Bruxism — teeth clenching and grinding — is one of the most destructive forces your teeth face. It happens involuntarily, primarily during sleep, and the forces generated by the jaw muscles during unconscious grinding far exceed normal chewing forces. Over time, bruxism wears down enamel, cracks teeth, loosens restorations, strains the TMJ, and causes chronic muscle pain and headaches.
A professionally made night guard protects your teeth from these forces and, equally important, is designed to keep the jaw muscles comfortable.
Dr. Kriston uses a two-layered night guard design called a Hard/Soft Comfort Night Guard, custom-fabricated by the lab from a digital scan of your teeth. The two layers serve different but equally important purposes:
The inner layer (against the teeth) is a clear, flexible material — similar to rubber — that hugs the teeth with gentle retention. This flexibility serves two key functions. First, comfort: the built-in cushion absorbs clenching and grinding forces, protecting both the teeth and the jaw joint from the full impact. Second, forgiveness: if the night guard hasn’t been worn for a while (a long trip, a period where it was misplaced), teeth shift slightly. A rigid, hard-plastic guard may not fit back in easily. The flexible inner layer adapts to minor tooth movement, so the guard still fits comfortably even after a few weeks away.
The outer layer (against the opposing teeth) is a clear, hard plastic that provides two essential functions. First, durability: the hard surface withstands years of grinding without wearing through. It’s far better to wear away plastic than enamel — and far less expensive to replace. Second, freedom of movement: the smooth, hard surface allows the opposing teeth to glide freely across it. This freedom is critical for muscle comfort. The jaw muscles are designed to move, and during sleep they will move involuntarily. A smooth surface lets them do so without resistance.
A professionally made night guard isn’t just about the materials — it’s about how the bite is calibrated on its surface. Dr. Kriston adjusts the guard so that biting forces are equally distributed front to back, right to left, and placed on areas where the teeth can safely support those forces.
This matters because not all teeth are in the same condition. Some may have cracks that shouldn’t bear additional force. Some may have large restorations that are vulnerable to fracture under pressure. Dr. Kriston knows where the weak points are — which teeth are cracked, which cracks are worse, and where to adjust the guard to protect them. This is essentially equilibrating the night guard for the harmony of the muscles and the protection of the teeth.
This level of customization is something no store-bought, online, or self-made appliance can provide.
Boil-and-bite night guards (and boil-and-bite sports guards used as night guards) are made of a soft, rubbery material throughout. When the opposing teeth sink into this material, they lock in place — the jaw cannot move freely. The muscles, which are contracting involuntarily during sleep, fight against this restriction. The result can be worse muscle soreness and jaw pain than wearing no guard at all. Additionally, self-made appliances often contact or cover the gums. Long-term wear traps plaque underneath, causing gum irritation and potential infection. If the material isn’t trimmed properly, it can press into the gums under biting pressure or, conversely, if trimmed too aggressively, the guard loses retention — falling out during sleep or, worse, dislodging and creating a choking hazard. Professionally made night guards avoid all of these problems through precision fit, proper material selection, correct trimming, and customized bite adjustment.
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Some medications, particularly antidepressants and other mood-stabilizing drugs, can increase jaw muscle activity and worsen grinding. If you’re taking these medications and experiencing signs of bruxism (worn teeth, morning jaw soreness, headaches), a custom night guard is especially important for protecting your teeth and managing the increased muscle forces.
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A TMJ orthotic is different from a night guard in both purpose and design. While a night guard primarily protects the teeth from grinding forces, a TMJ orthotic is designed to stabilize the temporomandibular joint itself and alleviate pain or soreness in the joint — not just the muscles.
Think of it the way you’d think of a brace or splint for a joint anywhere else in the body. A knee brace stabilizes the muscles, tendons, ligaments, and bones around the knee. A TMJ orthotic does the same thing for the jaw joint.
Location. A night guard is typically made for the upper teeth. A TMJ orthotic is usually made for the lower teeth.
Design philosophy. A night guard provides a flat plane for the opposing teeth to contact — it doesn’t actively direct jaw movement. A TMJ orthotic is designed to guide the jaw into a specific position, both when the teeth are in static contact and when the muscles are functioning (moving the jaw). It directs the jaw’s placement to stabilize the joint.
Wear schedule. A night guard is worn during sleep. A TMJ orthotic is often worn 24/7 — removed only for eating, brushing, and flossing — because the joint needs continuous stabilization to heal.
Clinical complexity. Making and adjusting a TMJ orthotic requires a more complex diagnosis than a night guard. Dr. Kriston uses our Carestream 3D CBCT to scan the joint and assess TMJ disk placement while the patient is wearing the orthotic. This imaging allows him to verify that the orthotic is positioning the jaw correctly relative to the disk and the joint structure.
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A TMJ orthotic is most often used for both diagnosis and therapy — it’s not meant as a permanent fix. The orthotic helps Dr. Kriston find the jaw position where the joint is comfortable, the muscles are relaxed, and the symptoms resolve. Once that comfortable position is achieved and confirmed with imaging, the orthotic provides the roadmap for a longer-term solution.
