General Dentistry · Last reviewed May 2026
Teeth Grinding (Bruxism): Protect Your Teeth
Before They Crack.
Custom-fitted night guard. We diagnose your grinding pattern from wear facets and a TMJ exam, then prevent enamel wear, fractures, and the chronic morning jaw soreness that comes with untreated bruxism. Cases are managed by Dr. Thao Tran, Dr. Nhung Duong and Dr. Emily Nguyen, with iTero digital scanning across our six branches.
What is Bruxism?
Bruxism is the involuntary clenching or grinding of teeth, most often at night ("sleep bruxism") but sometimes during the day ("awake bruxism"). Literature reviews estimate it affects roughly 8-31% of adults at some point. Untreated, it causes enamel wear, tooth fractures, jaw pain, headaches, and accelerates the failure of crowns, veneers and fillings. The cause is multifactorial: stress, sleep architecture, occlusal triggers, and sometimes medications such as SSRIs.
Signs You May Be Grinding
Most patients do not hear themselves grind. These are the signals we look for during a clinical exam, and the ones partners often notice first.
Morning Jaw Soreness
Stiffness, ache or tenderness in the masseter or temple muscles when you wake. A consistent pattern, not the occasional bad night.
Worn-Down Tooth Edges
Visible flattening of the front teeth or canines, especially asymmetric wear that does not match normal age-related wear.
Cracked Tooth or Chipped Restoration
Repeated chipping of fillings, veneers or crowns. A tooth that fractures without obvious trauma is often a bruxism red flag.
Tooth Sensitivity to Cold
Worn enamel exposes underlying dentine, which makes teeth sensitive to cold drinks and air. Often patchy across specific teeth.
Headaches in the Temples
Tension-style headaches that present at the temples, especially in the morning, can be driven by overnight temporalis muscle activity.
Tongue Scalloping
Indentation marks along the side of the tongue, where the tongue has been pressed against the inside of the teeth during clenching.
Cheek-Line Ridge (Linea Alba)
A pale white horizontal ridge along the inside of the cheeks, where cheek tissue has been compressed against the bite plane.
Partner Reports Grinding Sounds
If a partner has heard grinding or clenching sounds at night, treat that as direct evidence even if no other symptoms are obvious yet.
Why Picasso for Bruxism
Clinical Wear Assessment with Photography
Every case begins with high-resolution photographs of the wear facets. We document the starting point so future appointments can compare and confirm whether protection is working.
iTero Digital Scan for Guard Fabrication
No putty trays. The iTero scanner captures the upper and lower arches in minutes, and the laboratory mills or prints a guard that fits on the first try.
Hard Acrylic or Dual-Laminate
Choice of full hard acrylic for maximum durability, or dual-laminate (hard shell, soft inner liner) for a more comfortable feel against the teeth. Material is matched to your grinding intensity.
Bite-Balanced Fit at Delivery
At the fitting visit we check the guard for even contact across all back teeth. An unbalanced guard can drive new TMJ symptoms, so this step is non-negotiable.
Follow-Up at 4-6 Weeks
Once you have slept in the guard for several weeks, we review wear patterns, comfort, and adjust if needed. Small changes at this stage prevent larger problems later.
Replacement at 2-5 Years
We monitor the guard at every 6-month hygiene visit and replace it when the wear pattern compromises protection. Heavy grinders need more frequent replacement than light grinders.
Night Guard Types
Four common formats, only the first two are appropriate for diagnosed bruxism in adults.
Hard Acrylic (Custom)
Most durable, evidence-supported for moderate to severe bruxism. The standard recommendation when wear facets and fractures are already present. 1,500,000-.
Dual-Laminate (Custom)
Hard outer shell for durability, soft inner layer for comfort against the teeth. A good compromise for patients who find pure acrylic uncomfortable. 2,000,000-.
Soft Only (Custom)
Comfortable but heavy grinders chew through soft guards in months. Some studies suggest soft material can actually increase grinding activity. Not recommended for severe cases.
Boil-and-Bite (Over-the-Counter)
Not recommended for diagnosed bruxism. Poor fit can shift the bite, accelerate the problems it is meant to prevent, and provide a false sense of protection.
