Night Guard (Occlusal Splint) in Santiago

A night guard (also called an occlusal splint, bruxism splint or bite guard) is a custom device that sits between the teeth, usually on the upper arch, while you sleep. It changes the position of the joint, spreads the forces of clenching and protects enamel and restorations while the cause of the problem is treated. At AS Odontología Digital in Vitacura it is prescribed by Dr. Montserrat Ortega B., a specialist in temporomandibular disorders and orofacial pain, and made from an intraoral scan, with no alginate impression.

We prescribe a splint for two main reasons: to reduce inflammation in the temporomandibular joint when there is an inflammatory condition, and to protect tooth structure in patients who grind or clench at night, with wear, fractures or restorations that keep coming loose. In specific, well-studied cases, for example when gastroesophageal reflux is eroding the teeth, we use a resilient (soft) splint. Before prescribing one we evaluate the joint, the muscles, the bite and the airway, because a splint fitted without a diagnosis can hide a problem instead of treating it.

The point we most want you to understand: the splint is a tool within a comprehensive treatment, not the treatment itself. It reduces inflammation and protects while habits are corrected, other factors are managed and whatever lies behind the pain, the grinding or the wear is treated. Once the cause is treated, you stop using it. If an orthopedic surgeon prescribed an immobilizing boot for life, you would seek a second opinion. The same applies to a splint: leaving it in forever just hides the symptom.

We work with three types depending on the diagnosis: the pivot splint and the Sved splint, which always go on the upper arch, and the resilient splint, which can go upper or lower and is reserved for specific indications. Which one you need depends on the condition, the treatment goal and the number and position of your teeth. There is a clinical reason to prefer the upper arch: when there is a risk of sleep apnea, taking up space in the lower arch pushes the tongue back and narrows the airway.

That is why no splint is fitted here without a comprehensive evaluation that includes screening for obstructive sleep apnea: snoring, awakenings, getting up at night to urinate, night sweats, daytime sleepiness and certain facial and body features. Some splints can worsen an undiagnosed apnea. If there is suspicion, the conversation changes: a splint helps reduce joint inflammation, but what opens the airway is a mandibular advancement device (MAD), which brings the jaw forward. In some cases we use the splint first to treat the joint inflammation and the MAD afterwards. That work is done with our airway and sleep team.

Fabrication is digital from start to finish. The intraoral scan is more comfortable than an alginate impression, especially if you have a strong gag reflex or breathe through your mouth, and it captures the teeth in more detail. It also remains as a permanent, editable, repeatable record: if the splint needs adjusting or remaking, we do not start over. We choose the material by the mechanical demands of the case: 3D-printed resin when we want a personalized, precise, quickly made device; milled PMMA when we need more strength and durability. Conventional acrylic remains valid but has lower mechanical properties, so with a digital workflow available it is not our first choice for a splint under high forces. The evidence on the long-term performance of these materials still has open questions.

The splint is worn while sleeping. In some cases of joint inflammation we prescribe daytime use, but for limited periods, never continuously. Noticing more saliva or a dry mouth at first is normal. Tooth, joint or muscle pain is not: if it happens, stop using it and come in. Because it is worn for limited periods, it should not move your teeth. Nor is it replaced on a schedule: as long as it is not fractured and does its job, it stays. If a splint wears down or breaks easily, rather than assuming excessive forces we look for reflux, because an acidic environment degrades the splint just as it does the teeth.

About pharmacy splints, marketplace splints or the ones you soften in hot water and bite into: we do not recommend them. Self-prescribed and fitted at home, without a diagnosis or a treatment plan, they can worsen or hide a joint condition, reflux or apnea. And since nobody controls their thickness, size or tooth contacts, they rarely do what they promise.

We see patients from Vitacura, Las Condes, Lo Barnechea, Providencia and the rest of Santiago, including international patients. Splints can also be used in children and adolescents, always after a complete evaluation.