Tell you is to look into taking CE from John Kois. He is one of the top researchers and perio/prosth guys in the world.

I started his courses in 2021 after 12 years of practice and it completely changed my whole practice.

The way occlusion is taught in dental schools is really inadequate. I remember the first day of occlusion in dental school being told that I grind my teeth because I had wear on them. I believed it and for 12 years as a dentist I wore a night guard religiously.

But I started wondering- why are my teeth still getting sharper? Why are my canines still wearing? I wear this thing every night? How many patients do you see that say the same thing?
After his first course, I realized I had a different issue. A constricted chewing pattern. I was rubbing my teeth on the way into my bite. It wasn’t night time bruxism. It was an issue of my occlusion.
I did ortho, corrected the occlusal issues, and immediately all of my daytime clenching and tooth wear stopped.

There are cases of true RMMA(rhythmic masseter muscle activity). But those are in neurological patients, patients with GERD, or a very small percentage of patients.

Start reading the night guards you have diagnosed during hygiene visits. Are the wear streaks equal and lateral on both sides of the guard? If so, then that is a true night grinder.

But most are wear in a single location. Next wear case you see, sit the patient up and have them chew on a 200 micron piece of articulating paper. You’ll see a blue streak on every single spot of wear on the teeth.

A night guard is a good safety net. But diagnosing it off of wear is usually misguided. Occlusion happens from the outside into the bite. Not in the traditional canine guidance we were all taught. Throw canine guidance out the window.