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
 Braces
 Crowns, bridges or veneers
 Surgery

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.


If you are interested in a natural cure for TMJ then CLICK HERE for the best option.



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Dental Procedures for TMJ

TMJ and the Dentist Chair

Make the Pain Stop

The American Dental Association estimates there are as many as ten million Americans with TMJ disorders.

To the poor TMJer's who brave the Dentist office looking for relief you have my greatest admiration and my deepest sympathies.

When I was very young many moons ago, I lived and went to school in a small town in New Zealand.
On the grounds of most city schools was a small brick-built one or two-chair dental clinic. Young Dental Nurses employed by the Government fresh out of a rigid two-year course attended to the dental health of rosy-cheeked school children up to the age of thirteen.

I have such fond memories of those antiseptic smelling clinics, the nervous nurses and the cheery sound of the drill. Yep I am lying! The bloom went out of cheeks pretty fast I can tell you when I had to visit the Dental Nurse. As much as I didn't like the smell, sound or FEEL of that drill ( I am told it was powered by electricity but in a power outage it could be foot-operated!) I didn't know what I was in for until at the age of thirteen I had to go to the family dentist.

This guy was a close family friend. I figured my parents must have owed him a ton of money or run over his dog and having me in his chair was his chance at retribution. I think he used saline in the needles. His drill had these mammoth drill bits and he liked to run the drill really slowly.

I thought the juttering vibrations would cause me and the chair to crash through to the first floor. Hey, maybe that is where my headaches and TMJ started; from this heavy handed Dr of Misery. I feared this man and his evil equipment and on my visits to him I would deal with the pain by citing a poem over and over again in my head.

Well that was then and this is now. I love modern dentistry, sort of. Well it has improved tremendously with all the great new anesthetics and supersonic what-nots and I think the College of Dental Surgeons screen now for maniacal masochists. Yes, Dentistry has definitely come a long way.

So my TMJers what can it do for you?

Mouth Splint

Don't talk with your mouth full.

Dentists like splints because they are the most popular non-surgical means to treat TMJ pain in the jaw. The Occlusal splint is a removable dental appliance made from either hard acrylic resin or a soft resilient plastic. It is possible to buy a generic mouth slpint for your TMJ over the counter at some stores but it is alway wise to seek advise from a TMJ specialist first.

There are several distinct types of Occlusal splints.

Stabilization or flat plane splint. Designed to reduce teeth grinding and relax jaw muscles it fits over all the upper teeth.


Modified Hawley splint. This splint fits on the upper jaw and makes contact with only the six lower front teeth. Only worn at night it keeps the teeth from grinding and clenching.

NTI-tss (Nociceptive Trigeminal Tension Inhibition Suppression System. (Try saying that while you are wearing one.) It doesn't sound like it but it is small and fits on the front upper teeth and is designed to prevent tooth clenching and grinding. However, because it fits on only a few teeth, it places a great deal of stress on them and that can be harmful to those teeth. There is also a danger of this small device being swallowed if it comes off at night.

Repositioning splint. A more invasive form of splint treatment this device is used to move the lower jaw either forward or backward into a new position permanently.



Questions you should ask your Dentist about splints.

• Why are you recommending this type of splint to me?
• Are you recommending this splint to decrease my pain, reposition my bite or both?
• What are my other options?
• What happens if my pain gets worse while wearing the splint?
• What happens if I develop an open bite (teeth no longer touch)?
• What proof do you have that this splint will help?
• Do I wear the splint during the day, night, or both?
• How long do I have to wear the splint before I feel significant improvement?
• If the splint doesn't help, what's next ?
• Will follow-up treatments be required, how many and how much each visit cost?
• Will insurance cover the cost of the splint and the follow-up treatments?
• Must I sign a financial contract with you to begin treatment?

Dentists who treat TMJ disorders will administer X-rays and prescribe a splint. They may also have you get other treatments such as massage to help you get relief from TMJ and ease the wearing of a splint.

After the Splint what are the Options?

Since many splints can change the bite and the teeth-jaw relationship, it is advised that patients exercise caution when beginning treatment, and seek a second (or third) independent opinion before consenting to irreversible treatments like these.

Splints may only work for a short term period and may even change your bite. If a splint fails to work, your dentist may recommend options for re-alignment of your teeth.

If simple techniques fail, more invasive treatment can be considered.

This could be Orthodontics or veneers, crowns and bridges. Perhaps even reshaping (grinding) of the teeth.

• Please note that these treatments are IRREVERSIBLE (so they are permanent even if they do not work).

Surgery is considered a last resort by most TMJ experts.

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Most TMJ Sufferers will Not Require any Dental Procedure to get freedom from TMJ Pain. So spit out that Mouth Guard and Click Here to Try a Natural, Holistic 3 Step Remedy for TMJ Cure.

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Medical Treatments for TMJ

Alternative Medicines
What Choice Do I Have and Who Treats TMJ?

I have found it fascinating to discover how many different treatments there are for TMJ. I have tried to do justice and reveal all of them here but in my defense if I miss one or two it is only because I never heard of them. So contact me if there is one you would like to me add.

