Thursday, June 30, 2011

TMJ Splint Therapy

Splint and Other Names.

Discussions about splints can often be confusing as there are many other words used for splints:  bite plate, bite applicance, mouth guard, night guard, night splint, occlusal appliance, orthotic, brux guard, mouthpiece.

Have You Tried Conservative Treatment Options?

It is true that most TMJ disorders will be helped with natural, home and professionally non-invasive treatments.  There is no harm in trying these options in conjuction with Stress Management and possibly Psychotherapy. The decision to wear a mouth splint for TMJ syndrome should only come after you have tried more conservative treatments and are certain that none of them can help your TMJ
disorder.  In addition, you have found a reputable TMJ specialist with experience in orthodontics that you feel comfortable with and trust.
Preferably, given your condition, the TMJ specialist will have encouraged you to exhaust all home remedies and non-invasive medical procedures prior to a discussion about Splint Therapy.  Even though the wearing of a splint is not an invasive option the follow up to a splint will very likely be invasive.

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Splints Types

Stabilization splints prevent night-time Bruxism, the clenching and grinding of teeth.  This type of  splint covers all the teeth and can be manufactured using a hard or a soft material.
Repositioning splints are worn 24 hours a day and are adjusted regularly by an orthodontist to get the joint (TMJ) to slowly end up in the correct position in the socket. 
Wearing a correctly made splint is said to allow the muscles to relax and therefore help rid you of jaw and face pain.  A splint will also protect teeth from wear and tear, stress fractures and chipping.

Why You Need a Splint

Your TMJ or joint and teeth are correctly positioned when all your teeth make simultaneous contact at the exact moment the condyles are seated in the most stable position in the sockets.  In this ideal position , there are no forces to damage the disc, joints or teeth and the muscles are relaxed or in a neutral position.
For TMJ disorders, your teeth may come tgether but the joint is pulled out of the socket.  This position leads to Buxism , the grinding and clenching of teeth at night.  Another TMJ disorder has the joint positioned correctly but the teeth do not come together correctly or only partially.
Treating a damaged joint with splint therapy is not a cure.  The splint will help manage the problem by placing the joint in a less traumatizing position so pain and future damage are minimized.  You may experience difficulties with wearing a splint such as a problem speaking, sleeping and it may be uncomfortable at fiirst. You will have to modify your diet somewhat, choosing softer foods.
A correctly made splint will put the joint in the right position and provide a bite where teeth, muscles and joint do not work against each other. If your symptoms improve from splint use then it can determined that the problem is definitely TMJ dysfunction. 
Some people who are having success with their splint in relieving their TMJ symptoms opt to continue the therapy instead of proceeding to the next phase.

Phase One - Getting the Splint

Apart from giving your medical history the doctor should also know about any dental history and if you have had any accidents or injuries. Give a detailed account of your TMJ symptoms such as headaches, pain and any sleep disorders. The doctor will examine you thoroughly and take X-rays of the jaw and a panoramex film.  An MRI or CT scan, though expensive, are well worth the money to get a good diagnosis from the doctor.
Once the doctor has his diagnosis he will discuss a treatment plan and what it may include.  Obviously a splint and perhaps medication to help reduce pain and muscles spasms and inflammation.  He may also recommend physical therapy to strengthen and increase range of movement which will help to prevent further joint injury.  The doctor may suggest injections to relieve trigger points in muscles or
alleviate inflammation.  In some cases, severe myofascial pain and headaches can also be treated with Botox injections.

Dental moulds of your teeth will be taken and precise measurements made.  Lastly your splint will be checked for fit and the doctor will inform you about care of your splint device.

Next Phase After Splint

You have been getting good results now for several months from wearing a splint 24/7 and it is time to take it out.  However, once a splint has been worn for a period of months or in some cases years, you will likely find that it has changed your bite and jaw position. 
At this point you will enter the next phase of therapy which can include the following treatments:

 Reshaping and/or grinding the teeth
 Crowns, bridges or veneers

These treatments are permanent, cannot be reversed and there is a possibility that they may not work.

Splints and Research

It is important to note that there has been no significant or extensive research done on splints as a treatment for TMJ.  Be very caution
before beginning any treatment option that can cause irreversible harm.  Seek several independent, professional opinions prior to
commencing any treatment.

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