenching? upper or lower

i was given a lower, made by dentist

should i have gotten an upper? im assuming the tongue gets in way or do you get used to it?
  • Male | 36 years old

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Featured Answer

18 UpVoted this answer George K. Markle, DDS Dentist, San Francisco Jennifer McAroy, DDS Dentist, Prairie Village
Both work - a properly fitted nightguard should be comfortable and wearable regardless of which arch it is fitting oin. A lot of the choice has to do with the doctor's experience and preference. Understand that the guard will not cause you to clench the teeth any less, but it will protect the teeth it covers.

In my office, if you are a grinder (IOW, you move your jaw side-to-side, as opposed to clencher in the middle) I would fabricate a lower guard - This would be designed to separate your back teeth as you were moving your jaw around.

Clenching however, is a whole other ball game. Nightguards don't do much to alter a clenching habit and can intensify it. One design (known as NTI) helps, but doesn't cure the problem. And some neurologists are beginning to recommend Botox injections to decrease clenching forces..

The subject of clenching/grinding and joint problems is a very tricky one. There are loads of opinions on what works, what doesn't and what is right in your situation. If I have learned anything over these many years, it's that the solution is a very individual one and not "one size fits all"


Dr. Rick Liftig
Rick Liftig
10 UpVoted this answer
Both upper or lower night guards serve the same function . They provide a gliding surface for teeth to rub against rather than a direct impact on teeth to teeth. If someone has a gag reflex we may recommend a lower night guard . Clenching appliances are a different design and are meant to be worn temporarily , it's best to discuss and evaluate whether you clench and /or grind your teeth with your dentist
10 UpVoted this answer
A night guard is just a Band-Aid for bruxism. Many times the reason for bruxism is cervical spine dysfunction. I recommend you be evaluated by a chiropractor as soon as possible. Many times a simple cervical spine adjustment by a chiropractor resolves bruxism. Then there's no longer a need for a bruxism appliance.
Todd W. Walters, DDS
9 UpVoted this answer
After 21 years of making these occlusal guards, I find that lower appliances are better tolerated and provide a significantly better therapeutic effect. 24 hours is all that is necessary to get used to it. The tongue adapts beautifully.
7 UpVoted this answer
The answer to your question is likely both. The majority of night-time grinding is due to sleep disordered breathing Read about it as discussed by Gilles Lavignes, DDS University of Montreal. IF your grinding is associated with sleep problems then you should have an appliance that fits the upper and lower and advances the lower. THis will prevent the grinding mechanism form happening and protect your TMJ. Most single arch appliances tend to pose great risk for possible damage to the TMJ as the lower jaw will fall backward during sleep.
Lawrence D. Singer
6 UpVoted this answer George K. Markle, DDS Dentist, San Francisco
The design of your nightguard is dependent on several factors which might include your bite, your tolerance for having an appliance in your mouth, the affect on speech or airway, or even the preference of your dentist, just to name a few. There is no "right way" that applies to every situation. What is most important is that it fits, is used, and protects your teeth and jaw joint from the destructive forces that can accompany the harmful habits of unconscious grinding. For long term use, the nightguard should also cover all the teeth. This kind of design prevents shifting of your teeth and changes to you bite.
Jonathan F. Richards
5 UpVoted this answer
Dear Patient,

Good for you that you are being proactive and taking care of your teeth and jaw by getting a nightguard. Both upper and lower nightguards can effectively protect your teeth and jaw joint from clenching and grinding if adjusted properly. In my office I prefer to make upper guards, however, I have had many new patients that come with lower guards that work well. My preference for an upper NG is that it is easier to adjust and add to as needed for my patients.

Here's to your health,

Dr. Makuta
Linda Y. Makuta
5 UpVoted this answer
My preference is to fabricate the night guard on the upper, there are situations where it works well on the lower, but usually the upper. If you'd like to try an upper appliance, they are not expensive and can be purchased at your local drug store for less than 20.
Thomas A. Hogan
4 UpVoted this answer
Your treatment depends more on the philosophy of your dentist than anything else. His or her training, experience and beliefs are more likely the reasons for the type of night-guard that you have. If you ask 10 dentists what they'd do, you'll probably get 10 different answers. Good luck!
3 UpVoted this answer
Wear the night guard for at least 30 days, you will create a habit and you will be used to wearing it. But you have to be consistent: every night for 30 days. I do not believe you would have preferred an upper nightguard because the majority of patients who tried both preferred the lower nightguards as being more comfortable. When prescribing nightguards there are several factors that I take into cosideration when choosing the type of nightguard: upper or lower and the material it is made of: presence of cosmetic restorations like veneers or ceramic crowns , the need for future restorations, any missing teeth, periodontal condition and patient preferrence.