Aftercare
Night guards and bruxism — protecting veneers and implants
Why NZ patients with bruxism need a custom night guard after Picasso veneers or implants — forces involved, guard types, getting one in NZ, disclosing bruxism before treatment, and Masseter Botox as adjunct.
NZ patients with bruxism should wear a custom hard-acrylic night guard after Picasso veneers or implants; bruxism forces can exceed normal chewing load by up to 10 times and are the leading non-traumatic cause of veneer fracture; guards are fitted at Picasso before departure or fabricated by a NZ dentist from impressions; cost in NZ is typically NZD 300–700; May 2026.
Bruxism is one of the most common and most damaging habits that patients do not know they have. It operates during sleep, outside conscious awareness, and its effects accumulate invisibly until a veneer chips, a crown fractures, or a dentist points out molar wear that took years to develop. For patients with porcelain veneers or dental implants, understanding and managing bruxism is not optional — it is the single most impactful long-term care decision.
What is bruxism and why does it matter for dental work
Bruxism is habitual, unconscious grinding or clenching of the teeth — most often occurring during sleep (sleep bruxism) but also during waking hours in some patients (awake bruxism). It is not a character flaw or a sign of anxiety, though stress often correlates with its intensity. It is a parafunctional habit: jaw movement outside the normal functional purpose of chewing.
The forces generated during active bruxism are substantially higher than those produced by normal chewing. Research on bite force measurement suggests bruxing forces can reach 3–10 times the load of normal mastication, applied laterally and repeatedly across the tooth surfaces in patterns that normal chewing does not replicate.
For veneers: Porcelain is hard and wear-resistant under vertical (axial) loads — the type generated when chewing normally. It is far more vulnerable to lateral shear forces — the type generated by grinding across the incisal edge. Chips at the edge of front veneers are the most common fracture pattern in bruxers.
For implants: Unlike natural teeth, implants have no periodontal ligament — the fibrous shock-absorbing structure that surrounds natural tooth roots. Force is transmitted directly from the crown through the implant to the bone. Under normal chewing load, this is not a problem — the implant system is designed for it. Under repetitive parafunctional loading, the cumulative stress at the implant-bone junction can contribute to peri-implant bone stress over years.
Signs you may be grinding — the quiet destroyers
Bruxism often produces no pain during the act itself, which is why many patients are genuinely unaware they do it. Signs to look for:
- Waking with a dull ache in the jaw muscles, temples, or behind the ears — classic morning bruxism headache.
- A partner reporting grinding sounds during sleep.
- Flattened, chipped, or unusually smooth-looking molar cusps — a dentist will recognise this wear pattern immediately.
- Grooves or indentations on the inner surface of the cheeks or sides of the tongue from pressing against teeth during clenching.
- Enlarged or visibly hypertrophic masseter muscles — this produces a wide, squared jaw appearance that is particularly noticeable in people with otherwise slight builds.
- Increased sensitivity across multiple teeth simultaneously, without decay or other obvious cause.
- Broken fillings or crowns in the absence of biting something hard.
If three or more of these apply to you, raise it at your dental consultation before treatment — not as an afterthought.
Why veneers and implants are at higher risk
Natural teeth have several structural advantages that porcelain restorations do not. Enamel is hard but has some flex. The periodontal ligament absorbs and distributes force. The pulp inside the tooth can signal overload through sensitivity.
Emax Press porcelain is denser than enamel and has zero flex. When lateral shear force is applied repeatedly to a thin porcelain incisal edge, the material reaches its fracture limit. There is no early warning signal — the veneer chips, sometimes without the patient feeling anything, sometimes with a small snap.
For this reason, the presence of identifiable bruxism means the night guard is not a recommendation — it is a clinical prerequisite for veneers that are expected to perform within their warranted lifespan.
Types of night guards — what Picasso fits and what your NZ dentist can make
Custom hard-acrylic (PMMA) guard: This is the gold standard for bruxism management in patients with ceramic restorations. Made from precise impressions of your teeth, the guard fits exactly against your arch and distributes grinding forces across the entire occlusal surface rather than concentrating them on individual teeth or restorations. The hard surface is key — it is rigid enough that grinding forces are dissipated laterally rather than absorbed into the material (which soft guards do, with the effect of encouraging harder clenching in some patients).
