Night guard affected by ES surgery?

Hi. I’m newly diagnosed with ES and my doctors have suggested surgery as an option.

Unrelated, I have an appt. with my dentist in 2 days to be fitted for a night guard to alleviate TMJ pain.

I’m wondering whether I should find out if/when I need surgery before the night guard fitting. Would ES surgery (internal or external) change my bite at all? I have to pay out of pocket for the night guard and I would hate to need a new one so soon.

I’ve seen several posts on here about how soon after having surgery you can go back to wearing a night guard, but still wondering if I should hold off on getting one in the first place.


I think you should wait until after surgery if you can. I had a diagnosis of Eagles and the doctor said I should wait until it was interfering with quality of life so I did. In the meantime, I had TMJ, which really was trigeminal neuralgia and was told it was TMJ. I got a TMJ appliance paid for by insurance. Then I had surgery. I will tell you that my doctor said he removed a pencil. 2.8 cm were removed. Immediately thereafter, my TMJ appliance no longer fit my bite. The TMJ doctor tried to readjust it and it never worked again. So I need a new one and now about 4 years later, my eagles has regrown and is hurting so I may need to put off the TMJ splint, no longer have insurance for it. Also, your TMJ may go away after the surgery. Mine did not completely go away, but it was much less painful. Also, my surgery was intraoral, so I am on this site right now trying to find a doctor who will do a second surgery and do it externally. I just signed on and saw your new post. Try to get a doctor who does external surgery if you can. I believe they get more and there is a lower chance of regrowth. I did not have the luxury of this site before my first surgery. Good luck!
If your styloid or stylohyoid is in your tonsil area, it is probably affecting your bite already, I felt like a log had been removed from the jaw and suddenly, my appliance made my mouth feel like it was no longer even on both sides. My teeth on the surgical side felt like they needed a lift on the appliance because apparently the styloid was already lifting the bite. I hope this makes sense. Think of the styloid making the lower jaw bite clench higher on that side. The appliance is made that way. Take the pencil out and then the teeth with the pencil in between suddenly do not meet with the appliance because the width of the pencil has been removed. This is the sensation that I had.

1 Like

Wow, that’s a long post…which is great! I need to read it over another time or two, but since I have this dentist appt. tomorrow, can I ask you a few questions now?

  1. Did you have TMJ disorder before the ES diagnosis? I’ve had TMJD for ~25 years.

  2. Did you have clicking and popping of the jaws or just pain located in the TMJs? I can click and pop my jaws just about any time I want.

  3. Was your appliance an acrylic-type night guard or more of a semi-permanent thing?

I feel like the ES and TMJ aggravate each other. I’m wondering if I can go longer without surgery if I can alleviate some TMJ pain…on the other hand, I can feel the styloid process at the back of my throat…maybe it should come out no matter what…and they are charging me about $700 for the guard. Just thinking out loud, here. :slight_smile:

Thanks so much for your help.

This reply may be too late as you may have already seen your dentist, but I also have TMJ. Had it for many years before my ES diagnosis. I currently wear a lower night guard/splint and tried an upper one in college. My current dentist is a HUGE advocate of a lower jaw splint as opposed to upper. I must say that is my preference as well. I fought w/ the upper night guard/splint all night when it was in my mouth. The one I now wear on my lower teeth causes me no trouble.

Forgot to say that I wear the splint more to protect my teeth at this point than to help my TMJ, but I think has helped in both areas.

I told the dentist the I was interested in getting a night guard, but not until I found out more about possible ES surgery. I clench my teeth, but I don’t grind them. He said he doesn’t like lower jaw guards, though I’m not sure why.

Surprisingly, as soon as I mentioned Eagle Syndrome, he knew exactly what I was talking about and explained it to his assistant. So, I’ve been lucky…both my ENT and dentist were familiar with ES.

That’s good to know! Sounds like a sensible decision to wait for a guard.

I removed my response, as I already responded, but thought I had not sent it.

How do you remove a response? I’ve wanted to do that a couple of times but haven’t figured out how.
Thanks for your help!

Hi Isaiah, click the three “dots” below your post (to the left the of reply button) and hit the garbage can.

Thank you both Mod_support & Emma for your help!

Absolutely you need to wait until after surgery before considering a night guard and then you need to wait some more. Its an old solution that does nothing for the problem and fewer and fewer dentists are prescribing them. The old fashioned method of treating bruxism is to cover the teeth with a night guard to protect them from the strong vertical forces caused by grinding, which causes teeth to crack, break, and, over decades, slowly wear the teeth away to stubs.

The problem with this thinking is that a night guard fails to treat the root cause of why we grind our teeth.

This evidence-based fact tells us that teeth grinding (bruxism) is a red flag for sleep apnea.

So while your night guard might protect your teeth at night, it’s at the very best a bandaid solution for the symptom of a deeply serious underlying condition.

