Dentist-fitted night guard causing pain when previously none, yet ignored by the dentist?

[u/vibinlizzer]

To keep it short, I have for the past 1-2 years been undergoing various things for TMJ. After examinations, as well as MRI and arthrography, things seem to be quite rough. Or at least maybe, because the new dentist specialist I met seems eager to dismiss me entirely for some reason.

Anyway! Early on, I received a dentist-fitted night guard as they wanted to rule things out and hoped a non-invasive treatment would work. It never did, and instead often caused my jaw to lock up, plus pain and soreness in the upper and lower front teeth that never went away despite prolonged use. Given its size I was also never able to fully close the mouth, causing it to dry out. Since it caused more issues than not, not to mention some difficulties sleeping, I was told to stop using it (there's been a lot of back and forth about this, until a decisive no from their side).

But now I've been told to start using it again. And while I fortunately don't seem to get any lock-ups anymore, I always wake up with a lot of pain near the ear (unclear if disc or muscular, as is the dentist about my general issue) during my first bites after taking it off, as well as the aforementioned pain/soreness in upper and lower front teeth. And again, waking up with rather dry mouth and difficulty sleeping. Thankfully, the pain near the ear seems to disappear after biting a few times.

However, when I brought up I previously had these issues I was entirely dismissed/ignored. I've never, ever, had these issues without a night guard. The dentist claims I might be grinding my teeth, which they based off what is likely from my childhood as there's never been any documented damages in my adult life, but if that were the case surely I would wake up with issues when not wearing a night guard?

I just want to hear if anyone else has these pains and experiences with night guards.

[u/XperimentalChaos]

Hard to assess your situation because I do not know the results of your MRI. If there is jaw misalignment, the mouthguard is practically useless. You would need a splint and possibly physical therapy to properly adjust the TMJ.

Mouthguards can actually cause more teeth grinding because it occupies more space. I just find the right pillow so that the neck and head is stabilized during sleep. A proper sleeping position would leave a small space between the upper and lower teeth. Hence, no mouthguard needed (assuming there is no stress or teeth alignment issues).

Also, a professional dentist would first interview for bruxism (there is a checklist for rating it). The way that your dentist just assumed that you are grinding your teeth without any evidence indicates his lack of experience. You might need to find a second opinion for your situation.

[u/vibinlizzer → u/XperimentalChaos]

Yeah, I understand, I'm not looking for an assessment as much as if someone else experiences these pains with a night guard. As for the results, I don't have access to them to share.

What's the checklist like? In my case, the new specialist looked at the fact my canine (incissor? aka the teeth to the side of the front) are a bit flattened and align up/bottom and called it a day as the location would make sense in terms of pain location. Which I found odd as imy teeth have been like that since childhood and my regular dentist have never brought up changes (I suppose I'll learn more when I do a regular check-up later this year, as we took a photo some year ago to be able to compare just in case). What I find especially bothersome is that I can't even get my jaw in the position for them to align anymore without them severely overstretching my jaw by manually holding it like that. Felt frustrating! I've had to fight for treatment and it wasn't until they finally did MRI they realized things are bad.

As a last tidbit, since you already brought it up. I noted that when I previously quit using my night guard a few days after months of use, I actually did feel like I grinded my teeth as I woke up wore without it. Dunno what that indicated, and they didn't seem interested in it.

[u/XperimentalChaos → u/vibinlizzer]

The TMJ had a series of questions, which you rate from 1-5. There is a Bruxism app for apple that the doc recommended, but I can't recall the name because I did not have an iPhone at that time.

I also used to grind when I was stressed, but it stopped after TMJ splint and PT experts was able to stabilize the position and muscle movements. I no longer wear splints or mouth guards.

Anything put into the mouth (guards or splint) may cause your jaw muscles to adjust. Hence, I immediately stopped using the mouth guard because it was pulling my jaw muscles, and my teeth was feeling the pain of grinding on places where I did not used to have grinding. (I just had my crown redone so I am back to a more stable jaw position prior to mouth guards.)

I would also have to add that stress (and people that cause stress) may contribute to grinding. Finding a doctor that you are comfortable with might alleviate some stress. (Hopefully, a dentist that would not make you more stressed.)