Bruxism Pricing
Custom night guards in writing after consultation. Restorative work for already-damaged teeth is quoted separately.
| Service | Price |
|---|---|
| Custom night guard (hard acrylic or dual-laminate) | 1,500,000 – 3,000,000 |
| Diagnostic exam + occlusal analysis | |
| iTero digital scan (when needed) | 2,000,000 (often included in guard fee) |
| Replacement guard at 2-5 years | Same as new |
| Composite restoration of worn tooth edge | 400,000 – 700,000 per tooth |
| Crown for severely fractured tooth | 5,000,000 – 9,000,000 |
Already have fractured teeth? See porcelain crowns and composite fillings.
How Night Guard Treatment Works
Five steps from first exam to follow-up. Most cases complete in two appointments over 1-2 weeks.
1. Clinical Wear Assessment
Photographs of wear facets, palpation of the masseter and temporalis muscles, TMJ exam, and a review of headache and morning soreness symptoms.
2. iTero Scan or Impressions
Digital scan of the upper and lower arches. The data goes directly to the lab so the guard can be fabricated to digital tolerances.
3. Laboratory Fabrication
The lab mills or prints the guard in your chosen material (hard acrylic or dual-laminate). Turnaround is typically 5-7 working days.
4. Fitting + Bite Balance
At delivery we check fit, retention and even contact across all back teeth. Adjustments are made chairside until the bite is balanced.
5. Follow-Up at 4-6 Weeks
After several weeks of overnight wear we review the guard for wear patterns, comfort and any new symptoms, then adjust if needed.
Ongoing Monitoring
At every 6-month hygiene visit we inspect the guard alongside your teeth and recommend replacement once protection is compromised.
Beyond the Night Guard
A guard protects teeth from the consequences of grinding, but it does not stop the grinding itself. Here is the honest version of what else helps, and what does not.
Stress Management
Stress is one of the most consistent triggers in the bruxism literature. Exercise, sleep hygiene, cognitive behavioural approaches and reducing evening caffeine and alcohol all have evidence behind them.
Sleep Position Changes
Some patients grind more when sleeping on their back. A simple position change is free, low-risk and worth trying alongside guard wear.
Treating Co-Existing Sleep Apnea
Sleep apnea and bruxism frequently co-occur. Treating the apnea (CPAP, mandibular advancement) often reduces grinding as a side effect. If you snore heavily or wake unrefreshed, ask about sleep assessment.
Magnesium and B-Complex
The evidence is weak. Some patients report subjective improvement, the trial data is limited and inconsistent. We do not actively prescribe these supplements but do not discourage patients who find them helpful.
Masseter Botox (Off-Label)
An option for severe muscle-driven cases. Picasso does not provide masseter Botox in-house. If your case suggests this would help, we refer to a maxillofacial colleague who does this work.
Occlusal Equilibration
Selective adjustment of the bite, only used in carefully selected cases where a specific occlusal interference is driving the problem. Not a routine treatment for most bruxism patients.
Aftercare
A custom night guard lasts 2-5 years if you look after it. The basics, in order of importance.
Clean Daily with Cool Water
Rinse the guard each morning with cool water and a soft toothbrush. Hot water deforms the acrylic. No toothpaste, the abrasives scratch the surface.
Store Dry
Dry the guard before placing it in its case. A damp guard in a closed case is a culture for bacteria and odour.
Return for Adjustment
If the guard feels uneven, sore on a specific tooth, or the bite shifts after wearing it, come back. Small chairside adjustments take minutes.
Replace at 2-5 Years
We check the guard at each 6-month hygiene visit. Once protection is compromised by wear, perforation or distortion, we replace it.
Monitor for New Wear Facets
If new flattening or chipping appears on teeth despite wearing the guard, that is a sign the guard is not protecting fully and needs reassessment.
Wear It Every Night
Inconsistent wear is the most common reason bruxism damage continues. The protection only works on the nights the guard is in your mouth.
Risks & Honest Tradeoffs
A night guard is a low-risk appliance, but it is also limited in what it can do. Here is what we tell patients before they commit.
It Does Not Cure Bruxism
The guard protects teeth, it does not stop grinding. Most patients continue to grind while wearing the guard, the difference is that acrylic absorbs the wear instead of enamel.
Some Patients Chew Through Soft Guards
Heavy grinders can perforate a soft-only guard in months. This is one of the main reasons we steer most diagnosed cases towards hard acrylic or dual-laminate.
