If you grind or clench your teeth at night, you’ve likely heard recommendations for a night guard, a TMJ stabilization splint, or even Botox. These options aren’t interchangeable—each has different goals, different effects, and different risks. Choosing the wrong one can worsen TMJ symptoms, increase clenching, or mask an underlying airway problem like sleep-disordered breathing.

This guide explains what each treatment does, who benefits most, potential side effects, and why airway screening is essential before choosing any bruxism intervention.

What Each Option Solves

Night Guard (Soft or Hard)

Primary purpose: Protect teeth
Best for:

• Mild bruxism without TMJ instability
  
• Short-term tooth protection
  
• Patients who can’t access custom splints yet

What it does:

• Acts as a barrier between upper and lower teeth
  
• Prevents enamel wear
  
• Reduces sensitivity and fractures

What it does not do:

• Stabilize the jaw
  
• Reduce clenching
  
• Address airway issues
  
• Improve TMJ dysfunction

Soft guards can increase clenching by triggering more muscle activity.

More on the limits of guards here:
/blog/teeth-grinding-bruxism-causes-fixes

Stabilization Splint (Flat-Plane Hard Acrylic Splint)

Primary purpose: Stabilize the TMJ + reduce grinding force
Best for:

• TMJ dysfunction
  
• Jaw clicking or popping
  
• Joint inflammation
  
• Chronic clenching/grinding
  
• People whose night guards made symptoms worse
  
• Patients with suspected airway-driven bruxism

What it does:

• Provides a stable, even surface for the jaw
  
• Reduces muscle activity
  
• Supports the TMJ disc and joint structure
  
• Minimizes compressive force on the joint
  
• Decreases morning jaw pain

What it does not do:

• Fix structural airway collapse
  
• Cure sleep apnea

Splints are most effective when paired with TMJ therapy:
/services/tmj-therapy

Botox for Bruxism

Primary purpose: Reduce muscle activity
Best for:

• Severe masseter overuse
  
• Cosmetic facial slimming
  
• Patients needing short-term relief
  
• Clenching driven by muscle hyperactivity

What it does:

• Weakens the masseter and temporalis muscles temporarily
  
• Can reduce pain and grinding intensity

Major limitations:

• Does not address airway issues
  
• Does not stabilize the TMJ
  
• Can worsen sleep-disordered breathing by weakening airway-support muscles
  
• May lead to muscle atrophy with repeated use

More comparison:
/blog/teeth-grinding-bruxism-causes-fixes

Side Effects

Night Guards

• May increase clenching
  
• Can worsen TMJ pain
  
• Soft guards wear out quickly
  
• Tooth movement with poorly fitting devices

Splints

• Temporary muscle soreness (expected)
  
• Requires adjustment by a trained provider
  
• Not effective if airway dysfunction is the primary cause

Botox

• Chewing weakness
  
• Facial asymmetry
  
• Sunken or hollow appearance with long-term use
  
• Possible worsening of airway collapsibility during sleep
  
• Not recommended when UARS or sleep apnea are suspected

Need for Airway Screening

Grinding is often an airway rescue reflex, not a dental problem.
Before choosing a guard, splint, or Botox, screening should rule out:

• Snoring
  
• Mouth breathing
  
• UARS
  
• Obstructive sleep apnea
  
• Nasal obstruction
  
• Chronic congestion
  
• Flow limitation
  
• Nighttime awakenings
  
• Daytime fatigue

Why?
If airway collapse is the underlying issue, any intervention that doesn’t address breathing will fail or worsen symptoms.

If airway-driven bruxism is suspected, start here:
/services/sleep-apnea-therapy

Costs and Timelines

Night Guard

• Cost: Low to moderate
  
• Longevity: 6–18 months (soft guards often less)
  
• Timeline: Immediate tooth protection

Stabilization Splint

• Cost: Higher upfront, long-term value
  
• Longevity: 3–10 years
  
• Timeline: Noticeable relief in 1–6 weeks, full stabilization in 3–6 months

Botox

• Cost: Moderate to high (repeated every 3–4 months)
  
• Longevity: Temporary
  
• Timeline: Relief begins in 3–10 days

Splint + therapy is usually more cost-effective long-term compared to repeated Botox.

FAQ

Will a splint fix TMJ?

A splint can significantly reduce pain, stabilize the joint, and decrease clenching.
But full TMJ recovery usually requires a combination of:

• Manual therapy
  
• Myofunctional therapy
  
• Posture correction
  
• Breathing and airway optimization
  
• Stress-modulation strategies

A splint is one tool—not the entire solution.

Is Botox permanent?

No. Botox typically lasts 3–4 months, after which muscle function returns.
Repeated use may weaken muscles permanently, alter facial contours, and affect chewing strength.

Why did a night guard worsen my symptoms?

Because many night guards—especially soft, non-custom, or poorly fitted ones—cause:

• Increased muscle activation
  
• Jaw repositioning
  
• More clenching effort
  
• TMJ compression
  
• Worsening airway collapse

If a guard worsened symptoms, airway or TMJ dysfunction is likely contributing.

To explore comprehensive evaluation and care:

• TMJ Therapy: /services/tmj-therapy

Sleep Apnea Therapy: /services/sleep-apnea-therapy