A night guard will protect your teeth, but it isn’t going to protect your grinding muscles and jaw joint from damage. A night guard could also be interfering with a vital instinctual response that you use every night to prevent yourself from suffocating. SVT from sleep apnea is much more expensive to treat (if you don’t have a stroke or die first)

The real solution is to get a sleep study and treat THAT first. Then if you still need it, there are much BETTER ways to get it than through your dentist. He makes an impression sends it to the lab and they send a night guard back. The average cost across the country is $300.00. There are many alternatives including dealing directly with a dental lab or even a denturist that are less than 200.00. Here is one example I haven’t dealt with this group, but there are many around. There is BTW not one shred of evidence that the custom ones are a tad bit better than the 20 dollar ones you get and fit your self (usually by heating) from the pharmacist who will help you get the right size.



Another perspective: My night guard experience goes back to the 1970s when I had an upper night guard. My dentist though not a proponent of night guards had it made for me to try because my jaw muscles were constantly in spasm from clenching my teeth while I slept or was under stress. I was in college so stress was a constant issue.
My first night guard was a waste of money as it made my problems worse because I fought w/ it in my mouth all night and clenched even more.

Scroll forward 20 years (no night guard during this time). My TMJ problems got bad enough my jaw would lock open when I yawned. I could only get it closed again by smacking my jaw on one side & popping it back into place. At this juncture, I went to an orthodontist who put braces on my teeth to realign my bite. Two years of braces starting at age 48 was no fun, but the end result was nearly miraculous! My TMJ symptoms practically disappeared for a few years post braces. But…once a clencher, always a clencher, so over time, my jaw clenching took its toll again. This time around the orthodontist worked w/ my dentist & the recommendation was a retainer for my top teeth & a night guard for the bottom teeth.

Though this combination hasn’t cured my TMJ, nor will it, because my jaw joint has worn oddly over the years, and I still clench, it has helped to minimize my painful TMJ symptoms. Purportedly, clenching destroys the nerves & roots of the teeth over time, & a night guard helps reduce the direct pressure and ensuing damage on these. Thus, I am a proponent of night guards at least for cases such as mine.

Sounds like the braces back in your 20’s might have been an answer :grin: and the damage could have been prevented. Thats why they are moving towards treatment of the condition…Curious if you have had a sleep study? Its not just snoring.

There has been some very intresting studies of late equating the formation of Eagles to be caused by TMD/TMJ. Its a logical event as calcification occurs in other parts of the body for the same reason. (From the study above) Bone development and homeostasis are thought to contribute to the elongation of the styloid process, including the consideration of the presence of two ossification centers in the styloid process, embryonic mesenchymal conversion to osteoid matrix, osteoarthritic changes, and diseases of calcium–phosphate maintenance. The origin of styloid process is related to three different muscles and two ligaments. The stylopharyngeus muscle raises the pharynx, the stylohoid the hyoid, and the styloglossus the tongue. The stylohyoid ligament stabilizes the hyoid bone, and the stylomandibular the mandible by assessing the posterior part. Aside from all the “medicalese” and anatomy what they are describing is bruxism and the results of joint damage.

I have nothing Against night Guards (except dentists who charge $700.00 for an appliance the labs charrge him less than $50.00.)

The point is think of a cut. You cover it with a band-aid. It protects it. BUT it doesn’t heal it or fix it. The night Guard serves the same role. It doesn’t fix the problem. If one can fix it before the damage occurs, they are MUCH better off.


My TMJ symptoms started in junior hight. I actually had braces in my teens, but back then, braces mostly served the purpose of straightening teeth. Even today there are not many orthodontists that brace teeth w/ a goal of properly aligning the bite in addition to straightening the teeth. Having beautiful straight teeth continues to be the goal but the bite can still be askew. Invisaline a current popular & inexpensive form of orthodontia, for example, serves only to straighten crooked teeth.

I’m reasonably sure I do not have sleep apnea, but I have not had a sleep study to ascertain this for sure. I am slim i.e. low neck fat, have clear air passages i.e. no nasal congestion or post-nasal drip, etc., all of which contribute to sleep apnea, but I do acknowledge aren’t the end all in diagnosing it.

I will, look at your link regarding potential precursors to Eagles later. Thank you for including that.

Sadly, my jaw joint is too far gone to do anything but “put a band-aid on it”. I totally agree with you that early prevention is key in every (health) arena. I should have been born 30 years later than I was! (No regrets, mind you…). I also agree that dentists & other oral professionals charge an outrageous fee for night guards. I think I was charged $700-800 for mine. Thankfully my insurance paid a chunk of it. On the upside, they do last a long time. I’ve probably had my current one for 6 or 7 years.

All we can do is move forward and not look to far backward. You are right on all counts though.

BTW @Isaiah_40_31 its not over until its over. I have observed several Total temporomandibular joint (TMJ) replacement which entails surgical replacement of the TMJ with a total joint prostheses as well as orthognathic surgery. I’m not convinced its ready for prime time or that most surgeons have the numbers necessary under their belts outside of teaching hosptals, but it is very close. There has been some real significant improvement in the appliances even in the last year. We can thank air bags for that. Oral surgeons haven’t had much work since they became common (really)

It may well be an option for you in the future. Right now function is easy, but a reduction of “pain” from the dysfunction is inconsistent. In any event you are still a kid in my book.

My dentist said that, in addition to protecting the teeth, a night guard would prevent my jaw from closing all the way, which in turn, would prevent it from sliding back.

Evidently, it is this “closed and receded” position that causes pain in the joint and muscles.