DENTAL SPLINTS- TYPES, BENEFITS, AND MAINTENANCE

Medically Reviewed by Dr. Sony Sherpa (MBBS) - March 4, 2024

Many experience discomfort in their jaws or engage in teeth grinding, especially during the night. This common issue not only affects oral health but can also lead to more significant concerns. To understand the remedy, it is important first to define two key terms: bruxism and TMJ disorders.

Bruxism is a medical condition characterized by the grinding or clenching of teeth, often unconsciously. This habit can occur either during sleep (sleep bruxism) or when awake (awake bruxism). Although the precise reasons for bruxism can differ, they frequently involve anxiety, psychological stress, an irregular bite, and missing or crooked teeth. In contrast, TMJ disorders involve the temporomandibular joint, which connects your jaw to the skull. Problems with this joint can cause pain and compromised movement of the jaw.

In addressing these discomforts, dental splints emerge as a simple yet effective solution. A dental splint is a protective device for the mouth that helps reduce grinding and clenching, especially during sleep. It relieves pressure on the jaw and teeth by establishing a physical barrier between the upper and lower teeth.

Dental splints offer benefits beyond preventing nighttime teeth grinding. They can also help to reduce snoring, protect restorations and dental implants, and even alleviate symptoms of TMJ disorders by redistributing the forces exerted on the jaw.

Types of Bruxism and Their Impact

Bruxism is broadly categorized into two types:

• Awake Bruxism: Primarily related to emotions such as anxiety, stress, anger, concentration, or coping strategies.
• Sleep Bruxism: A sleep-related movement disorder often associated with other sleep disorders.

Both types share common symptoms like jaw discomfort, headaches, and worn-down teeth. The causes are multifaceted, ranging from psychological factors like stress and anxiety to physiological issues such as misaligned teeth or an abnormal bite.

Stress and anxiety play a significant role in triggering bruxism. In today's fast-paced world, where stress is commonplace, bruxism has become a prevalent issue. Furthermore, some drugs, alcohol usage, and caffeine intake can raise the chance of developing this condition.

What is a Dental Splint and How Does it Help?

Dental splints, often referred to as night guards or occlusal splints, are custom-fitted oral appliances designed to address various dental issues, particularly bruxism (teeth grinding) and TMJ (temporomandibular joint) disorders. These devices play a crucial role in protecting teeth, mitigating jaw stress, and enhancing overall oral health.

The Function of Dental Splints

• Protecting Teeth and Reducing Bruxism

Dental splints serve as a protective layer over your teeth. These splints successfully avoid direct contact during grinding or clenching by establishing a physical barrier between the upper and lower teeth. This is especially beneficial for people with bruxism, a condition that can lead to excessive wear and tear on teeth, potentially causing fractures, chips, and enamel erosion. Splints distribute the pressure exerted during clenching or grinding, thereby safeguarding the teeth from damage.

• Reducing Jaw Stress and Improving TMJ Function

Beyond protecting teeth, dental splints play a pivotal role in reducing stress on the jaw muscles and joints. Splints assist by keeping the jaw in a relaxed position, which is beneficial for people with TMJ issues, which can cause pain and restricted movement in the jaw joint. Pain and jaw function may both improve as a result of this stress relief. The proper alignment provided by splints can also aid in minimizing symptoms associated with TMJ disorders, such as headaches, earaches, and facial pain.

• Impact on Jaw Muscle Tension and Overall Oral Health

One of the lesser-known benefits of dental splints is their ability to reduce muscle tension in the jaw. By preventing habitual grinding and clenching, these splints allow the jaw muscles to relax, reducing the likelihood of muscle fatigue and strain. This relaxation of the jaw muscles can also contribute to a decrease in related symptoms like neck pain and tension headaches.

• Safeguarding Teeth During Jaw-Clenching Activities

Dental splints are not only beneficial during sleep but also prove useful in daytime activities that might involve involuntary jaw clenching, such as during certain sports or while concentrating intensely. By wearing a splint, people can protect their teeth and jaw from the excessive forces exerted during these activities.

Types of Dental Splints

Dental splints are versatile devices used in dentistry for a variety of conditions, from protecting teeth against grinding to realigning the jaw. Each type of splint serves a unique purpose, catering to different dental needs. Here, we explore the various types of dental splints and their specific roles.

• Occlusal Splints

These are used primarily for patients with bruxism or TMJ disorders. Occlusal splints work by creating a physical barrier between the upper and lower teeth, reducing wear from grinding and alleviating pressure on the jaw joints. They help redistribute bite force evenly, which can relieve pain and prevent further dental damage.

• TMJ Splints

Specifically designed for temporomandibular joint disorders, TMJ splints can reduce symptoms like jaw pain, clicking, and difficulty in moving the jaw. These splints help in stabilizing the jaw position, thereby providing relief and promoting healing.

