Quick Answer: For mild teeth grinding, an OTC boil-and-bite guard from the pharmacy is a reasonable starting point. For moderate grinding, online custom guards (using at-home impression kits) offer better fit at a mid-range price. For severe bruxism or significant jaw pain, a dentist-custom hard acrylic guard is the clinical standard. Fit quality and material both matter.
In This Article
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The Three Tiers of Teeth Grinding Guards
The market for mouthguards for teeth grinding has expanded significantly. Beyond the dentist's office, there are now multiple options at different price points, each with legitimate use cases and genuine limitations. Understanding where each tier fits helps you make the right choice for your specific situation.
The decision is not simply about price. It is about matching the guard to the severity of your bruxism and the specific problems you are trying to address. A mild grinder who has never noticed significant enamel wear has very different needs than someone whose dentist has flagged serious wear patterns across multiple teeth.
How to Assess Your Bruxism Severity
Signs of mild bruxism: occasional jaw stiffness on waking, minimal enamel wear noted at checkup, no TMJ clicking or pain. Signs of moderate bruxism: regular morning jaw soreness, noticeable enamel wear, occasional morning headaches, flat biting surfaces visible in the mirror. Signs of severe bruxism: significant tooth wear or cracking, persistent TMJ pain, morning headaches most days, visible masseter muscle enlargement. Higher severity indicates a stronger need for custom dental work.
OTC Guards: When They Work and When They Don't
Over-the-counter mouthguards fall into two subtypes: stock guards (pre-formed, one-size) and boil-and-bite guards (softened in hot water and shaped by biting). Stock guards are bulky, fit poorly, and are generally not recommended. Boil-and-bite guards are the better option at the pharmacy level.
Boil-and-bite guards cost roughly $20 to $80 at Shoppers Drug Mart, Rexall, or similar retailers. The fitting process is straightforward: boil in water until soft, insert and bite down to create a rough impression of your teeth. The result is an approximate fit that is better than nothing but not precision-fitted.
Limitations of OTC guards: the fit is imprecise, which means they can be uncomfortable to wear and may move around during sleep. The material is typically soft thermoplastic, which brings the same concern as soft dental guards generally -- some research suggests it may actually increase chewing muscle activity in certain individuals. OTC guards also wear down faster than professionally made ones and need replacement every one to three months with regular use.
OTC guards are a reasonable starting point if you are waiting for a dentist appointment, if your bruxism is recently diagnosed and you want immediate protection while deciding on a long-term option, or if your grinding is genuinely mild and infrequent.
Online Custom Guards: The Middle Ground
Online custom guard services (such as Pro Teeth Guard, Chomper Labs, and similar companies shipping to Canada) work by sending you an impression kit, having you take moulds of your teeth at home, and then fabricating a custom guard in their dental lab. The result is a guard made to your actual tooth anatomy, at a price between OTC and full dental prices.
Typical cost: $100 to $200 CAD depending on the company and the material chosen (most offer soft, hybrid, or hard acrylic options). For moderate bruxism in a patient who does not yet have dentist involvement, this tier offers a meaningful improvement over OTC fit quality.
The limitation is the absence of direct clinical oversight. A dentist can assess your bite, check your TMJ, look for signs of nerve involvement in worn teeth, and monitor changes over time. An online service cannot do any of this. If you suspect TMJ issues, have significant enamel wear, or experience persistent jaw pain, seeing a dentist rather than ordering online is the appropriate path.
Note on Canadian Shipping
Most major online guard services ship to Canada, though turnaround times are typically two to three weeks given cross-border processing. Check that the company offers a remake policy if the fit is not right before ordering -- reputable services typically do.
Dentist-Custom Guards: The Clinical Standard
A custom guard made by your dentist involves professional impressions, a dental lab fabrication process, and a fitting appointment where the dentist checks the bite, makes any needed adjustments, and assesses the overall fit. The result is the most precisely fitting guard available.
Most dentist-custom guards for bruxism use hard acrylic, which distributes grinding forces evenly and does not stimulate additional jaw muscle activity the way soft guards sometimes do. Some dentists offer a dual-laminate option (hard outer surface, soft inner layer for comfort) as a compromise.
Cost in Canada: typically $300 to $800, depending on the dentist and the specific type of guard. This is often covered partially by dental insurance under "occlusal guard" or "splint" coverage -- check your plan's details. If you have significant bruxism, this cost is justified by the enamel protection alone; replacing a cracked molar is far more expensive.
