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Night Guard Cost & FSA/HSA Reimbursement Guide (2025)
September 15, 2025 · Ashely Notarmaso

Quick answer: Custom night guards are typically FSA/HSA-eligible medical expenses when used to treat bruxism (teeth grinding/clenching). Submit an itemized receipt (and if your plan asks for it, a Letter of Medical Necessity) for reimbursement. Learn more → Are custom night guards FSA-eligible?

Eligibility is governed by IRS rules—see Pub 969 and Pub 502.

Insurance note: Sentinel Mouthguards does not accept or bill dental insurance. Because we’re a direct-to-consumer lab (not your treating dentist), most dental plans do not reimburse purchases made directly from us. Customers typically use FSA/HSA with our itemized receipt.

Last updated: September 14, 2025

This article is part of our Night Guard Education hub and links to our Complete Guide to Night Guards.

  • Typical costs: Custom lab-made night guards usually cost less online than at a dental office and far outlast boil-and-bite options.

  • FSA/HSA: Generally eligible. You’ll need an itemized receipt; some plans may ask for a Letter of Medical Necessity (LMN) from your dentist. See official HSA definition at HealthCare.gov.

  • Dental insurance: Sometimes contributes when medically necessary—policy language and pre-auth matter.

  • Taxes: Night guards can count toward medical deductions if you itemize and meet IRS thresholds (check current rules).

  • If denied: Appeal with plan citations + LMN. We include templates below.

Who this guide is for

Anyone comparing night guard prices, wondering what insurance or FSA/HSA will cover, or trying to submit/appeal a claim without the back-and-forth.

Night guard cost comparison (at a glance)

Option Typical Price Range Lifespan (with care) FSA/HSA Eligible? Notes
Boil-and-bite (retail) $20–$80 Months Sometimes Quick, but bulkier, shorter life.
Custom lab-made (direct-to-you) $$–$$$ 1–5+ years (material-dependent) Yes Professional fit from your dental impression or scan.
Custom via dental office $$$–$$$$ 3–5+ years Yes Highest chair-time cost; may help with insurance pre-auth.

Swap in your exact Sentinel price ranges and product names for the best conversions.

Price is one piece—proper fit prevents pressure points and slipping. Learn more: [How should a night guard fit?]

 


What makes a night guard “medically eligible”

  • A clinician recommends it to treat bruxism or protect teeth/jaw/TMJ.

  • The device is custom-fitted (from impression or scan) and intended for therapeutic use.

  • Your itemized receipt clearly states product type and purpose (e.g., “Custom Occlusal Guard for bruxism/TMJ protection”).

At Sentinel: BPA/BPS-free & phthalate-free materials, U.S. lab, FDA-registered facility with quality checks before shipping (details available on request).


FSA vs HSA vs HRA—what changes for night guards?

  • FSA: “Use-it-or-lose-it” (with possible grace/run-out). Night guards are generally eligible; some plans ask for an LMN.

  • HSA: Funds roll over; eligible when used to treat bruxism/TMJ symptoms.

  • HRA: Employer-funded; eligibility depends on plan design—check your summary plan description.

Keep these handy: plan name, member ID, your employer’s plan portal, and your itemized receipt (and LMN if requested).


How to get reimbursed (step-by-step)

  1. Purchase your guard (keep order confirmation).

  2. Request an itemized receipt with:

    • Your full name and order number

    • Date paid and amount paid

    • Product name: Custom Occlusal Guard (night guard) for bruxism/TMJ

    • Business info: Sentinel Mouthguards, St. Petersburg, FL (contact details)

    • Payment method (last 4 digits ok)

  3. (If required) Ask your dentist for a Letter of Medical Necessity (LMN template below).

  4. Submit your claim in your FSA/HSA portal with the receipt (and LMN if asked).

  5. Track the claim. If the payer needs clarification, respond with the documentation below.

Paste-ready email to request your itemized receipt

Subject: Itemized Receipt Request – Night Guard
Hi Sentinel Team—
Please send an itemized receipt for my order #_____ including: my name, date, amount, product name (“Custom Occlusal Guard for bruxism/TMJ”), and your business details. I’m submitting to my FSA/HSA.
Thank you!


