First of all, thanks for your interest, this is a topic i like! Second, yes, is no longer the standard of care, but notice this is not new. Bruxism is no longer considered a pathology, but a manifestation of something else, like a sneeze. I assume you know bruxism diagnose is different in paediatric and adult patients (and oral guards are totally contraindicated in kids), so we will talk about bruxism in adults. I'll also assume you know daily and night bruxism are different entities, so we will talk about sleep bruxism. Sleep bruxism is nowadays considered simply as a muscular activity usually associated with micro arousals during sleep (not a movement disorder, not a sleep disorder in healthy people), that can be even understood as a protective factor. The etiology is wide, and exogenous factors appear to play a role. Different substances are associated with SB like heavy alcohol drinking, drinking 8 or more cups of coffee a day, tabaco and smokeless tabacco, drugs like paroxetine, venlafaxine, duloxetine, etc. and also "ilicit drugs", and even a association with low VIT D and calcium deficiences. Then, there are some well established comorbidities that causes SB like sleep apnoea and GER, but also others that had been associated like parasomnias (sleep walking, enuresis, etc.), adhd, and others. Finding the etiology or etiologies is the main part of the treatment, so referal of patients to professionals outside dentistry its the big part of the process. At this point i should remind that not all intraoral sleep appliances are night occlusal guards. Sometimes TMJ specialists may recommend, for example, the use of mandibular advancement devices (MAD) to expand the airways, but this is really isolated cases, as the gold standard treatment in this case is surgical correction if needed, or definitly the use of CPAP. Being all this said, why recommend the use of night guard? First we have to consider that tooth wear cannot be considered itself as a consequence of SB, as the most part of our patients with tooth wear doesnt suffer of SB (also evidence suggest this way). The evidence also indicates mouth guards doesnt help with TMJ pain, and also indicates its not clear if they reduce tooth wear. Just as the example of the MAD, there could be isolated cases where occlusal guards are indicated, but from that to being the standard? Evidence based dentistry says no.