Treatments

Splints

There are a variety of splints available for use in the management of various temporomandibular disorders. A frequently made appliance is called a Stabilisation Splint (also known as a Michigan Splint or a Tanner Appliance). This is an appliance which provides a balanced bite and removes any interferences to smooth jaw movement. When fitted and balanced all teeth in the opposing jaw will touch the splint at the same time with the same degree of force. It reduces the bite force that the muscles can generate. This splint is used if you have a problem with your bite or if you are a heavy tooth grinder or tooth clencher. It is usually only worn at night.

If you have a problem with clicking from your jaw and the click disappears when you posture your lower jaw forwards and open and close, then the splint of choice is an Anterior Repositioning Splint. This guides your jaw downwards and forwards into a position from which you can open and close without causing the click and this allows the disc to reposition because of its natural elasticity. The splint is worn 24 hours a day only being removed for cleaning and is usually worn for three months.

Internal Derangements

The bite without an anterior repositioning splint in place.

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Here is an example of someone using an anterior repositioning splint.

The most frequently made splint is a soft poly vinyl appliance similar to a gum shield. These are not made to any particular prescription and are made with the suggestion that they will “absorb” some of the bite force. What does happen in actual fact is that these allow an increase in the bite force and tooth grinding habit in a significant number of people as they are aware of having a soft compressible material between thier teeth. This can often increase the rate of tooth grinding or tooth clenching. These can wear very rapidly.

Internal Derangements




Here is an example of a stabalisation appliance.

One design of splint which should be avoided at all costs is a partial coverage appliance. These are sometimes made to cover the back teeth only because patients do not like the appearance of the splint covering their front teeth where it is visible. What inevitably happens with an appliance such as this is that it permits unwanted and uncontrolled and unplanned tooth movement and can severely disrupt the bite if worn for any period of time.

There are a few instances when a specialist might prescribe a partial coverage appliance to intentionally encourage controlled and planned tooth movement. This will be discussed with you first and the treatment objectives will be predicted and rationalised.