The additional value of going through a dentist: they will examine your teeth, jaw, and bite before making the guard. They may identify issues (like early TMJ changes, cracked tooth syndrome, or bite problems) that need addressing regardless of the guard. They can also monitor your enamel wear at subsequent checkups to assess whether the guard is working.
Full Comparison Table
| Option | Cost (CAD) | Fit Quality | Material Options | Durability | Best For |
|---|---|---|---|---|---|
| OTC boil-and-bite | $20-80 | Low-moderate | Soft thermoplastic only | 1-3 months | Mild/occasional grinder; immediate protection |
| Online custom | $100-200 | Moderate-high | Soft, hybrid, or hard acrylic | 1-3 years | Moderate bruxism; good fit without dentist cost |
| Dentist custom (soft) | $300-600 | High | Soft laminate | 1-3 years | Mild-moderate; preference for comfort |
| Dentist custom (hard acrylic) | $400-800 | Highest | Hard acrylic (standard); dual-laminate | 3-5+ years | Moderate-severe bruxism; TMJ involvement; clinical standard |
Cleaning and Care
A night guard that is not kept clean poses genuine health concerns. The mouth contains hundreds of bacterial species, and a moist guard stored in a closed case provides good growing conditions for bacteria, fungi (including Candida species), and other microorganisms.
Proper care extends guard life and protects your health:
- Rinse immediately after removing each morning with cool water (not hot -- heat distorts thermoplastic guards)
- Brush gently with a soft toothbrush and mild non-abrasive soap (not toothpaste, which is abrasive enough to scratch acrylic)
- Allow to air dry fully before placing in the storage case -- a moist case is a bacterial incubator
- Once or twice a week, soak in a diluted denture-cleaning tablet solution or diluted white vinegar (not bleach, which degrades materials)
- Store away from pets and children, away from heat sources
- Inspect regularly for cracks, holes, or significant wear -- a worn-through guard offers little protection
The Connection to Sleep Quality
At Mattress Miracle, we think about sleep comprehensively. Bruxism severe enough to cause morning headaches and jaw pain disrupts sleep quality -- waking with pain is not the same as waking rested. Addressing the bruxism through a proper guard (a dental question) and addressing the physical sleep environment (our area of expertise) are complementary steps. If you are working through sleep problems and want to think through the mattress and pillow side of the equation, come see us at 441½ West Street.
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Call 519-770-0001Frequently Asked Questions
Does dental insurance cover mouthguards for bruxism in Ontario?
Many employer dental plans in Ontario include coverage for occlusal guards or splints, typically covering 50 to 80% of the cost up to an annual or lifetime maximum. Check your specific plan under "major restorative" or "prosthodontics" coverage. Coverage is generally limited to dentist-fabricated guards; OTC guards are not covered.
Can I wear a mouthguard every night indefinitely?
Yes. Night guards for bruxism are designed for indefinite nightly use. They need to be replaced when worn through or when they no longer fit properly (for example, after dental work that changes your bite). A well-maintained hard acrylic custom guard can last three to five years or longer.
Should the guard go on the upper or lower teeth?
Both are used. Upper guards are generally more common (more stable on the larger arch), but some dentists prefer lower guards, particularly for patients who have a sensitive gag reflex. Lower guards are also sometimes preferred because they are less visible when speaking. Your dentist will recommend based on your anatomy and their clinical preference.
I grind only occasionally -- do I still need a guard?
If your dentist has already noted enamel wear, protecting those tooth surfaces from further damage is worthwhile even if grinding is not nightly. If you have no enamel wear and only occasional jaw tension on waking, the urgency is lower, but monitoring at dental checkups is still important so any emerging wear is caught early.
Sources
- Macedo CR, et al. "Occlusal splints for treating sleep bruxism (tooth grinding)." Cochrane Database of Systematic Reviews. 2007;(4):CD005514.
- Lobbezoo F, et al. "Bruxism defined and graded: an international consensus." Journal of Oral Rehabilitation. 2013;40(1):2-4.
- Lavigne GJ, et al. "Bruxism physiology and pathology: an overview for clinicians." Journal of Oral Rehabilitation. 2008;35(7):476-494.
- Martins RC, et al. "Microbial contamination of night guards." Journal of Prosthodontics. 2017;26(4):302-308.
- Okeson JP. Management of Temporomandibular Disorders and Occlusion. 8th ed. Elsevier, 2019.
- Canadian Dental Association. "Bruxism: Grinding and Clenching." 2023. Ottawa: CDA.
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Sleep problems often have more than one contributing factor. If you have the dental side under control and still are not sleeping well, come in and let us help you work through the physical comfort side of things.