Bite Splint vs. Night Guard: Why the Difference Matters for TMJ, Clenching, and Facial Pain

If you’ve ever been told to wear a night guard for teeth clenching or TMJ pain, you’re not alone. Millions of people suffer from jaw discomfort, headaches, facial asymmetry, and tooth wear caused by chronic clenching or grinding. Unfortunately, conventional dentistry has long relied on a tool that only masks the symptoms: the night guard.

While night guards and bite splints may look similar on the surface—both typically made from clear medical-grade acrylic—they serve very different purposes. Understanding the difference between these two appliances can make or break your journey toward long-term relief.

What Is a Night Guard?

bite splint for tmj

A night guard (also called a bite guard or occlusal guard) is a protective barrier placed between the upper and lower teeth. It is custom-molded to your teeth and is typically worn on the upper arch. Its goal is to absorb some of the forces from nighttime clenching and grinding (bruxism) and to prevent tooth damage. But that’s all it does.

Night guards do not:

  • Address the root cause of clenching
  • Balance the bite or jaw joints
  • Improve tongue posture
  • Guide muscle relaxation

In fact, placing a bulky plastic appliance on the upper teeth can restrict the natural cranial movement at the mid-palatal suture, which is essential for healthy cranial rhythm. And since night guards do not correct jaw imbalance or encourage a “neutral position,” they often leave patients still clenching—just on plastic instead of teeth.

What Is a Bite Splint?

A bite splint (also referred to as a TMJ splint or orthotic) is a therapeutic appliance designed to correct the jaw relationship and provide a neuromuscular “neutral position” for the bite.

Here’s how bite splints work:

  • Made to fit the lower teeth, not the upper
  • Fabricated using precise neuromuscular measurements, not just tooth molds
  • Calibrated to allow the muscles of the jaw, face, neck, and shoulders to rest
  • Encourages proper tongue posture and improves airway space

A bite splint is not just a buffer; it’s a diagnostic and therapeutic tool that helps the jaw find a structural and muscular equilibrium. Many patients report relief from jaw pain, neck tension, headaches, and even improvements in sleep. While not a sleep apnea appliance, bite splints may reduce airway obstruction simply by allowing the tongue to rest in a better position.

The Importance of the Neutral Bite Position

The “neutral position” is a structural zone where the jaws can close in balance, and the surrounding muscles are at rest. When a person’s natural bite does not allow for this rest position, the body compensates with tension—often manifesting as clenching, grinding, TMJ pain, and postural strain.

The bite splint creates that neutral bite plane, reducing overactivity in the:

  • Masseter and temporalis muscles
  • Neck and shoulder muscles (especially the trapezius)
  • Muscles of facial expression

This is what makes a bite splint so powerful: it treats the root cause, not just the symptom.

Why Most Dentists Default to Night Guards

The truth is, conventional dentistry has not been well-trained in neuromuscular function or TMJ therapy. Making a night guard is a relatively simple process: take an impression, send it to the lab, and have them fabricate a generic plastic barrier.

Creating a bite splint, however, requires:

  • CBCT imaging to assess joint position and airway
  • Jaw tracking and bite registration in a neutral position
  • Post-doctoral training in TMJ and craniofacial development

In other words, bite splints require much more skill, training, and individualized care.

When Is a Bite Splint the Better Option?

If you suffer from any of the following, a bite splint may be a better choice than a night guard:

  • Chronic teeth clenching or grinding
  • TMJ dysfunction or clicking
  • Neck, head, or jaw muscle tension
  • Facial asymmetry or postural imbalances
  • Airway-related sleep issues

A bite splint can be used long-term for management, or as a diagnostic tool to determine the ideal jaw position before starting definitive treatment with:

Final Thoughts

While night guards may offer short-term protection against tooth wear, they do not treat the cause of clenching or TMJ pain. Bite splints, when properly made and calibrated by a TMJ-trained provider, offer a path toward true relief by creating a stable, neutral jaw position.

Don’t settle for a generic plastic barrier. If you’re dealing with jaw pain, clenching, or facial tension, it may be time to consider whether a bite splint is the missing piece in your treatment plan.

Contact our office to learn more about how we determine your neutral bite position and whether a bite splint is right for you.

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