• Nociceptive Trigeminal Inhibitory (NTI) Splint

This type of splint is a more targeted approach for bruxism and is particularly effective in reducing clenching and grinding during sleep. The NTI splint works by only covering the front teeth, which minimizes the contact between the upper and lower teeth. This reduction in contact can significantly decrease the intensity of clenching and grinding.

• Orthodontic Splints

Orthodontic splints are used in conjunction with braces or other orthodontic treatments. They help in stabilizing the jaw and ensuring that the teeth move correctly during the orthodontic treatment process.

• Night Splint

Night splints are similar to occlusal splints but are specifically designed for nighttime use. They protect the teeth from grinding and clenching while sleeping, which is a common issue for many people.

• Sport Mouth Guards

These are essential for athletes, providing protection against dental injuries during sports. They cushion the teeth and gums, reducing the risk of fractures, dislocations, and soft tissue injuries.

• Anti-snoring Splints - Oral Appliance Therapy

These splints are designed to keep the airways open during sleep, thus reducing snoring. They work by adjusting the position of the jaw or tongue, ensuring smoother airflow and reducing sleep disruptions.

• Whitening Splint

Unique in their dual functionality, whitening splints not only protect the teeth but can also be used to hold bleaching agents, making them effective teeth-whitening devices. They offer advantages over traditional whitening methods such as custom fit, controlled dosage, and the convenience of at-home treatment.

• Retention Splints

After orthodontic treatments like braces or Invisalign, retention splints help maintain the new position of the teeth. They are crucial for preventing teeth from shifting back to their original position and can also correct mild to moderate malocclusions. Their role extends to closing gaps, improving bite, and boosting patient confidence.

• Space Maintainers

These are typically used in pediatric dentistry when a primary tooth is lost prematurely. Space maintainers hold the space open until the permanent tooth erupts, ensuring proper spacing and alignment of the teeth.

• Repositioning Splints

Repositioning splints are used to correct the jaw alignment. They are often prescribed for TMJ disorders where the jaw needs to be moved to a new position to relieve pain and improve function.

​Categorization of Dental Splints

Dental splints, essential in various dental treatments, can be broadly categorized based on their material, rigidity, and design. Understanding these categories is crucial for selecting the right type of splint for specific dental conditions. Let us explore these classifications in detail:

Based on Flexibility

• Flexible Splints: These splints are made of materials that offer a high degree of flexibility. They are generally used in conditions where minimal support is needed, and a degree of movement is beneficial. Flexible splints are often more comfortable and are ideal for patients who require gentle jaw support.
• Semi-Rigid Splints: These offer a balance between flexibility and support. Semi-rigid splints are often used in cases where some movement is necessary, but a degree of stabilization is also required. They are commonly used in treating TMJ disorders and mild cases of bruxism.
• Rigid Splints: Made from hard materials, rigid splints provide maximum support and stabilization. They are often prescribed for severe cases of bruxism and TMJ disorders, where restricting jaw movement is necessary to prevent further damage or to aid in the healing process.

Based on Material and Customization

• Soft Splints: These are typically made from a softer material, offering comfort and ease of use. Soft splints are often used for mild cases of teeth grinding or as a temporary solution.
• Hard Splints: Constructed from durable materials, hard splints offer a higher level of protection and are used in more severe cases. They are effective in preventing teeth grinding and in treating TMJ disorders.
• Custom-Made Splints: Tailored to the individual’s mouth, custom-made splints provide the best fit and effectiveness. They are designed based on the patient's specific dental impressions, ensuring maximum comfort and optimal treatment results.
• Over-the-Counter Splints: These are pre-made and not customized to an individual's mouth. While they are more accessible and affordable, they may not offer the same level of effectiveness and comfort as custom-made splints.

Based on Permissiveness

• Permissive Splints: These splints allow for some degree of movement and are generally more comfortable. They are designed to permit certain jaw movements while still providing the necessary protection and support.
• Non-Permissive (or Direct) Splints: These are designed to restrict jaw movement entirely. Non-permissive splints are typically used in severe cases where complete immobilization of the jaw is necessary for treatment.

Each category of dental splint serves specific purposes, and the choice depends on the individual's condition, severity of symptoms, and treatment goals. The right type of splint can significantly improve the effectiveness of treatment, enhance comfort, and speed up the recovery process for various dental and jaw-related issues.

Benefits of Dental Splints

Dental splints offer a range of benefits for people suffering from various oral health issues, particularly those related to bruxism, TMJ disorders, and sleep-related conditions. These benefits extend beyond mere symptom relief, contributing significantly to overall oral health and well-being.

• Reduction of Tooth Wear

Dental splints act as a protective barrier between the upper and lower teeth, effectively reducing the wear and tear caused by grinding, thus preserving the enamel.

• Alleviation of TMJ Pain and Discomfort

Splints help in redistributing the forces exerted on the jaw, easing the tension in the jaw muscles. This relief extends to reducing associated facial pain and headaches.

• Improved Sleep Quality

By minimizing nighttime grinding, dental splints contribute to more restful and undisturbed sleep, which is crucial for overall health.

