After years I am finally doing mostly better, but would not wish that on anyone. Unfortunately I'm not an expert and can't tell you what is better, but there are few decisions I regret more than doing a cheap over the counter nightguard.
Hit and miss. Dentists are an example of a non-insurance area in the US.
Regular health insurance doesn't cover dental procedures, and all dental insurances have a _maximum_ payout of around $1k a year. Not out-of-pocket maximum like regular health insurance, but a maximum value that _they_ pay out.
I have paid for two of these custom made guards. By far, have both been worth every single cent. I sleep so much better and have already reduced wear on tear on my teeth. I cannot sleep without my guard.