- An occlusal guard can protect dental prostheses and significantly enhance their longevity
- Hard occlusal guards are often more effective than soft ones in bruxers
- Soft occlusal guards are often more effective than hard ones in clenchers
The use of acrylic or porcelain artificial teeth brings different challenges related to nocturnal paranormal function. High occlusal forces can be mitigated by wearing of a protective occlusal guard. Acrylic teeth may wear over time and/or become dislodged from the denture base. In general, acrylic teeth are easier to adjust and easier to repair than porcelain teeth. However, some clinicians feel that porcelain teeth offer an advantage in esthetics and texture. Porcelain teeth are less likely to exhibit wear than acrylic teeth; instead, they manifest their response to mechanical overload through fracture – which can necessitate replacement of the entire prosthesis.
If a patient is known to have paranormal function such as bruxing or clenching, this should be accommodated in the treatment plan by appropriate choice of prosthesis design and materials. For these patients, an occlusal guard should be included in the original treatment plan.
Occlusal Guard design considerations
An occlusal guard lies over the artificial teeth and protects them by providing an intervening substance against which the opposing teeth apply force. The guard acts as an absorber and distributor of occlusal forces. In general, soft occlusal guards are better tolerated, and hence have greater patient compliance, than hard occlusal guards. Soft guards are particularly effective in clenchers, who exhibit an axial direction of occlusal force. Bruxers, who have a lateral motion to their paranormal activity, are best served by a hard occlusal guard that has good wear properties.