A special thanks goes to

Health & Wellness House

811 Rogers Close, Victoria, BC, V8X 5L5

Phone: (250) 592-6001

and

David Arnold, BESc, DSHomMed, RCSHom, RAc, RTCMP
Practitioner of Traditional Chinese Medicine and Classical Homeopath

for allowing the use of the following:

Traditional Chinese Medicine (TCM)

The two main components of Traditional Chinese Medicine (TCM) are Acupuncture and Herbal Medicine.

Acupuncture has been used for thousands of years and continues to be a reliable and effective treatment for many ailments. The technique involves inserting and manipulating very thin needles (single-use sterile stainless steel) into various points on the body. Some points are inserted locally to relax tense muscles, to reduce pain, or to accelerate healing of an affected area. Most points are located along energetic pathways called ‘meridians’. These meridians relate to all aspects of our body and mind, they regulate bodily functions as well as thoughts and emotions. Through various diagnostic methods the Practitioner is able to determine where ‘qi’ (or energy) running through them may be blocked, deficient, excessive, or simply where it needs balancing. Stimulation of these points and their corresponding functions leads to improved energy flow and overall balance throughout the body. This allows the body to be better able to heal itself, as well as maintain an increased state of health and vitality.

Chinese Herbs have been successfully used for thousands of years. They are prescribed either in decoction (cooked in water) or in powders, granules, pellets or tablets. They are most always combined together into a custom Formula that is specific to the patient’s illness and constitution.

There are also many other related therapies under the scope of TCM practice, including Acupressure, Tuina Massage, Moxabustion, Cupping, Gua Sha, Qi Gong, Tai Chi, Meditation.

Additional Treatments of TCM.

Acupressure

The same acu-points and treatment principles as acupuncture, but only finger pressure is used. This may be used in conjunction with an acupuncture treatment, or used alone for those who do not like needles.

Moxabustion

The burning of Mugwort leaf on or over acupuncture points to warm and invigorate the meridians and channels.

Cupping

Using a flame to heat the inside of a glass cup and applied to the body (commonly along the back) immediately creates a small vacuum as the air cools. The result is that the skin is gently pulled upward. The function is to move stasis and remove toxins or pathogens from the body. The cups may remain stationary or are moved to create a massage like experience.

Gua Sha:

Combined with massage oil, gentle scraping tools are used to stimulate the surface of the skin. It may be used as a diagnostic tool as well as for moving stagnant qi or blood.

Tuina Massage:

A form a Chinese massage that incorporates a variety of manipulation and kneading techniques, directed along meridians and energetic pathways.

Ear Seeds:

Reflex areas of the entire body are mapped on the ear. In this treatment, small seeds or pellets (gold/silver) are applied to the indicated points of the ear and may be left on for days at a time, acting as continuous stimulation for healing of the problem area.

Medical Massage for TMJ

Rub me the Right Way.

I have trouble lying on my front due to neck pain so I doubt this would work for me. Although I do like a good massage to relief tension and tight muscles.

TMJ and Physical Therapy.

Physiotherapy seems to consist of stretching and strengthening exercises for the face, head and neck muscles and and helping with relaxation. If you have a mouth guard or appliance these exercises can enhance their effectiveness.

A treatment program may include one or more of the following:

• Stretching and strengthening exercises of the jaw, head and neck
• Postural correction, relaxation and breathing exercises
• Manual stretches and mobilizations of the jaw and neck joints
• Laser, ultrasound and electrical stimulation to improve healing.

Injections

What's in that syringe, Doctor?

There are few clinical studies on the effectiveness of injection treatments and they are not approved by the FDA for treating TMJ Disorders. However, your health care provider may recommend injections treatments so be sure to ask what the basis is for recommending such a treatment.
You injection cocktail may be one of three drugs or substances.
Botulinum toxin type A (also known as Botox).
Research is under way to learn how Botox specifically affects jaw muscles and their nerves. The results of this research will let us know if this drug may be useful in treating TMJ disorders.

Steriod Injection (ie Cortisone).

According to The TMJ Association controversy still surrounds steroid injections as a treatment for TMJ disorders. Injections are used in reducing inflammation in cases of an acute flair-up of degenerative joint disease or rheumatoid arthritis. However, it is only a temporary measure and does not address the cause of the problem. If used too often the injections can actually cause degenerative joint changes which is like adding insult to injury.

Hyaluronan (also called hyaluronic acid).

This is sometimes used to treat osteoarthritis in the hips or knees, and is not approved by the FDA in treating TMJ.

Here is what The TMJ Association has to say about Prolotherapy:
"Prolotherapy (also known as sclerotherapy). Prolotherapy is a technique in which an irritating solution is injected into a ligament or muscle tendon near a painful area with the intent of inducing the proliferation of new cells and thus strengthening these structures, supporting the weakened muscles, and eliminating the pain. Although it has been used mainly to treat chronic low back pain, it has also been recommended for patients with temporomandibular disorders. However, there is no scientific evidence to show that weakened ligaments and tendons are the cause of pain in TMD patients, or to substantiate the effectiveness of this procedure in eliminating the pain. Moreover, there are no studies to show what these solutions actually do to the tissues. Therefore, prolotherapy should be avoided."

Medications

I hope you found something interesting on this page. There is one more medical treatment I want to tell you about but I will save it for another page because it is one I have experienced personally and I can tell you that there is hope for relief from TMJ pain. It will be called TMJ and IMS.
Look for my next post on Dental Prodecures for TMJ.