My husband has senile dementia, and grinds his teeth. Would a mouth guard be a good idea?

1 answer | Last updated: Oct 14, 2016
A fellow caregiver asked...

My 93 year old husband grinds his teeth very, very loud when he sleeps. He has never done this before in the 61 years we have been married. He has had many health problems in the past year. He has Senile Dementia at times, but is quite lucid at other times. Our dentist said a mouth guard might be appropriate, but he would probably remove it as he usually removes p.j.s, sheets, blankets, etc. Any helpful suggestions?

Expert Answers

Dr. David Blende, DDS, has more than 20 years' experience providing comprehensive dental care. His practice, the Blende Dental Group, serves the phobic, disabled, geriatric, and medically compromised communities through sleep dentistry. A division of his practice, Bay Area House Call Dentists, delivers dental services to senior communities and private homes in the San Francisco Bay Area.

The teeth grinding and clenching you are hearing and seeing is called bruxism. The cause of nocturnal bruxism is unknown. Most theories link bruxism to central nervous system disorders, anxiety, medications, or other medical and dental conditions. Over time, bruxism causes damage to the teeth, gums, and the Tempromandibular joint or TMJ. Treatment for bruxism largely includes management with a removable device such as a night guard or NTI splint. Night guards and splints prevent tooth wear, but do not cure bruxism. The patient will continue to grind into the acrylic guard.

Three types of night guards include a soft guard, a hard night guard, and a NTI or nociceptive trigeminal inhibitor splint. All night guards are fabricated from impressions and moulds made at the dental office. The hard night guards are made of clear acrylic and may contain wire clasps for retention making it difficult to remove during sleep. This type of guard may require assistance in its removal for a patient with dementia. The soft night guards tend to wear quicker depending on use and do not contain clasps. They are also called a sports guard. NTI splints, which only cover the front teeth, act to alter the angle of the jaw and prevent muscular contraction of the jaw muscles.

More invasive treatments are available if a night guard does not improve bruxism, but the efficacy of these procedures is unknown. Such treatments include orthodontics to align the teeth properly, Botox, or as a last resort, surgery.

It is important for your husband to receive a comprehensive dental examination and maintain hygiene visits in order to monitor changes in his oral health. If his dentist prescribes a night guard for grinding, bring his appliance to each hygiene visit to monitor wear and fit.