What About Splints / Supports ?
One of the most common treatment recommendations from dentists for TMJ related issues are splints or supports aimed at either relieving pressure on the jaw and associated muscles or repositioning the jaw into a more normal posture to distribute the load of muscle contraction evenly across the joints and teeth. They are also known as nightguards, splints, stabilization appliances, occlusal splints, interocclusal splints, or bruxism splints. They can be made of both hard or soft material, vary in thickness and generally need a dentist to fabricate them as they would be specific to your particular issue. They fall into two general categories: Permissive Splints and Non-Permissive Splints. Of the two Permissive Splints are the most common.
Permissive Splint: These can be fitted to both the upper and lower teeth to limit grinding and clenching, as well as to help the muscles align the jaw joints with the sockets. Permissive splints feature smooth and flat surfaces so the teeth can move freely as the jaw closes.
Non-Permissive Splint: designed to reposition the jaw by limiting movement, and force the jawbone into a specific position (often forward) when the mouth is closed.
Splints are often prescribed for Bruxism (night grinding). Pricing can range from several hundred to several thousand dollars depending on your issue and where you choose to get one from.
There is generally good evidence in the literature for the effectiveness of Splints for reducing pain and increasing mouth opening. Primarily it is thought to do this by reducing the muscle tension in and about the jaw.
A Word About Orthodontics and Invisalign
Traditionally most people have thought of orthodontics as the use of wires and stays to mold the teeth into a more aligned position. In recent years Clear Aligners have come on the market as an alternative to the traditional metal approach. These clear aligners are a series of progressive molded devices that fit over your teeth and are intended to gradually reshape your teeth. At first glance they can look like a TMJ splint. The most popular one is Invisalign. Both types of orthodontia (traditional and clear aligners) have the potential to alter bite and jaw structure. While commenting on the why, how and when aspect of orthodontics is outside of my professional expertise, The National Association of Dental and Cranial Research advises against treatments that cause permanent changes to the jaw joints, teeth, or bite; or that involve surgery. This doesn't mean you don't need or shouldn't pursue orthodontics for oral health issues, it just means if your only concern is a TMJ problem this may not be the direction you want to go.
How Do Splints Compare to Other Treatment ?
A 2021 article in the Journal of Oral Maxillofacial Surgery compared the following treatment approaches for TMJ / TMD Issues:
- counseling therapy
- occlusal appliances (splints)
- manual therapy
- laser therapy
- dry needling
- intramuscular injection of local anesthesia (LA) or botulinum toxin-A (BTX-A)
- muscle relaxants
- hypnosis/relaxation therapy
- oxidative ozone therapy
- placebo or no treatment
The primary outcome variables were the reduction of pain and mechanical sensitivity. The secondary outcome was the maximal mouth opening (MMO). Here is what they found: "manual therapy can be considered the most effective treatment for M-TMD, followed by counseling treatment, intramuscular injection of LA, and occlusal appliances . However, considering the limitations of the studies included, and the scarce of strong evidence, the present findings should be interpreted cautiously."
My practice specializes in manual therapy. We would be happy to talk with you regarding any pain or problems you may be having with your TMJ and see if we can help, or recommend something that can. Feel free to give us a call and schedule a phone consultation at no charge.
Yours in Health,
Doug Williams, D.C.
TMJ Relief Center at Care Chiropractic
134 Executive Drive #3
Lafayette, Indiana
47905
(765) 448-6489