Letter of Medical Necessity (LMN) — template for your dentist

Patient: [Full Name, DOB]
Diagnosis: Bruxism (teeth grinding/clenching) and/or temporomandibular disorder symptoms
Recommended Treatment: Custom occlusal guard (night guard) to protect teeth and reduce muscular/joint load
Duration of Need: [e.g., 12 months, renewable]
Clinical Rationale: Patient exhibits signs/symptoms consistent with bruxism/TMJ (e.g., enamel wear, morning jaw pain, headaches). A custom guard is medically necessary to prevent further damage and relieve symptoms.
Provider: [Dentist Name, Credentials, NPI], [Practice Address, Phone]
Signature & Date:

Tip: Your plan may accept a signed chart note with the same elements in place of a separate LMN form.


Will dental insurance pay for a night guard?

Sometimes. Plans vary widely. Improve your odds by:

  • Calling your insurer with the procedure description (occlusal guard) and your diagnosis (bruxism/TMJ symptoms).

  • Asking about pre-authorization, frequency limits, and any exclusions.

  • Confirming estimated patient cost before you commit.

If your plan doesn’t pay, you can still use FSA/HSA funds for the purchase.


If your FSA/HSA claim is denied: how to appeal (fast)

  1. Read the denial reason (e.g., missing itemized receipt, “not eligible,” “needs LMN”).

  2. Fix the gap: attach itemized receipt and/or the LMN.

  3. Appeal with this short note:

Paste-ready appeal note

This expense is for a custom occlusal guard (night guard) to treat bruxism/TMJ symptoms, which is an eligible medical expense under IRS guidance. I’ve attached the itemized receipt [and LMN]. Please reprocess the claim.

  1. Escalate via your plan’s appeal process if needed. Keep copies of all documents.


Taxes (high level)

  • Night guards can count toward medical expenses if you itemize and exceed the IRS medical expense threshold (commonly 7.5% of AGI in recent years—verify current rules).

  • You can’t “double dip”: expenses paid with FSA/HSA funds generally can’t also be claimed as itemized deductions.

  • This guide is educational, not tax advice—consult your tax professional.


Care, lifespan, and when to replace

  • Clean daily (a non-abrasive routine) and let it dry fully.

  • Avoid heat and harsh chemicals.

  • Consider replacement when you notice cracks, looseness, or major wear—or if your bite changes after dental work.


Common questions (FAQ)

Are custom night guards FSA-eligible?
Yes, typically FSA/HSA-eligible when used to treat bruxism/TMJ. Submit an itemized receipt; some plans may ask for an LMN.

Do I need a prescription?
Plans differ. Many accept an itemized receipt; some request an LMN from your dentist to document medical necessity.

Can I buy now and submit later?
Yes—just submit within your plan’s deadline (watch your FSA plan year, grace, and run-out periods).

What if I already tried a boil-and-bite?
You can still submit for a custom guard. If your plan asks, explain prior failure/intolerance in your LMN.

What should my receipt say?
Your name, date, amount, and “Custom Occlusal Guard (night guard) for bruxism/TMJ.” Include seller details.

Custom guards by material (quick picker)

Custom Material Relative Cost (within customs) Typical Lifespan FSA/HSA Eligible? Best For
Soft (EVA) 2–3 mm $ 1–2 years ✅ Yes Mild–moderate bruxism, cushioned feel
Dual-laminated (soft inside / hard outside) $$ 2–4 years ✅ Yes Moderate bruxism; comfort + durability
Hard (copolyster) 1.5–3 mm $$–$$$ 3–5+ years ✅ Yes Moderate–severe bruxism; longest wear

For real price ranges and lifespan value, see → [How much does a custom night guard cost?]


Q: Are custom night guards FSA/HSA-eligible?
A: Yes—when used to treat bruxism/TMJ. Submit an itemized receipt for reimbursement.

Q: Does Sentinel accept dental insurance?
A: No. We don’t bill dental insurance. Most customers use FSA/HSA and submit our itemized receipt for reimbursement. If your dental plan allows member-submitted claims, you can send them our receipt (and an LMN if requested).

Q: What makes a night guard medically eligible?

A: Common signs include enamel wear and **morning headaches**—learn more: [Why do I wake with headaches from grinding?]

 


Gentle disclaimers

  • Medical: This guide is educational and not a diagnosis or treatment plan. See your dentist/physician for personal care.

  • Benefits & tax: Plan rules and tax law change—confirm with your benefits admin or tax professional.


  • Need an itemized receipt? Contact us—we’ll make it easy.
  • Ready to protect your teeth? Choose your custom night guard and use your FSA/HSA at checkout.