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)

Purchase your guard (keep order confirmation).

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)

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

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

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)

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

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

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.

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

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.

Sentinel Mouthcare Blog

Night Guard Cost & FSA/HSA Reimbursement Guide (2025)