Types of occlusal splint (night guard): which one you need for your case

If you have been recommended an occlusal splint, you have probably noticed something: they are not all the same. There are different types, each designed for a specific problem, and choosing the right one is not a matter of preference but of diagnosis. In this article we explain which types exist, how they differ and how to decide which one you need.

What is an occlusal splint and what is it for?

An occlusal splint (also known as a night guard or bite splint) is a custom-made device, usually made of a rigid or semi-rigid material, which is placed over the teeth —almost always at night— to protect the mouth from the overload caused by clenching or grinding the teeth.

Its three main goals are:

• Protecting the teeth from wear, cracks and fractures.
• Reducing muscle tension in the jaw and facial area.
• Relieving the load on the temporomandibular joint (TMJ).

One thing should be clear from the start: the splint protects and relieves, but does not “cure” the underlying habit on its own. It is a key part of the treatment, not the complete solution.

Types of occlusal splint: main differences

Before looking at each one, an important idea: the type of splint is determined by the diagnosis, not by the patient’s preference. What works very well in one case may be useless or even counterproductive in another. These are the main types.

Muscle relaxation splint (Michigan splint)

This is the most common one for bruxism. It is a rigid splint, usually fitted on the upper arch, which works by relaxing the chewing muscles and distributing clenching forces evenly. It is indicated when the main problem is tooth clenching or grinding with muscle overload, and it is the one used in most of these cases at Face Clinic.

Joint repositioning splint

This one is designed for cases of TMJ dysfunction or displacement of the articular disc. Unlike the relaxation splint, its goal is not only to relax the muscles but to reposition the jaw in order to improve joint function. It is not used routinely because it requires a precise joint diagnosis and close follow-up; incorrect use can cause problems. It is typically used in cases of tmj disorder.

Occlusal stabilisation splint

This is indicated when bite problems are involved. Its purpose is to balance the dental contacts, so that pressure is distributed evenly and the overload on the joint and muscles is reduced. It helps to stabilise the occlusion when the teeth do not fit together harmoniously.

Mandibular advancement device

This one has a different use from the previous types: it is mainly used for snoring and mild sleep apnoea. Its mechanism consists of moving the lower jaw slightly forward to keep the airway open during sleep. Although it is also an intraoral device, it is not designed to treat clenching or grinding, but rather a sleep-related breathing problem.

Soft vs. rigid splints: which is better?

This is one of the most frequent debates, and it is worth clarifying: soft splints are not always better, even though they feel more comfortable at first. In many patients who clench, a soft splint can even encourage clenching, because it invites the wearer to “chew” on the material.

• Rigid splints are usually the option of choice for clenching and grinding, due to their ability to protect the teeth and distribute forces.
• Soft splints are reserved for specific, less intense cases, or as a temporary solution.

The choice of material, once again, depends on the diagnosis, not on perceived comfort.

When the splint is not enough: complementary treatments

The splint protects the mouth, but does not remove the cause of the problem (the stress, muscle hyperactivity or associated factors are still there). That is why, in some cases, it is not enough on its own.

In intense cases with masseter hyperactivity, persistent pain, or when the splint fails to control the symptoms, it may be necessary to combine it with other treatments, such as neuromodulators injected into the chewing muscles to reduce the force of contraction. This is a treatment that is assessed and prescribed under medical criteria; you can find the details on the neuromodulators for bruxism page. Habit correction, physiotherapy or stress management are also often added.

How to know which type of splint you need

The conclusion from all of the above is clear: only a correct diagnosis can determine the right splint. To decide, the specialist assesses:

• The presence and type of clenching or grinding (nocturnal, daytime, intensity).
• The condition of the TMJ and whether there is joint dysfunction.
• The type of bite and how the teeth fit together.
• The predominant symptoms: wear, muscle pain, joint pain, headaches…

That is why it is inadvisable for patients to choose or buy a splint on their own: without a diagnosis, it is easy to use the wrong device and get no results (or make things worse).

Common mistakes with occlusal splints

These are the most frequent errors to avoid so that the splint does its job.

Buying over-the-counter or boil-and-bite splints without a diagnosis

Generic splints do not fit your mouth or your specific problem. They can be uncomfortable, ineffective and even harmful if your case required a different type of device. A splint is an individualised treatment, not a standard product.

Stopping using it when the pain improves

The fact that symptoms subside does not mean the problem has gone. Abandoning the splint when you notice improvement usually causes the habit and the discomfort to come back.

Not attending regular check-ups

The splint wears down and may need adjustments. Check-ups make it possible to verify that it is still suitable and that your progress is as expected.

Using a soft splint when a rigid one is needed

As we have seen, a poorly indicated soft splint can encourage clenching instead of relieving it. The material must respond to the diagnosis, not to initial comfort.

How long is the splint worn and when do you notice improvement?

It is important to have realistic expectations. Relief is not usually immediate: many people start to notice improvement in the first few weeks, as the muscles relax and the overload decreases.

As for duration, the splint is usually a long-term treatment: in many cases it is kept indefinitely (especially at night), since clenching and grinding tend to be chronic problems that should be kept under control. Progress depends on factors such as the intensity of the habit, the stress component, the condition of the TMJ and consistency in wearing the splint and attending check-ups.

Occlusal splints at Face Clinic: how the process works

At Face Clinic, the occlusal splint is approached as an individualised medical treatment, not a standard device. The usual process includes:

• Diagnosis: assessment of your clenching pattern, bite and TMJ condition to determine which type of splint you need.
• Taking records: impressions and records of your mouth are taken to manufacture a fully custom-made splint.
• Manufacture: the device is made to fit your anatomy and your specific case.
• Follow-up: regular check-ups to adjust the splint, check its condition and assess your progress, adding other treatments if necessary.

If you grind or clench your teeth, or have been told you need a splint and are not sure which one is right for you, the best starting point is a correct diagnosis. We invite you to request an assessment at Face Clinic so we can design the treatment that truly fits your case.