A custom occlusal guard is priced mainly by design and laboratory work, and the range is wide because the appliances are genuinely different objects: a rigid full-coverage splint adjusted so the bite contacts are even is not comparable to a soft tray. The cost people fail to plan for is replacement. An appliance worn by a heavy grinder thins and eventually perforates, and that is the appliance doing exactly what it is for. Absorbing forces so the teeth do not. Treating replacement as an expected recurring cost, not a failure is the accurate way to budget. Over-the-counter devices are far cheaper and are not equivalent, because they involve no examination, cannot be adjusted, and go unmonitored for bite change. Partial-coverage designs are cheaper still but carry a real risk of unwanted tooth movement if worn long-term without supervision, which is why the design itself, not just the price, is worth understanding before choosing the cheaper option.
Published fees for the coded services
| Service | Delta Dental of Washington plan, 2023 | Maryland Medicaid, 2025 |
|---|---|---|
| Occlusal guard, hard, full arch (D9944) | $330 | $150 |
| Occlusal guard, hard, partial arch (D9946) | $165 | $150 |
| Repair or reline of an occlusal guard (D9942) | $24 | Not listed |
Private offices can charge more, and fees differ by region and case. Sources: the Delta Dental of Washington fee schedule (as of June 8, 2023) and the Maryland Healthy Smiles 2025 fee schedule. For a fee lookup by ZIP code, see FAIR Health Consumer.
What moves the number
Cost drivers
| Factor | Detail |
|---|---|
| Design | Hard full-coverage splint, soft guard, dual-laminate or a repositioning appliance. These differ substantially in laboratory work and fee. |
| Coverage | Full-arch versus partial. Partial-coverage devices are cheaper and carry a real risk of unwanted tooth movement if worn long term unsupervised. |
| Laboratory | Technical work is a large part of the fee and varies with material and precision. |
| Adjustment appointments | Getting the bite contacts even takes time and often more than one visit. Ask how many are included. |
| Records | Impressions or digital scans, plus bite records where the design requires a specific jaw position. |
| Replacement frequency | Determined by how heavily you grind, and the largest long-term cost variable. |
Benefits
How plans treat occlusal guards
- Covered by some plans and excluded by others, often with a frequency limitation measured in years
- Plans may distinguish between a guard for bruxism and one for a joint disorder, with different rules
- Sports mouthguards are usually a separate category
- Appliances for diagnosed sleep apnoea are commonly assessed under medical instead of dental benefits
- Replacement within a frequency limit is generally not a benefit even where the original was covered
- Where the guard protects extensive restorative work, some plans view it more favorably
Value framing
What the appliance is actually protecting
The case for a custom guard is usually clearest when set against what it protects. Replacing chipped veneers, remaking fractured crowns, or repairing a full-arch prosthesis costs many times what an appliance does, and grinding forces are the mechanism behind a substantial share of those failures. That does not mean everyone who grinds needs one immediately, but it does mean that if you have had significant restorative work and grinding was identified, declining protection is a false economy. Ask what specifically it is protecting in your mouth, and what replacing that would cost.
Red flags
What should make you pause
A partial-coverage or anterior-only device supplied for long-term unsupervised nightly use
No examination of wear patterns, joints or muscles before the appliance is made
No question asked about snoring or daytime sleepiness
No follow-up adjustment appointment included
A boil-and-bite device presented as equivalent to a custom appliance
Extensive restorative work planned for a worn dentition with no protection in the plan
Insurance
A night guard and an athletic mouth guard are not the same benefit
Cigna's DPPO page says athletic mouth guards are generally not covered as preventive care. A night guard for grinding or clenching is a different appliance with its own procedure code, and some plans cover it, some cover it with a frequency limit and some exclude it. Because the code and the diagnosis both matter, ask the plan what it pays toward an occlusal guard, how often it pays for a replacement and whether it needs a diagnosis first. If you have a medical plan that covers jaw joint treatment, ask whether it applies. That is a separate question from your dental plan.
Ask the office which procedure code it will submit and whether it is the one your plan recognizes.
One arch or both
Design, arch and replacement
| Factor | Detail |
|---|---|
| Upper or lower arch | Most guards cover one arch. Confirm which is proposed and why. |
| Hard, soft or dual-layer | Materials differ in wear and comfort. Find out why the design fits your pattern. |
| Replacement | Heavy grinders can wear through an appliance. Ask what a replacement costs and how long the first one should last. |
| Adjustments and repairs | Find out whether fit checks and repairs are included in the first fee. |
See the jaw pain and grinding guides for when a guard is part of a wider plan.
Who provides it
Dentist-made, over-the-counter and mail-order
A dentist can make a custom guard from impressions or a scan, and pharmacies sell ready-made ones. Some companies make guards by mail. They differ in fit, material, price and the exam behind them. A dentist who examines you can also check for a cause and other findings, and a guard that fits poorly can make jaw discomfort worse. If you buy a ready-made or mailed guard, ask a dentist whether it suits you. If pain, clicking or locking is part of the picture, an orofacial pain specialist may be involved.
