Are Night Guards Covered By Dental Insurance?

When your dentist first tells you that you need a night guard, the dental office may tell you whether or not your insurance will pay the cost. While your dentist is knowledgeable in this area, each dental plan is unique, so you’ll want to double-check with your insurance carrier to make sure you’re covered. If your dental clinic informs you that night guards are covered but you subsequently find out that they aren’t, you’ll still be liable for paying for them.

Check with your insurance carrier to be sure. In most cases, you can research your plan online or call your dental insurance customer care and request an explanation of your benefits. He or she will know whether night guards are fully covered, somewhat covered, or not covered at all.

Preventative care such as cleanings and x-rays are covered by most dental insurance policies, but major care such as crowns and night guards is not covered by all. If your plan covers other major dental procedures like crowns, bridges, or dentures, it’s likely to cover night guards as well, but always double-check.

Once you’ve determined whether or not your plan covers night guards, you’ll need to determine how much they’re covered. Night guards are frequently covered at 50%, which means you are responsible for half the cost of the night guard (or your plan’s allotment for night guards, whichever is less) while your insurance company covers the other half. Even if your plan covers night guards at 50%, if your dental provider (aka your dentist) is out of network, you could find up spending more than half.

Sounds like a lot of nonsense, right? We understand that insurance might be perplexing. Let’s have a look at a few examples. We’ll imagine that the total cost of the night guard without insurance is $1,000, and that your insurance plan’s night guard allowance (the amount your dentist can charge) is $800 in both cases.

Scenario 1: Your dental provider (also known as your dentist) is in network (i.e., they participate in your insurance plan) and your insurance covers night guards for 50% of the cost. This does not necessarily imply that you would pay half the amount for your night guard, as the allowance is also taken into consideration. You’ll pay half of the allowance, not necessarily half of the night guard’s cost, if you use a participating service. So you’d pay $400 in this situation.

Scenario 2: Your dental provider (i.e., your dentist) is out of network (i.e., they aren’t covered by your insurance plan) and your insurer only pays half of the cost of night guards. In this situation, you would still be responsible for half of the allowance, or $400, as well as the $200 difference between the total cost of the night guard and the allowance. In this case, you would pay $600 for your night guard out of pocket.

The amount of coverage, allowances, and cost restrictions on dental insurance plans vary depending on your dental insurance provider and plan, so it’s always a good idea to check with your dental insurance provider to see what’s covered and how much is covered in your scenario. The basic truth is that if you buy a night guard from your dentist, whether or not it is covered by your insurance, you could end up spending a lot of money.

Your Options When Night Guard is not Covered by Your Insurance

It’s a real sorrow to learn that your insurance doesn’t cover night guards. Your teeth are physically crying for relief, but the cost of a night guard, according to your dentist, is prohibitively expensive. If this is the case, there are two big solutions that won’t break the bank: over-the-counter mouth guards and custom-fit night guards.

Over-the-counter Mouth Guards

This first choice is certainly quite appealing because you can immediately get a night guard at your local drugstore or on Amazon for a fraction of the amount your dentist quoted. Unfortunately, while this alternative is inexpensive and convenient, it is not perfect.

Night guards sold over the counter claim to be one size fits all, however this isn’t always the case. Some over-the-counter night guards employ the “boil and bite” method to try to shape the guard to your mouth, but you won’t obtain the exact fit that a custom night guard will provide.

If you’ve ever had to wear a boil and bite mouth guard for a sport, you know how they tend to shift around or fall out because it’s impossible to have a perfect fit with a product made to fit every mouth.

Furthermore, over-the-counter night guards are more prone to cause problems like pain, tooth movement, and jaw misalignment. These are most likely the issues you’re trying to solve with a night guard. Custom-fit night guards are a better option than over-the-counter night guards, yet they’re still reasonable!

Custom-fit Night Guards

Instead of being a one-size-fits-all solution, custom-fit night guards allow you to take imprints of your teeth at home, just as your dentist would. You save money by cutting out the middleman by ordering them online rather than going via your dentist, and you can do it all from the comfort of your own home.

The Bottom Line

Restorative dental procedures, including night guards, is not cheap. Repairing chipped or shattered teeth is both costly and unpleasant. If you want to maintain your smile and are tired of the bad consequences of clenching and grinding your teeth at night, you should invest in a good night guard that fits your mouth and protects your teeth.

You should consider your options carefully, especially if your insurance does not cover night guards. The goal is to hire a good night guard at a reasonable price. Don’t risk your teeth by using an over-the-counter night guard that may or may not fit. Choose a personalized night guard that will feel comfortable and will fit perfectly.

How much does a night guard cost from the dentist?

