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What are dental splints and why would my dentist recommend one?

A dental splint is an appliance used to protect teeth and their supporting structures from damage caused by grinding or clenching. The splint may be in the form of either a tooth night guard or an occlusal splint.

Clenching or grinding of the teeth, also termed bruxism, can happen when a patient is awake or asleep. It has been reported that 20 per cent of adults engage in bruxism when awake, while 8 per cent do so when asleep. Sometimes, it is incorrectly thought that the arrangement of teeth in the mouth, or the occlusion, is responsible for bruxism. In fact, stress is the primary cause – during both wakefulness and sleep – and sleep bruxism is understood to be a sleep-related disorder. In sleep bruxism, the brain causes activation and contraction of the muscles that open and close the jaw. This generally occurs just before the onset of rapid-eye-movement sleep (REM sleep).

Chronic teeth clenching and teeth grinding can cause overuse of the muscles controlling the lower jaw, leading to pain from those muscles. The load on the joint itself can also cause changes inside the joint, leading to pain and limited opening of the mouth.

Chronic teeth grinding and clenching may eventually lead to temporomandibular disorders (TMDs). TMDs are a group of conditions that involve the muscles controlling the lower jaw, the jaw joint (temporomandibular joint) and supporting structures. Behavioural management has been found to be effective for patients suffering from TMDs. This involves reducing stress as well as making the patient aware of times during the day when they may be unconsciously clenching or grinding – such as when in front of the computer or studying, or when faced with stress at work.

If your teeth are showing wear that indicates you may be clenching or grinding your teeth at night, your dentist may recommend a tooth night guard. Night guards prevent the upper and lower teeth from coming into contact while you sleep, making them highly effective at protecting the teeth from further damage.

If you are suffering from a TMD, your dentist might suggest either a night guard or an occlusal splint. Other treatments for a TMD include changing to a soft diet, reducing stress, improving sleep, avoiding extreme jaw movements such as yawning, applying warm packs to the joint, and in some cases prescription of anti-inflammatory or muscle-relaxant medications.

For some patients, a “stabilisation” type of occlusal splint may be recommended. This is a slim acrylic guard fitted to the upper jaw and can be either soft or hard.

All kinds of dental splint distribute the forces generated by bruxism equally between the upper and lower teeth, reducing muscle strain and joint overloading. However, these do not cure bruxism itself and patients may continue to clench and grind their teeth at night.

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