Night guards are the most commonly recommended intervention for bruxism—but they protect teeth, not reduce grinding. Biofeedback, by contrast, aims to reduce the grinding behaviour itself. The research supports it. The problem? Biofeedback devices essentially don't exist on the consumer market.

Understanding what each approach actually does—and doesn't do—is essential for choosing the right management strategy.

How night guards work

Occlusal splints (night guards) create a physical barrier between upper and lower teeth. When grinding occurs, the splint absorbs and redistributes the force, preventing direct tooth-on-tooth contact.

What they do well:

• Protect enamel from further wear
• Prevent cracks, chips, and fractures
• Distribute clenching forces across a wider surface
• May reduce some muscle strain by changing jaw position

What they don't do:

Night guards do not stop grinding or clenching. The muscle activity continues—it's just occurring against plastic rather than enamel.

Here's the frustrating reality that many patients discover: some research suggests that certain splint designs may actually increase clenching in some individuals. The TMJ Association notes that while splints can protect teeth, "they don't stop the bruxism itself" and treating bruxism with a guard alone "does not always resolve jaw pain."

For most people with moderate to severe bruxism, night guards are valuable for preventing dental damage. But they're a management tool, not a treatment for the underlying behaviour.

How biofeedback works

Biofeedback for bruxism uses sensors to detect jaw muscle activity, then provides real-time feedback—sound, vibration, or gentle electrical stimulation—to interrupt the grinding behaviour.

Here's the critical context: biofeedback devices for bruxism are not widely available on the market. While the research is compelling, products have either never launched, briefly existed then disappeared (like GrindCare), or remain in development. This means biofeedback is rarely prescribed or recommended in clinical practice—not because it doesn't work, but because there's nothing accessible to recommend.

The mechanism differs for awake versus sleep bruxism:

For awake bruxism: Biofeedback builds conscious awareness. When clenching is detected, feedback prompts voluntary relaxation. Over time, this can retrain automatic habits.

For sleep bruxism: Research shows the brain can process sensory information during light sleep without full awakening. A systematic review found that contingent electrical stimulation (CES) can trigger a natural reflex that relaxes the jaw muscles—reducing grinding episodes without significantly disrupting sleep (Jokubauskas & Baltrušaitytė, 2018).

What the research shows

Night guards

Decades of clinical experience support splints for dental protection. They're safe, well-tolerated, and prevent the worst physical consequences of grinding.

However, evidence that splints reduce grinding frequency or intensity is mixed. They address consequences rather than causes.

Biofeedback

A randomized controlled trial using contingent electrical stimulation found a 52% reduction in EMG episodes per hour during treatment sessions compared to baseline (Jadidi et al., 2013). The study noted this reduction was statistically significant, though the small sample size (11 patients) limits generalisability.

A systematic review and meta-analysis concluded that after 5 nights of biofeedback therapy, "bruxism episode frequency significantly decreased compared to placebo devices" (Jokubauskas & Baltrušaitytė, 2018). Importantly, no major sleep disturbances were observed from the feedback stimuli.

Key limitations: Most biofeedback studies are small and short-term. Long-term learning effects—whether the reduction persists after stopping the device—remain under investigation. Some studies show a return to baseline levels after biofeedback is discontinued; others suggest lasting effects in certain patients.

Cost and accessibility

Night guards:

• Custom dental splints: £200-800 (varies by region)
• Over-the-counter: £15-50
• One-time purchase (though custom guards may need replacement every few years)
• Widely accessible through any dentist

Biofeedback devices:

• Essentially no consumer options currently available
• Research devices used in clinical trials are not commercially sold
• Historical products (like GrindCare) showed results but were discontinued
• This gap between validated research and available products is a significant problem in bruxism care

Can you use both?

Night guards and biofeedback are not mutually exclusive. In fact, a combined approach may be most practical:

• Night guard: Provides immediate protection while working on behaviour change
• Biofeedback: Targets long-term reduction of grinding activity

This mirrors how bruxism experts increasingly view treatment: multimodal approaches addressing both consequences (dental protection) and underlying behaviour (awareness and modification).

The bottom line

Night guards manage consequences. Biofeedback targets causes.

Choose night guards if:

• Primary concern is protecting teeth from further damage
• Looking for a simple, well-established intervention
• Symptoms are primarily dental rather than pain-related

Consider biofeedback if:

• Want to reduce the grinding behaviour itself
• Have already tried splints without adequate relief
• Interested in awareness training for awake bruxism

Consider both if:

• Have moderate to severe bruxism with ongoing dental damage
• Want protection while working on longer-term behaviour change

Neither approach is a "cure." Bruxism is a complex behaviour influenced by stress, sleep, and neurological factors. Effective management typically requires multiple strategies working together—dental protection, awareness training, stress management, and physical therapy.

The future likely lies in integrated solutions that combine monitoring, feedback, and protection in coordinated treatment plans. Until then, understanding what each tool actually does helps set realistic expectations and choose wisely.