Tuesday, September 17, 2013

Splint Therapy for TMJ

Is Splint Therapy Your Friend or Your Foe?

Did you know that splint therapy is the most popular and most misused treatment of TMJ? For some a splint is their friend, however, for many people a splint does not relieve pain or TMJ symptoms.

TMJ Disorders are usually accompanied with other problems such as muscle contractions, headaches, and jaw pain. Splints themselves cannot relieve this type of pain and physical therapy is often a helpful treatment.

So why do we use splint therapy? It stabilizes the relationship between the jaw and the joint, or in medical terminology the condyle-fossa and the joint.

Some things you may want to ask your dentist, is what type of splint he/she uses? Hard splints are preferable because they do not move the teeth. Upper splints are also preferred because they provide full arch support and anterior guidance. They are effective in relieving muscle soreness because of the change in teeth contact proprioception. Unfortunately, 15% of patients will resume para-functioning, meaning they will return to old habits of grinding.

Rotational appliances can also be used and can be an effective treatment for Bruxism, grinding, and clenching. These appliances can alter muscular proprioception. These splints are used on the upper teeth, are made of hard acrylic, and should be in conjunction with physical therapy.

Rotational splints are broken up into two categories: Type A and Type B. That doesn't mean different personality types receive different guards. However, they do address different jaw behavioral tendencies. Type A splints are night guards, they are Bruxism(grinding) appliances, and are best for occlusal interference cases. Type B are rotational, are thicker, better for deep bites and assist in restoring proper vertical dimension. These should be worn day, night, and during meals. Type B appliances are used long term over a course of 6-9 months.

There are also Type C splints which are used as a re-positioning appliance. This appliance decreases adverse loading forces in osteoarthritis or other arthritic disorders with decreased joint space. Much like Type B, these are worn during meals and worn day and night. However, this splint is only worn as long as needed and then you have to switch back to an A or B splint.

The TMJ A,B,C's are not for every patient because as previously mentioned, 15% go back to grinding and clenching and they can still experience their painful TMJ symptoms. More importantly, splints only address some TMJ symptoms and causes. This means numerous patients are given treatment that will not address their individual TMJ. For example, if the disc is not properly aligned or their is too much scar tissue and debris around the joint a splint is not going to alleviate the painful TMJ symptoms the individual is experiencing. Instead, there are other treatments that will be of greater assistance and value, such as arthrocentesis and arthroscopy.

For more information about what TMJ treatment is right for you, call our office for a consultation 
(310)276-5300 or toll free (866)DOC-4TMJ. 

Dr. Fariborz Farnad, DMD
421 N. Rodeo Dr. Ste T8
Beverly Hills, CA 90210

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