Picasso can fabricate a guard during your treatment visit and ensure the occlusal contacts are calibrated against your new veneer position before you leave — this is the ideal scenario, as the guard is made to the exact bite established by the veneers.
Soft or semi-rigid over-the-counter guards: These are available at pharmacies and are adequate for very mild cases where bruxism is minimal. For any patient with active, noticeable grinding and porcelain restorations, they are not sufficient. The soft material provides inadequate force distribution, and many bruxers clench harder against soft resistance.
Getting a night guard in New Zealand after treatment
If you were not fitted with a guard at Picasso before leaving, your NZ dentist can fabricate one from impressions. The process involves an impression appointment, 1–2 weeks of laboratory fabrication, and a fitting and adjustment appointment.
When briefing your NZ dentist for guard fabrication:
- Tell them you have Emax Press porcelain veneers (or Lava/Zirconia crowns, as applicable).
- Ask them to confirm the occlusal contacts on the guard are even and do not create a high point on any individual veneer — this is the most common error with NZ-fabricated guards for patients with multiple veneers.
- Request a hard-acrylic (not soft) guard.
Cost in NZ is typically NZD 300–700. Replace the guard every 2–3 years, or sooner if you can see significant wear grooves in the acrylic surface.
If you grind and want veneers — disclosing before treatment
Disclose bruxism explicitly in your /free-quote/ consultation submission. Photograph your molar teeth if visible wear is present — this is more informative than a verbal description.
With known bruxism, Picasso’s planning considerations include:
- Fabricating the night guard during the treatment visit, calibrated to the new veneer position.
- Selecting veneer thickness that allows for slightly higher occlusal loading without compromising aesthetics.
- Adjusting the shade selection if thicker porcelain is needed, to maintain the right opacity and translucency.
- Ensuring the occlusal design does not create leverage points on incisal edges under lateral excursion.
None of these considerations disqualifies a bruxer from veneers. They change the technical approach, and they change the aftercare requirements — consistently.
Masseter Botox — an optional adjunct
Masseter Botox involves injections of botulinum toxin into the masseter muscle on each side of the jaw. By partially weakening the muscle’s resting force, it reduces the bite force generated during bruxism episodes.
The reduction in force is not complete — masseter Botox does not eliminate bruxism, and it does not replace a night guard. But for patients with severe bruxism where the guard alone provides insufficient protection, Botox as an adjunct can meaningfully reduce cumulative loading on restorations.
Effect duration: approximately 4–6 months per treatment cycle, after which force gradually returns as the toxin breaks down.
Masseter Botox is available from NZ cosmetic medicine providers and some dental practices. It is not something Picasso arranges as part of treatment, and the clinical decision should involve a NZ provider familiar with your medical history. It is worth discussing if your bruxism is severe and your dentist confirms significant wear despite consistent guard use.
Sports guards — separate from night guards
A sports mouthguard is designed for impact absorption during contact sport — rugby, hockey, boxing, martial arts, and similar activities. It is typically softer, thicker, and covers more of the arch than a night guard.
It does not protect against night grinding. Using a sports guard at night is not appropriate for active bruxers — it may reduce some impact risk if worn but will not distribute grinding forces correctly and may encourage harder clenching.
If you play contact sport and grind at night, you need both: a custom night guard for sleep, and a sports mouthguard for sport. Brief whichever provider makes your sports guard about your veneer material so they can select a guard design that does not create hard contact points on porcelain incisal edges.
See also: Veneers — full treatment guide · Veneer care tips — daily maintenance · Chipped or loose veneer — what to do · Dental implant aftercare
Next step
If you suspect bruxism and are planning veneers or implants, mention it in your /free-quote/ submission. For SmileCare warranty terms and how bruxism relates to warranty conditions, see /warranty/. For the full dental implant guide see /dental-implants/.