How much does a dentist’s night guard cost? The cost of a night guard from a dentist can range from $200 to $1,000, however most are between $300 and $500. Because you’re paying for the dentist’s services, this is the most expensive choice.

Do dentists give night guards?

Bruxism is the term used by dentists and medics to describe the habit of grinding or clenching one’s teeth at sleep. Because bruxism occurs while you sleep, you have little control over it, and it can be harmful. Grinding or clenching your teeth can wear them down over time.

In many circumstances, a dentist will recommend a night guard to help protect your teeth. This therapy strategy, however, could be hazardous in some situations. Why? Knowing a little about night guards for bruxism can help you grasp this problem.

Is a mouthguard a dental appliance?

Mouthguards are dental accessories that protect your teeth and gums from injury. Although over-the-counter stock mouthguards are affordable, custom-fit mouthguards from a dentist provide better protection for your teeth. Children and adults who participate in leisure activities or contact sports should always have a mouth guard on hand to protect their teeth from impacts and mishaps.

Mouthguards and other dental equipment protect your teeth, gums, tongue, and cheeks from trauma caused by sports or teeth grinding. People who suffer from sleep apnea can speak with their dentist about having a nightguard made specifically for them.

What type of dental service is night guard?

The surfaces of your teeth that are used for chewing are referred to as “occlusal.” An occlusal guard may be advised by your dentist if you are harming those surfaces by clenching or grinding your teeth.

An occlusal guard, also known as a nightguard, bite guard, or bite splint, is a removable dental appliance that fits over your upper or lower teeth. It protects your teeth from the damage that can be caused by teeth grinding and clenching, often known as bruxism. 1

While occlusal guards do not prevent you from grinding or clenching your teeth, they do assist protect the tooth surfaces from harm. Jaw pain, head and neck muscle soreness, tooth wear and fracture, tooth sensitivity, and migraines are all symptoms of bruxism that can be relieved by occlusal guards.

Occlusal guards resemble sports mouthguards in appearance, but they are often less bulky and composed of smoother, thinner plastic.

2 They can be custom-made by your dentist to suit your mouth perfectly, purchased ready-made (boil-and-bite or microwaveable) at a local drugstore, or ordered online.

You might be thinking if you need a nightguard or an occlusal guard. While teeth grinding or clenching on occasion should not be a major cause for concern, long-term bruxism can result in pain, fractured teeth, tooth enamel loss, and, in severe cases, tooth loss. An occlusal guard could be quite beneficial to those who suffer from mild to severe bruxism.

Bruxism is a problem that affects a large number of people. About ten percent of adults and up to fifteen percent of youngsters are thought to be impacted. 3 The grinding and clenching usually happens at night, but it can also happen during the day, and most people are completely unaware that they have a problem. Unless your sleeping companion complains, your dentist will usually be the first to notice the damage to your teeth and raise an alarm.

There are three types of occlusal guards that are commonly used to reduce the consequences of bruxism. If you’re unsure about which type is ideal for you, we recommend speaking with your dentist, who will be able to help.

1. Soft nightguard – Used to relieve bruxism symptoms in mild cases. They are usually comfortable to wear and easy to get used to.

2. Dual laminate nightguards – Designed for tooth grinders who grind their teeth moderately to severely. They have a soft, comfy interior and a sturdy, long-lasting outside.

3. Hard nightguards – These are only used in the most severe cases of bruxism. They are constructed of acrylic and must be custom-fitted by a dentist. They are incredibly sturdy and long-lasting.

The purpose of your occlusal guard is to make your mouth more comfortable. If it doesn’t, it’s possible that you don’t have the correct fit. It’s possible that your occlusal guard will need to be altered after it’s been placed, so let your dentist know if you’re unhappy with it or if you’re in pain. They’ll be able to assist you.

The majority of occlusal guards are only worn at night, although those who grind or clench their teeth during the day may benefit from wearing them during the day.

If aesthetics are an issue, your dentist can create a bespoke daytime guard that is less noticeable from the front, but may be less durable than nighttime guards.

It’s critical to clean your occlusal guard before and after each use because germs and other microbes might colonize them.

7. Inadequate care can result in worsening oral health issues or the spread of other diseases.

Occlusal guards will not prevent you from clenching or grinding your teeth, but they can be a highly effective approach to safeguard your teeth during the day or at night if you have those unintentional damaging oral habits. If you do decide to acquire an occlusal guard, the type you get will be determined by the severity of your problem, as well as your comfort requirements and economical constraints.

If you’re unsure if you require an occlusal guard, we recommend scheduling an appointment with your dentist. He or she will be able to detect any bruxing damage and assist you in choosing the best treatment choice for you.