In many cases, that longer-term solution is a full mouth reconstruction — rebuilding the bite at the position the orthotic identified as optimal, so the teeth themselves maintain the jaw relationship that eliminated the pain.
The NTI (Nociceptive Trigeminal Inhibition) appliance is designed for a very specific situation: acute, severe muscle pain in the jaw — the kind of sharp, intense pain that feels like an emergency, not the chronic ache of long-term TMJ dysfunction. It is also used for migraine headaches to reduce the activity of the temporalis muscles in the temple areas.
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The NTI is a small, clear plastic appliance that sits on the upper front teeth and has a small flat platform that contacts only the lower four incisor teeth. It works on a neurophysiological principle similar to proprioception — a feedback loop between the teeth and the brain.
The best way to understand it: imagine you’re eating a bowl of rice, and hidden in the batch is a tiny piece of gravel. You place the soft rice in your mouth, your teeth start to close, and the instant they contact that unexpected hard object between the front teeth, the muscles reflexively back off. You didn’t think about it — it happened involuntarily, like a knee-jerk reflex when the doctor taps below your kneecap with a rubber mallet.
The NTI exploits this same reflex. When a hard surface is positioned between only the front teeth, the brain signals the jaw muscles to shut down — to stop clenching and grinding. The result is an immediate, dramatic reduction in muscle activity that provides relief from acute pain.
The NTI is not a long-term solution. It’s designed to get the patient through the acute crisis — the period of severe, sharp muscle pain — while adjunct protocols (heat/cold compress, anti-inflammatory medication) help reduce the inflammation that’s contributing to the problem.
Once the acute phase has passed, Dr. Kriston assesses the underlying cause and determines a longer-term solution — which may involve a night guard, a TMJ orthotic, equilibration, or full mouth reconstruction depending on the source of the dysfunction.
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A custom sports guard protects teeth, gums, and jaw joints from impact during athletic activities. Like all our oral appliances, sports guards are fabricated from a precise digital scan for an exact fit that stays securely in place during competition.
Professional sports guards are reinforced with materials specifically chosen for high impact resistance and force distribution. When a blow to the chin drives the lower jaw upward, the contact between the teeth and the guard must be properly aligned — both for the protection of the teeth and for the safety of the jaw muscles and TMJ. This alignment, combined with proper trimming away from the gum tissue, is something only a professionally fitted guard can provide.
We are proud to offer the ORB Sport Smart Mouthguard — a custom-fitted, 3D-printed sports guard with built-in technology that goes far beyond protection.
The ORB is fabricated from a Medit digital scan using 3D printing technology and contains a built-in microchip that tracks over 20 health and performance metrics in real time, including:
This data is transmitted in real time through an iPhone app (with Android support coming in the future), giving coaches and parents immediate visibility into an athlete’s condition during play. The impact tracking is particularly valuable for sports with concussion risk — the ORB can detect and record the force and location of head impacts as they happen.
The ORB Smart Mouthguard can be worn by athletes of all ages, with two considerations: younger athletes experiencing growth-related tooth movement will need replacement more frequently as their teeth shift, and the ORB is not compatible with orthodontic braces.
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In addition to night guards, TMJ orthotics, NTI appliances, and sports guards, we also fabricate custom oral appliances for obstructive sleep apnea (OSA). These appliances are worn during sleep and work by advancing the lower jaw forward, pulling the tongue and attached soft tissue away from the airway to prevent the collapse that causes snoring and apneic episodes.
Sleep apnea appliances are effective for mild to moderate OSA and are an alternative to CPAP machines for patients who find them uncomfortable or difficult to use. OSA has been associated with high blood pressure, cardiovascular stress, and a substantially increased risk of cardiac events due to the oxygen deprivation that occurs during apneic episodes.
We recommend a professional examination and sleep study diagnosis before fabricating a sleep apnea appliance. For more severe cases, surgical intervention to reduce the soft tissue obstructing the airway may be needed.
Every custom oral appliance starts with a precise digital scan using our Medit i900 intraoral scanner. No messy, gagging impression trays — just a comfortable handheld wand that captures a 3D model of your teeth in minutes.
The digital scan is sent to the lab electronically, where the appliance is fabricated to exact specifications. The lab stores your digital files for up to five years, so if an appliance is lost, damaged, or eaten by the dog, a replacement can be made quickly without needing a new scan.
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By far the best dentist I’ve had! Extremely thoughtful in his work, taking time to explain the reasoning behind decisions and will even show you the details of what is going on with your teeth through a micro camera. I had a few significant issues with my teeth, and Michael was the first of four dentists I had seen to provide a thoughtful long term solution in the least invasive way possible. He is truly concerned with the health and function of your teeth and gums, and is extremely skilled to implement great solutions. Would highly recommend.