TMJ Pain May Need Further Treatment
If joint pain, clicking or limited opening persists despite a well-fitted guard, the problem is more than tooth-level bruxism. See our TMJ page for next steps.
Restorations Often Wait
Crowns and veneers placed on teeth of an active heavy grinder fail faster. Where possible we control grinding with a guard first, then plan restorations once the bite environment is stable.
Initial Discomfort is Normal
Most patients adapt to a night guard within 1-2 weeks. If discomfort persists beyond that, the guard needs adjustment, not endurance.
Sleep Apnea Must Be Ruled Out
Conventional flat-plane night guards can occasionally worsen obstructive sleep apnea by altering jaw position. If apnea is suspected we coordinate with a sleep physician before fitting.
Your Bruxism Team
Bruxism cases at Picasso are managed by our general dentists and clinical leadership.
Dr. Thao Tran
General Dentist. Performs wear assessments, fits and adjusts custom night guards, and coordinates restorative work for teeth already damaged by grinding.
Dr. Nhung Duong
General Dentist. Manages bruxism cases including occlusal analysis, guard fitting and ongoing follow-up, with particular focus on patients presenting with morning headaches and TMJ symptoms.
Dr. Emily Nguyen
Founding Clinical Director. Sets the protocols for case selection, material choice and bite-balancing across all six branches, and reviews complex cases involving extensive prior wear.
Common Questions
How do I know if I grind my teeth?
Most patients do not hear themselves grind. The signs we look for are flattened tooth edges, cracked or chipped restorations, morning jaw soreness, headaches in the temples, tongue scalloping along the side, and a white ridge (linea alba) on the inside of the cheek. A partner reporting grinding sounds is also a strong signal.
Can stress cause teeth grinding?
Stress is one of the most consistent associations in the bruxism literature, but it is not the only cause. Sleep architecture, occlusal triggers, certain medications including SSRIs, and co-existing sleep apnea all contribute. Bruxism is multifactorial, which is why we treat the consequences (tooth wear) rather than chasing a single cause.
Will a night guard cure my grinding?
No. A night guard is a protective appliance, not a cure. It absorbs and redistributes the force of grinding so your teeth, fillings and crowns are not the surface taking the damage. Most patients continue to grind while wearing the guard, the difference is that the acrylic wears instead of enamel.
Hard or soft night guard, which is better?
For diagnosed bruxism, hard acrylic or dual-laminate (hard outside, soft inside) is the evidence-supported choice. Soft-only guards are comfortable but heavy grinders chew through them in months and some studies suggest they can actually increase grinding activity. We rarely recommend soft-only guards for established bruxism.
Can I just buy a boil-and-bite guard online?
For diagnosed bruxism, no. Over-the-counter boil-and-bite guards do not fit precisely, can shift the bite, and tend to be either too thin to protect against heavy forces or too thick to wear comfortably. A poor-fitting guard can accelerate the problems it is meant to prevent.
Do children grind their teeth?
Yes, sleep bruxism is common in children and most outgrow it as adult teeth come in. We rarely fit night guards on growing children since the appliance would need to be replaced as the dentition changes. We monitor wear and intervene only if there is meaningful tooth damage or persistent symptoms.
What about Botox for grinding?
Masseter Botox is an off-label option that some patients with severe muscle-driven bruxism find helpful. Picasso does not provide masseter Botox in-house. If your case suggests this would be useful, we will refer you to a maxillofacial colleague who does. A night guard remains the first-line protective measure.
Will a night guard stop my morning headaches?
Often, partially. If your headaches are driven by overnight masseter and temporalis activity, a well-fitted guard reduces that load and many patients report fewer or milder morning headaches within a few weeks. If headaches persist, the cause may not be bruxism alone and we will refer you for further assessment.
Can pregnant women wear a night guard?
Yes. A night guard is a passive acrylic appliance with no medication or invasive procedure involved, and is safe during pregnancy. Stress-driven bruxism can flare during pregnancy, so a guard is sometimes specifically useful in this period.
How often does a night guard need replacing?
Most custom hard or dual-laminate guards last 2-5 years, depending on grinding intensity and how well you care for the appliance. We check the guard at every 6-month hygiene visit and replace it once the wear pattern compromises protection.
Start Here
Protect Your Teeth
Before They Crack.
Book a free bruxism consultation. We'll photograph your wear pattern, examine your TMJ and bite, recommend the right guard material, and quote you in writing before any work begins.