Retainer or Nightguard

One of our patients who completed his orthodontic treatment about 5 years ago came in with his retainers chewed to bits. This latest set of retainers has only been in use for less than a year. He acknowledged that he has been very stressed lately and that he has been grinding his teeth intensely in his sleep. This has resulted in his retainers breaking into several pieces.

In view of his current situation, we prescribed a full coverage nightguard to serve both as a retainer and as protection for his teeth. As the cost of the full coverage nightguard cost more than a retainer, the patient was unsure as to whether he should spend the additional money.

We told the patient that night time grinding (bruxism) generates more force on his teeth than he could possibly produce when he is awake. We have seen teeth snap in two as a result of bruxism.
With the full coverage nightguard, he would be grinding against acrylic (which is softer) instead of against his own natural teeth. The nightguard will ultimately fail under such abuse. However, in the long term, it would be much cheaper to replace a nightguard than to replace a fractured tooth (greater than 1:8 ratio).

In light of this information, the patient decided to go ahead with the nightguard.