About this page
Medically reviewed by
Dr. Emily Nguyen
Founding Clinical Director, Picasso Dental Clinic
DDS · Founder and Clinical Director, Picasso Dental Clinic group
Clinical focus: Cosmetic dentistry · Veneers · Smile design
Dr. Emily Nguyen founded Picasso Dental Clinic in 2013 (originally Serenity International Dental Clinic) and led its 2023 rebrand. She sets clinical standards across the group's six branches in Hanoi, Da Nang, Ho Chi Minh City, and Da Lat, and personally reviews cosmetic protocols including the Portrait Sitting workflow for veneers and smile makeovers.
Frequently asked questions
Can I get veneers if I grind my teeth?
Usually yes, but bruxism must be disclosed before treatment. Picasso will factor it into the treatment plan — typically recommending a night guard fabricated before or during the veneer appointment, selecting appropriate veneer thickness to accommodate higher occlusal loads, and possibly adjusting the shade choice to allow for slightly thicker porcelain where needed. Undisclosed bruxism that causes veneer fracture is unlikely to be covered by the warranty.
What is the difference between a night guard and a sports mouthguard?
They are different devices for different purposes. A night guard is a hard acrylic appliance, fitted precisely from impressions of your teeth, worn during sleep to protect against grinding and clenching forces. A sports mouthguard is softer and thicker, designed to absorb impact during contact sport and protect against trauma. If you grind at night and play contact sport, you need both. Using a sports guard at night is not an adequate substitute for a proper night guard.
How do I know if I grind my teeth?
Common signs: waking with a dull jaw ache or headache; your partner reporting grinding sounds during sleep; flattened or chipped molars on your back teeth; worn-down cusps; groove marks on the inner cheek or tongue from pressing against teeth; enlarged jaw muscles (a wide, square jaw appearance); or increased sensitivity across multiple teeth without a clear cause. A dentist can identify wear patterns on your teeth that confirm bruxism even if you are unaware of the habit.
What does a custom hard-acrylic night guard cost in New Zealand?
Typically NZD 300–700, depending on the laboratory used and the complexity of your occlusion. Some dental practices charge more for guards with more precise occlusal equilibration. The guard needs to be remade approximately every 2–3 years as the acrylic wears down under grinding forces. This cost is modest compared with replacing fractured Emax veneers, which would cost considerably more.
Will a pharmacy boil-and-bite guard protect my veneers?
No. Over-the-counter soft guards — the type you mould at home in hot water — are insufficient protection for active bruxers. The soft material actually encourages some patients to clench harder against the resistance. A custom hard-acrylic guard made from precise impressions of your teeth is the clinically appropriate option when veneers or implants are present. The precision fit also means it does not shift during sleep.
What is Masseter Botox and does it help with bruxism?
Masseter Botox involves injections of botulinum toxin into the masseter muscle — the primary jaw-closing muscle — to reduce its resting force. This reduces the grinding forces generated during sleep. The effect lasts approximately 4–6 months before re-treatment is needed. It is available from NZ cosmetic medicine providers and some dental practices. It is an adjunct to a night guard, not a replacement — the two work well together for severe bruxers. Discuss with a NZ provider; this is not something Picasso arranges remotely.
My NZ dentist wants to make me a night guard after seeing my veneers. Is that the right approach?
Yes, generally. If you did not have a guard fitted at Picasso before departure, having one made by your NZ dentist is the correct next step if bruxism is identified or suspected. Brief them on your veneer material — Emax Press, with a 7-year warranty — so they calibrate the guard thickness and occlusal surface appropriately. A guard that creates a high contact on one veneer can actually concentrate forces rather than distribute them.
Does a night guard need to be replaced?
Yes. Hard acrylic wears down over time under grinding forces. Most guards last 2–3 years with heavy bruxers, and up to 5 years for lighter bruxers. You will see visible wear on the occlusal surface of the guard — often a smooth, polished groove where the opposing teeth have been grinding. Once the acrylic is thin enough that it no longer provides adequate distribution of force, it needs replacement. Take your guard to each dental check so the dentist can assess its condition.