G. 2 MJ; 2 MJ; 2 MJ; 2 MJ; 2 MJ (n.d.). Preventing orofacial trauma with occlusal adaptation and mouthguards. https://pubmed.ncbi.nlm.nih.gov/19408816/ Retrieved on August 14, 2020.

a) (n.d.). https://www.nhs.uk/conditions/teeth-grinding/ (accessed August 14, 2020).

6 S. Lal, S. Lal, S. Lal, S. La (2020, February 06). Bruxism Management is a term that refers to the management of bruxis https://www.ncbi.nlm.nih.gov/books/NBK482466/ Retrieved 14 August 2020 from https://www.ncbi.nlm.nih.gov/books/NBK482466/

What can I use instead of a night guard?

If mouth guards are uncomfortable or do not assist, talk to your dentist about these three other possibilities.

  • Splints for the eyes. An occlusal splint is one of the more similar treatments to a mouth guard.

Why do dentists push night guards?

A sleep guard may be recommended by your dentist to alleviate morning headaches, relieve TMJ jaw pain, and prevent damage to your teeth, jaw, crowns, and other dental restorations.

Can you buy night guards over-the-counter?

An over-the-counter night guard or sports guard can be purchased at your local drugstore or online. A pharmacy-bought night guard is better than nothing, but it won’t last nearly as long and won’t relieve symptoms as efficiently as a personalized night guard made from an impression of your mouth. The disadvantages of over-the-counter night guards, in my opinion, exceed any potential benefits.

  • They’re big and massive – Nightguards sold over the counter are a one-size-fits-all solution. As your dentist, I can guarantee you that no two mouths or teeth are alike in size or shape. These night guards are big and don’t fit properly, making it difficult to close your mouth, which can lead to further jaw pain and stiffness.
  • When patients bring me their over-the-counter night guards, I see that the “boil-and-bite” type can’t get a proper fit and don’t suction to the teeth. They tend to pop right out, so they wind up on your pillow rather than in your mouth at night.
  • They can cause extra damage – If your night guard isn’t properly aligned, you risk injuring or breaking your teeth by grinding on it.
  • They have a short shelf life — Over-the-counter night guards have a short shelf life. They usually last 1-3 months before starting to break down. I consider it a poor investment because they cost between $30 and $50 each time (and are likely to fit incorrectly, causing more problems).

Although custom night guards are more expensive up front, their longevity, success rate, and protective features make them well worth the money. Every night, I put on a personalized night guard, and it’s still going strong after five years!

  • We make your night guard based on the form and placement of your teeth, and we make sure the points of contact between your top and bottom teeth are perfect when you come to our office. We can also shave down any bulky areas so you may sleep peacefully with your lips closed. Our top goal at our Anderson Township dental office is ensuring that your night guard is comfortable and fits precisely. If it isn’t comfy, you are unlikely to wear it.

Many people profit from the procedure in addition to the protection of their teeth. Nightguards allow you to sleep with your mouth slightly open, yet give you something to bite on so that your mouth doesn’t open entirely. Because of this placement, night guards are generally effective in reducing mild snoring and sleep apnea. It is not a substitute for any sleep apnea treatment recommended by a doctor, and you should always visit your doctor if you have any sleep-related issues. Your family members may have a better night’s sleep if you wear an unique night guard!

Can you choke on a mouthguard in your sleep?

If the mouth guard does not fit properly, it will not provide enough protection. It’s risky to use a mouth guard that doesn’t grip your teeth tightly. It has the potential to come off in the middle of the night and suffocate you.

Should night guard cover gums?

The crown of the tooth above the gum line, as well as the junction and root of the tooth below the gum line, are all protected by athletic mouth guards. A sports mouth guard covers both the teeth and the gums (gingiva), but a night guard simply needs to cover the teeth and, most crucially, their biting surfaces. Irritation and inflammation of the gum tissue is common. Bacteria trapped against our gingival tissues for the duration of our sleep could be detrimental to our gum health. During a night’s sleep, the bacteria levels around the gums would increase. Repeatedly doing so will almost certainly result in gingivitis and possibly even gum disease (periodontitis). Periodontal disease is irreversible and might result in tooth loss. Our own spit is nature’s mouthwash! Saliva will wash our teeth and gingiva on a regular basis. This natural cleansing power helps to maintain the pH in our mouth balanced (preventing decay) and keeps germs at bay. This natural cleansing system is considerably hampered if any moderate to full coverage appliance is worn. A mouth guard or night guard with perforations (holes) is preferable because saliva may flow more freely, and sips of water can be swished to assist wash the teeth and gingiva, minimizing bacteria colonization.