TMJ Treatment, Night Guards, and Custom Mouthguards

That is the reason this work belongs with a specialist in how teeth fit and function: a guard that sits wrong on the bite can do as much harm as good.

TMJ evaluation and treatment

The temporomandibular joint (TMJ) is the hinge that connects your jaw to your skull. When it's strained — often by clenching, grinding, or a bite that doesn't meet evenly — it can cause jaw pain, headaches, clicking or popping, and difficulty opening wide.

Dr. Steel evaluates how your teeth come together, how the joint moves, and where the strain is coming from, then recommends treatment aimed at the cause. For many patients that means an occlusal splint or night guard that takes pressure off the joint and muscles. The goal is to relieve the symptoms and protect the teeth, starting with the most conservative option that fits the problem.

Night guards for grinding and clenching

Grinding and clenching, especially during sleep, wear teeth down, crack fillings and crowns, and strain the jaw. A custom night guard — also called an occlusal splint — is a fitted appliance worn while you sleep that cushions the teeth and keeps them from grinding against each other.

The fit is what matters. A drugstore guard is molded roughly to your teeth and can shift your bite; a custom night guard is made from a precise impression of your mouth to sit correctly and protect the bite you have. This is routine prosthodontic work, and it often prevents far more expensive damage down the road.

Custom sports mouthguards

A custom sports mouthguard protects teeth and jaws during contact sports and other athletics. Made from an impression of your teeth, it fits better and stays put more reliably than a boil-and-bite version from a store, which means better protection and easier breathing and speaking while you wear it. These are available for patients 12 and up.

Sleep apnea oral appliances

For some patients with obstructive sleep apnea or heavy snoring, a custom oral appliance is an alternative to a CPAP machine. Worn during sleep, it gently holds the lower jaw forward to keep the airway open. Dr. Steel makes and fits these appliances; a sleep apnea diagnosis comes from a physician, so this works best alongside your medical provider's evaluation. If you haven't been evaluated for sleep apnea, we'll point you toward getting that done first.

The process and timeline

1. Evaluation. Dr. Steel examines your bite, teeth, and jaw, and reviews your symptoms or, for a sports guard, your needs.
2. Digital impression. A precise impression of your teeth is taken with an intraoral scanner.
3. Fabrication. The lab builds the appliance to fit your bite exactly.
4. Fitting and adjustment. The appliance is checked, adjusted for comfort and bite, and you're shown how to wear and care for it.

Why a prosthodontist

Every appliance on this page depends on the bite, and the bite is the prosthodontist's core subject. Dr. Steel is board-certified by the American Board of Prosthodontics, the specialty defined by how teeth fit and function together, which is precisely what a guard or splint has to get right. More about her training and credentials. What a prosthodontist does, and when to see one.

Placeholder: photo of a custom night guard and appliance coming soon.

Common questions