Custom Nightguard Construction Instructions

There are two main of types grinding appliances that I recommend.

The first appliance is a full arch flat plane nightguard. This is what most people think of when they think of a night guard. I recommend you make one of these when you know that grind (areas of wear on your teeth) but don’t have any muscular pain, headaches, or TMJ pain associated with it. You can make this either on the top teeth or the bottom teeth, whatever is most comfortable for you.

The second type of appliance is known as an anterior midpoint stop appliance. This appliance is best for people who grind and have other symptoms associated with it (muscular pain, headaches, or TMJ pain). You can also make this appliance on either the top or bottom teeth. Please read through this list, which explains the different situations in which you should not use an anterior midpoint stop appliance…

Loose front teeth from periodontal disease. Because this device only touches the front teeth, it can create a good amount of force on those teeth.
If due to TMJ problems, you can only open very minimally with no ability to stretch your range of motion any wider – See a professional quickly. This is a possible sign of a problem (closed lock) with your joint that needs to be corrected by someone with experience with TMJ issues.
If you have very little overlap between your top and bottom front teeth, you should use this device with caution. The TMJ will sometimes readjust into a new position and cause bite changes that lead to the front teeth no longer coming together. For many people with severe TMJ issues, they are more than willing to take this risk if it helps their TMJ pain.

Full Arch Flat Plane Nightguard Instructions:

Get your supplies together (read through our “Read This First Section” for a full list and links. You’ll need thermoplastic beads, a piece of parchment paper, a Dremel or hot knife, and a mug.

Take your beads and place a small pile on the parchment paper.

Fill up your mug with water and heat to approximately 140 degrees Fahrenheit / 60 degrees Celsius. If you don’t have a thermometer, heat until steaming but not boiling. You should be able to put a finger in the water very quickly without scalding yourself.

The beads will turn clear in the water. Remove the beads from the hot water and place on parchment paper. It is very important to use parchment paper as they are extremely sticky in this state and will stick to most other surfaces.

Squeeze the beads together until they form a solid mass. Take the material and mold it into the basic shape of your dental arch as seen below.

While it is still soft, place over your top or bottom teeth and use your fingers to adapt it to your teeth. You want it touching your teeth but not your gum tissue. Close your teeth together very gently until your other teeth just barely contact it. You can then either wait for it to set most of the way on its own or you can take a drink of ice water to speed the process. Wear a bib because you’ll probably make a mess!

**Important** Before it sets up all the way you’ll want to take it out and then put it back in place. This makes sure that it doesn’t get locked into place when it sets up all the way. If you do manage to get it locked into place you’ll need to swish with hot water to soften the material.

The material turns white when it hardens again. When it is fully hardened it should “snap” into place on your teeth. If you don’t feel like it stays in place well or if it is putting too much pressure on any one spot, start over.

Once it has set you can start adjusting it. The goal with this appliance is to have even contact of all your teeth when you bite down and when you move your teeth in different directions. The pictures show exactly how you want it to look.

Use your Dremel or hot knife to make adjustments. I personally like the Dremel because it works faster. The best attachment for adjusting it is a very coarse sandpaper wheel as seen below. This is going to make a huge mess so it do outside or somewhere that is easy to clean up. You may also want to wear eye protection as plastic flies everywhere.

When you’re finished it should look similar to this. Adjust the surfaces to your comfort level. Ideally you want a couple of millimeters of thickness on the biting surface. You will build up some heat while adjusting it so be careful not to distort the appliance as it won’t fit correctly.

All done!

Wear the appliance to bed every night as most people grind primarily at night. It will take a couple of weeks to get used to speaking and sleeping in it.

Store the appliance somewhere away from heat. Never leave it in a hot car. You can clean it with cold soapy water or brush it with your toothbrush.

In the future if you notice it is starting to get thin from your grinding, you can heat up more material and add it to the worn areas or you can easily make a new appliance with your supplies. You should have enough to last your entire life.

Anterior Midpoint Stop Appliance Instructions:

Get your supplies together (read through our “Read This First Section” for a full list and links. You’ll need thermoplastic beads, a piece of parchment paper, a Dremel or hot knife, and a mug.

Take your beads and place a small pile on the parchment paper.

Squeeze the beads together until they form a solid mass. Take the material and make a small ball approximately the size of your front four teeth.

While it is still soft, place over your top or bottom teeth and use your fingers to adapt it to your front four teeth. You want it touching your teeth but minimally on your gum tissue. Close your teeth together very gently until your other teeth just barely contact it. You can then either wait for it to set most of the way on its own or you can take a drink of ice water to speed the process. Wear a bib because you’ll probably make a mess!

Once it has set you can start adjusting it. The goal with this appliance is to have only the two front teeth in contact with the appliance when you bite down. This should also be the case no matter where you move your jaw. The pictures show exactly how you want it to look. Notice how the back teeth never touch, no matter what you do. This is critical for the appliance to work! Also, only make the appliance as thick as it needs to be in order to achieve this effect. If it opens your mouth too far, you can cause additional TMJ pain.

When you’re finished it should look similar to this. Adjust the surfaces to your comfort level. You will build up some heat while adjusting it so be careful not to distort the appliance as it won’t fit correctly.

Wear the appliance to bed every night as most people grind primarily at night. It will take a couple of weeks to get used to speaking and sleeping in it.

Store the appliance somewhere away from heat. Never leave it in a hot car. You can clean it with cold soapy water or brush it with your toothbrush.

In the future if you notice it is starting to get thin from your grinding or no longer keeps all the teeth apart, you can heat up more material and add it to the worn areas or you can easily make a new appliance with your supplies. You should have enough to last your entire life.