Lowering the bill
Ways to reduce cost without lowering the standard
Call a dental school clinic to find out whether it makes occlusal guards and what its fee is
Ask your plan whether it covers occlusal guards and how often
Ask the office what is included: the exam, the impression or scan, the delivery and the follow-up
Ask what a replacement costs and what wear to expect
Ask about a temporary ready-made option while you decide, and whether it is suitable for you
Questions people ask
Common questions
01Why is a custom night guard so much more than a drugstore one?
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Because they are different objects. A custom appliance is made from impressions or scans of your teeth, in a material and design chosen for your situation, and adjusted so the bite contacts are even, which is what makes it comfortable and effective. It also follows an examination of wear, joints and muscles. Over-the-counter devices are self-fitted, cannot be adjusted, wear quickly, and involve no assessment of what is actually causing the wear.
02How often will I need to replace it?
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It depends almost entirely on how heavily you grind. Some appliances show only light wear facets after years; heavy grinders can thin or perforate one considerably faster. Wear on the appliance is the appliance working, not failing. Bringing it to routine dental appointments means wear and fit get checked and replacement can be planned instead of becoming urgent, and it is worth knowing that insurers often apply a frequency limitation to replacements.
03Will insurance pay for it?
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Some plans cover occlusal guards, often with a frequency limitation measured in years; others exclude them. Plans may treat a guard for bruxism differently from one for a joint disorder, and appliances for diagnosed sleep apnoea are commonly assessed under medical, not dental benefits. Sports mouthguards are usually separate. Ask about your specific plan before assuming either way, particularly if you need a replacement.
04Is a cheaper soft guard good enough?
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For short-term or occasional protection it may be adequate, but for long-term grinding a hard full-coverage splint is generally more durable and can be adjusted so the bite contacts are even. Some people clench harder against a soft surface, and if muscle symptoms worsen after starting one, that is a reason to revisit the design instead of persist. Soft guards also wear through faster, which affects the real cost over time.
05Do I need one for both arches?
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Usually one appliance, most often upper, is sufficient. It separates the teeth and absorbs the forces regardless of which arch it sits on. A second appliance is occasionally advised for specific reasons. If two are being proposed, it is fair to ask what the second one adds clinically, because it roughly doubles both the initial cost and the replacement cost over time.
06Does a repositioning splint cost more than a standard stabilization splint?
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Often somewhat more, since a repositioning design typically requires more precise records and adjustment appointments to achieve a specific jaw position instead of simply providing an even, flat biting surface. Ask why a repositioning design specifically is being recommended over a standard splint.
07Is the initial consultation and bite assessment included in the quoted price?
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Usually yes as part of the overall fee, but confirm this explicitly, since a thorough assessment of wear patterns, joint sounds and muscle tenderness is what should be driving the specific design recommended, not an assumption applied without examination.
08Can a night guard be relined or adjusted instead of fully replaced as it wears?
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Sometimes, particularly for minor wear or a fit that has changed slightly, and this is typically far cheaper than a full remake. Ask whether your specific appliance and wear pattern is a candidate for adjustment before assuming a full replacement is the only option.
09Does a night guard for a child cost the same as one for an adult?
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Similar in laboratory cost, but a child's appliance may need replacing more frequently as the jaw and teeth continue developing, making the ongoing cost over time potentially higher even if the individual appliance price is comparable.
10Is a mouthguard for sports the same cost as an occlusal guard for grinding?
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Not necessarily: a sports mouthguard is designed for impact protection during activity and a grinding guard is designed for nightly wear managing bite forces; the two serve different purposes with different designs, and pricing can differ accordingly, so clarify which you actually need.
11Does insurance ever cover a night guard as preventive, not treatment?
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Rarely as purely preventive: most plans require a diagnosis of bruxism, a joint disorder, or evidence of wear before considering coverage, since a guard provided with no clinical indication is not typically treated as medically or dentally necessary by insurers.
12Does a night guard designed to also treat sleep apnea cost more than one purely for grinding?
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Typically yes: an appliance designed to also address sleep-disordered breathing usually requires more complex design, coordination with a sleep physician, and different materials than a standard grinding guard, and it may be assessed under medical instead of dental benefits entirely.
13Does dental insurance cover a night guard?
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It depends on the plan. Cigna's page says athletic mouth guards are generally not covered as preventive care, but an occlusal guard for grinding is a different appliance with its own code. Some plans cover it, some limit how often, and some exclude it. Check what the plan pays for the specific code.
14How long does a night guard last?
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It depends on how hard you grind and on the material. A heavy grinder may wear through an appliance sooner, and that wear is the guard doing its job. Ask your dentist what to expect, how to check for wear and what replacement costs. Check whether the plan limits how often it pays.
15Is a store-bought night guard okay?
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It may be a stopgap, but fit and design vary, and a poor fit can leave you uncomfortable. A dentist who examines you can tell whether a guard is suited to your pattern and can check for other causes. Ask before you rely on one, especially if you have jaw pain.
Related glossary terms
Sources
- Oral Health TopicsAmerican Dental AssociationAccessed 2026-08-17
- Medicare Dental CoverageCenters for Medicare & Medicaid ServicesAccessed 2026-08-17
- Dental Preferred Provider Organization (DPPO) PlansCigna HealthcareAccessed 2026-09-24
- What Is a Dental PPO Plan?MetLife Oral Fitness LibraryAccessed 2026-09-24
- Finding Dental CareNational Institute of Dental and Craniofacial ResearchAccessed 2026-09-23