Are dental guards and occlusal splints really effective to treat Bruxism (teeth grinding)?

As long as the guards / splints are well designed and worn consistently, they can be effective for those people who grind so badly that they damage their teeth. Ill-fitting splints, however, can create more problems than they solve (besides which, they are rarely worn because they are uncomfortable).

In my practice, the most common problems I’ve seen with splints is that they are too big. This throws off the placement of the temporomandibular joint (TMJ) which then makes the muscles of the jaw (most notably the masseter and pterygoid muscles) painful and tight. Very often, the tension in these muscles feeds into the grinding through muscle tension and heightened activation.

In the below diagrams, the red areas indicate the primary patterns of pain associated with bruxism. In the first diagram, the muscle drawn at the back of the jaw is the masseter, which is the main chewing muscle. You can easily feel this muscle when clenching your jaw:

Masseter muscle

Bruxism also affects the medial and lateral pterygoid muscles:

The medial and lateral pterygoid muscles

which are very difficult to reach, but important to treat for TMJ pain and bruxism.

There is a good product out now for self-treatment of the muscles of the jaw, called The MyoFree Solution:

The MyoFree Solution

Very often, if you deactivate trigger points in the jaw and restore normal tone and resting length, the bruxism reduces or is eliminated entirely.

In the meantime, though, let your dentist know that the splint is uncomfortable, and ask them to reexamine the fitting. Good luck!

What could cause severe, unexplained tooth pain?

While there can be a myofascial (muscle/connective tissue) component to this, it will, of course, be secondary to any significant findings by dental surgeons. This answer presupposes you have already sought a diagnosis from a dental surgeon.

Most commonly, the myofascial diagnosis will be of TMJ (temporomandibular joint dysfunction). Muscles that can cause pain in the teeth (due to myofascial trigger points) include:

Temporalis – a broad, flat muscle on each side of the head, which is a key muscle in mastication:


The “knots”, or trigger points, in this muscle refer (or send) pain to the regions denoted in red – including the teeth. To find if this is the cause of the pain, we’re going to do a bit of trigger point decompression. Heat the temporalis muscle and press on the “x’s” above until they feel like they soften or disappear. The tooth pain should immediately lessen or disappear as well.

Masseter – a quite strong muscle running vertically along the back of the jaw. This picture also images the lateral pterygoid muscle:


To find if the masseter muscle is the cause of the pain, we’ll treat it as we treated the temporalis muscle. First, heat the muscle. Then, hold compression on the areas indicated by the black dots. Do this until the knot feels like it is dissolving or becoming less painful.

Afterward, yawn as wide as you can, comfortably. Then take the muscle through its full range of motion by moving the lower jaw front/back/R/L/in/out/up/down. Yawn once more.

Again, if the tooth pain has reduced or has disappeared, a myofascial issue is probably your primary culprit.

If not, take yourself back to the your dental surgeon’s scans.