TMJ / Bruxism

Dental Appliances - TMJ Bite Adjustment Splints

Upper Bite Plate

The most common of all dental appliances, this one usually has the highest failure rate. Most dentists fabricate this type of appliance because that's what they were taught in school.

Unfortunately, many dental schools have NO concept on how to properly treat TMJ or headaches. This type of device can worsen a patient's symptoms because it increases muscular activity. The jaws sense upper splints as foreign objects and rejects them...more often than not.

These upper splints are ineffective because they do nothing to reposition the lower jaw in the proper anatomical relationship that needs to be attained for pain reduction. Furthermore, these appliances can allow the lower jaw to skate around causing an increase in bruxing, clenching, and grinding because it provides a skating ring for the lower jaw. Subsequently, muscles spasms increase and pain worsens.

Expansion Appliances

Some doctors who treat TMJ believe that expanding the upper jaw can provide pain relief. This is incorrect treatment if the lower jaw is not placed in the proper position. Expanders can cause more pain because they can displace the lower jaw into a more painful position.

NTI Technology

A very effective device if used for moderate pain cases. It can also help about 50% (by our clinical observation) of migraine sufferers. This device can cause more pain if it is not adjusted properly in the mouth.

Many of these devices that we see fitted by other dentists are incorrectly adjusted. If you have this device and it is not providing pain relief then you must consider that either the device is ill-fitted or your condition warrants more advanced care.

Lower Splints

These are usually the most effective appliances to correct jaw imbalances and cure even the worst headache and migraine sufferers. Even simple flat plane bruxism splints can provide relief, if adjusted properly. The most effective devices used at our office are called Levandoski and FACT appliances. These splints position a patient's jaws into a predetermined position (based on x-ray analysis and muscle testing) similar to the way a cast would support a broken leg. The appliance should not allow you to freely move your jaws, as they should dictate and teach you a new way to speak, chew, swallow, etc. These appliances must be worn constantly in order to provide proper therapy. They may also need to be adjusted on a monthly basis.

Appliance Failure

If you have been fitted with a proper dental appliance (lower repositioning) and your pain has not subsided within 3 months it is recommended that you:

Have your specialist readjust the splint and explain to you what he/she is trying to accomplish with it. If a clear explanation is not forthcoming, find another specialist...this is exact science, it's not guesswork.

Consider that you must wear your appliance 24 hours a day, 7 days a week. Anything less than this renders your treatment useless.

If you are fighting your appliance, then consider that you may need a break-in period of treatment. This may consists of wearing different appliances until you get used to the correct one. Normally, a small device such as the NTI is used to break you in, followed by a lower bruxism splint (or soft splint) and then followed by a repositioning splint. It may take more than 4 months before you can even start wearing the correct appliance.

In most cases, physical therapy and postural education is also required before the appliance can have a high success rate. If your specialist has not evaluated your posture or has not considered physical medicine requirements, you may want to seek a second opinion. Our clinical experience has shown that over 75% of our patients require physical medicine intervention.