• Enhanced Oral Health

The use of splints can lead to a reduction in inflammation caused by constant clenching or grinding, thereby improving overall oral health.

• Boost in Confidence

Dental splints can improve the appearance of one's smile by preventing the damage caused by grinding, and in some cases, they can assist in teeth alignment, enhancing aesthetics.

• Teeth Alignment

Certain types of splints are designed to assist in the alignment of teeth, correcting mild to moderate malocclusions and maintaining alignment post orthodontic treatment.

• Protection from Accidents

Sports mouth guards, a type of dental splint, are essential in protecting teeth from accidents and injuries during physical activities.

• Improved Sleep and Snoring Reduction

Dental splints can play a vital role in managing snoring and mild forms of sleep apnea by keeping airways open, thus enhancing the quality of sleep for both the individual and their partner.

• Easy Maintenance

Dental splints are generally easy to maintain due to their removable nature. Regular cleaning and proper storage suffice to keep them in good condition, adding to their practicality and convenience.

Choosing the Right Dental Splint

Selecting the appropriate dental splint is crucial for effective treatment and comfort. The right fit depends on a variety of factors, including individual symptoms, budget, lifestyle, and the specific type and material of the splint. Understanding these aspects can guide you in making an informed decision.

Factors to Consider

• Symptoms: The nature and severity of your symptoms play a pivotal role in determining the type of splint needed. For instance, a severe bruxism case may require a more robust splint compared to mild teeth grinding.
• Budget: Splints vary in price, with custom-made options generally being more expensive than over-the-counter (OTC) alternatives. Your budget will influence the type of splint you can afford.
• Lifestyle: Consider your daily routine and activities. For athletes, a durable sports guard is essential, while those seeking relief from nighttime grinding might prefer a comfortable night splint.
• Type and Material: The type of splint (e.g., occlusal, TMJ, orthodontic) is dictated by the specific dental issue. Materials vary from soft TPU for comfort to hard acrylic for durability, impacting the splint’s effectiveness and wearability.
• Fit: A well-fitting splint is vital for comfort and effectiveness. Ill-fitting splints can cause more harm than good.
• Cost: While cost is a consideration, it is important to balance it with quality and suitability for your needs.

Custom-Made vs Over-the-Counter Splints

• Custom-Made Splints: These are tailored to your specific dental structure, providing a precise fit and often more effective treatment. They are made by a dentist following an impression of your teeth. Although more expensive, they are generally more durable and comfortable.
• Over-the-Counter Splints: These are more affordable and readily available. However, they offer a generic fit, which may not be ideal for everyone. OTC options can be less durable and might not provide the same level of relief as custom-made versions.

Consulting a Dentist

Ultimately, the best approach is to consult with a dentist. They can examine your dental health and provide tailored recommendations. They can also talk about your individual needs and suggest the best kind of splint. A dentist's guidance ensures that you choose a splint that not only fits well but also effectively addresses your dental concerns. Keep in mind that a well-chosen dental splint can greatly enhance your oral health and overall well-being.

Living with a Dental Splint

Adapting to life with a dental splint involves understanding and managing various aspects of its use, including maintenance, comfort, aesthetics, and practical concerns. Here is a guide to help you navigate these areas effectively.

Maintaining Hygiene

• Regular Cleaning: It is crucial to keep your dental splint clean to prevent bacterial buildup and ensure oral health. Every time you remove it, rinse it well and give it a gentle brushing with a soft toothbrush and a non-abrasive cleanser.
• Storage: When not in use, store your splint in a dry, clean case to protect it from damage and contamination.

Aesthetics, Comfort, and Speaking

• Aesthetics: Modern dental splints are designed to be discreet. Custom-made splints, in particular, offer a more natural look.
• Comfort: Initially, you may experience some discomfort or mild irritation. Over time, your mouth will adjust to the splint. If discomfort persists, consult your dentist for adjustments.
• Speaking: You might find speaking challenging initially. Practice talking while wearing the splint to help your tongue and mouth adapt.

Addressing Common Concerns

• Adjustment Period: The first few days to weeks can involve a period of adjustment. It is normal to experience increased saliva production or a slight alteration in bite feeling.
• Nighttime Use: If using a splint for sleep bruxism, wearing it consistently at night is crucial. It might feel strange at first, but consistency is key to its effectiveness.

Wearing Schedules and Replacement Timelines

• Wearing Schedules: Follow the wearing schedule advised by your dentist. Some splints are meant for nighttime use only, while others might be recommended for daytime use.
• Replacement Timelines: Regularly assess your splint for wear and tear. On average, a dental splint may need replacing every 1-2 years, but this can vary based on the material and usage. You can get advice from your dentist on when to get a replacement.

Conclusion

By maintaining proper hygiene, getting used to the splint, and following your dentist’s advice, you can ensure a comfortable and effective experience. Remember, every individual’s experience is unique, and adjustments can be made to enhance your comfort and the splint’s effectiveness.

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