If Dr. Langston or Dr. Kashlan observe signs of occlusal destruction, then they will recommend an occlusal appliance (nightguard). This appliance is often combined with occlusal (bite) adjustment. The bite guard is a hard acrylic appliance fabricated to the specification of each patient’s needs to prevent wear and temporomandibular joint (TMJ) damage caused by grinding, gnashing, or clenching the teeth during sleep. The bite guard is a precision fit, custom-made appliance engineered in the office. At the delivery visit, time is spent developing a harmonious relationship between the nightguard and the movement of the opposing teeth.