I had my first visit with Dr. Kriston and had the best experience in a dental office, by far. I was looking for a dentist to revamp my smile and a friend recommended Dr. Kriston. Dr. Kriston spent a lot of time listening to my vision and together we came up with a plan for my smile that I'm very happy with. Everyone in the office was friendly, helpful and welcoming. My bar was set high and Dr. Kriston went well above it with his knowledge, recommendations and real understanding of my situation.
The office is beautiful, modern and spotless. They have relaxing music playing throughout that right away made me feel calm. The front receptionist is very attentive and supportive; she answered all my questions and clearly explained the cost and my insurance. I qualified for an interest free payment plan and was able to afford my dream smile.
I just had to write this review because I'm so happy I found Dr. Kriston. I've been self conscious about my teeth for years and I just couldn't find a dentist I felt this good about. I highly recommend Dr. Kriston.
Clean, professional, and easy to use. Velora gave my agency the polished online presence it needed."
Clean, professional, and easy to use. Velora gave my agency the polished online presence it needed."
Clean, professional, and easy to use. Velora gave my agency the polished online presence it needed."
Clean, professional, and easy to use. Velora gave my agency the polished online presence it needed."
By far the best dentist I’ve had! Extremely thoughtful in his work, taking time to explain the reasoning behind decisions and will even show you the details of what is going on with your teeth through a micro camera. I had a few significant issues with my teeth, and Michael was the first of four dentists I had seen to provide a thoughtful long term solution in the least invasive way possible. He is truly concerned with the health and function of your teeth and gums, and is extremely skilled to implement great solutions. Would highly recommend.
I had my first visit with Dr. Kriston and had the best experience in a dental office, by far. I was looking for a dentist to revamp my smile and a friend recommended Dr. Kriston. Dr. Kriston spent a lot of time listening to my vision and together we came up with a plan for my smile that I'm very happy with. Everyone in the office was friendly, helpful and welcoming. My bar was set high and Dr. Kriston went well above it with his knowledge, recommendations and real understanding of my situation.
The office is beautiful, modern and spotless. They have relaxing music playing throughout that right away made me feel calm. The front receptionist is very attentive and supportive; she answered all my questions and clearly explained the cost and my insurance. I qualified for an interest free payment plan and was able to afford my dream smile.
I just had to write this review because I'm so happy I found Dr. Kriston. I've been self conscious about my teeth for years and I just couldn't find a dentist I felt this good about. I highly recommend Dr. Kriston.
By far the best dentist I’ve had! Extremely thoughtful in his work, taking time to explain the reasoning behind decisions and will even show you the details of what is going on with your teeth through a micro camera. I had a few significant issues with my teeth, and Michael was the first of four dentists I had seen to provide a thoughtful long term solution in the least invasive way possible. He is truly concerned with the health and function of your teeth and gums, and is extremely skilled to implement great solutions. Would highly recommend.
I had my first visit with Dr. Kriston and had the best experience in a dental office, by far. I was looking for a dentist to revamp my smile and a friend recommended Dr. Kriston. Dr. Kriston spent a lot of time listening to my vision and together we came up with a plan for my smile that I'm very happy with. Everyone in the office was friendly, helpful and welcoming. My bar was set high and Dr. Kriston went well above it with his knowledge, recommendations and real understanding of my situation.
The office is beautiful, modern and spotless. They have relaxing music playing throughout that right away made me feel calm. The front receptionist is very attentive and supportive; she answered all my questions and clearly explained the cost and my insurance. I qualified for an interest free payment plan and was able to afford my dream smile.
I just had to write this review because I'm so happy I found Dr. Kriston. I've been self conscious about my teeth for years and I just couldn't find a dentist I felt this good about. I highly recommend Dr. Kriston.
By far the best dentist I’ve had! Extremely thoughtful in his work, taking time to explain the reasoning behind decisions and will even show you the details of what is going on with your teeth through a micro camera. I had a few significant issues with my teeth, and Michael was the first of four dentists I had seen to provide a thoughtful long term solution in the least invasive way possible. He is truly concerned with the health and function of your teeth and gums, and is extremely skilled to implement great solutions. Would highly recommend.
I had my first visit with Dr. Kriston and had the best experience in a dental office, by far. I was looking for a dentist to revamp my smile and a friend recommended Dr. Kriston. Dr. Kriston spent a lot of time listening to my vision and together we came up with a plan for my smile that I'm very happy with. Everyone in the office was friendly, helpful and welcoming. My bar was set high and Dr. Kriston went well above it with his knowledge, recommendations and real understanding of my situation.
The office is beautiful, modern and spotless. They have relaxing music playing throughout that right away made me feel calm. The front receptionist is very attentive and supportive; she answered all my questions and clearly explained the cost and my insurance. I qualified for an interest free payment plan and was able to afford my dream smile.
I just had to write this review because I'm so happy I found Dr. Kriston. I've been self conscious about my teeth for years and I just couldn't find a dentist I felt this good about. I highly recommend Dr. Kriston.
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