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

Dental splints, also known as ‘’nightguards’’ or ‘’occlusal bite splints’’, refer to appliances that cover the biting (“occlusal”) surfaces of teeth of the upper or lower jaw. They are custom-made – usually of hard acrylic – and provide full coverage of all teeth of either the upper or lower jaw.

Why would my dentist recommend a dental splint?

Your dentist may recommend dental splints as part of management of temporomandibular disorder (TMD). TMD refers to any issues associated with the jaw joints (‘’temporomandibular joints’’) or jaw muscles (‘’masticatory muscles’’) that may cause pain, restricted mouth opening, headaches, or other signs and symptoms. Risk factors for TMD include trauma to the joint and muscle areas, clenching or grinding, stress and anxiety, and even habits such as nail biting.

Clenching and grinding, also termed ‘bruxism’, is the gnashing of teeth which leads to wear and is a relatively common sign of TMD. It can occur during the day and/or during sleep.       

Awake bruxism primarily occurs as a semi-voluntary reaction to stress and anxiety. The cause of sleep bruxism however is still unknown, but can also be attributed to stress and anxiety, obstructive sleep apnoea, heavy consumption of alcohol or caffeine, smoking and some antidepressants.

Bruxism can have many detrimental effects on teeth and jaw joints and muscles. Teeth can be subjected to excessive forces during clenching and grinding that lead to wearing down of the biting surfaces of the teeth (also known as ‘’attrition’’) and cracks. Their supporting structures, such as the gums, ligament and bone surrounding the tooth, are placed under heavy loads as they help the tooth to withstand these forces. This can lead to soreness in the gum area and, as the structures are irritated, gum recession or shrinkage can occur.              

This undue pressure can translate into the jaw joints which, over time, can lead to wear and tear of the joint surfaces. This can be heard as clicking or grating sounds on opening and closing and can lead to limited opening of the mouth. 

During bruxism, the jaw muscles are working overtime. As a result, they may become sore and feel fatigued.  Other symptoms include headaches on waking and signs of cheek biting.

How will a dental splint help me?

Dental splints form part of the management of sleep bruxism associated with TMD.  The splint provides a flat surface, allowing for even distribution of pressure across all teeth when clenching and grinding. By preventing force concentration into one tooth or a group of teeth, their supporting structures are not placed under excessive pressure, and so they are protected from trauma over time.

The teeth themselves are also protected by the dental splint which absorbs the forces created during bruxism. The relationship between the upper and lower jaws is also stabilised as the splint prevents teeth from being guided into unfavourable positions when biting together. The thickness of the splint maintains a degree of mouth opening that is optimal for the jaw joints, mimicking their natural position at rest. This helps to relieve stress on the jaw joints and muscles.

What is the process of getting a dental splint?

If your dentist has advised you to wear a dental splint at night, an impression or mould is taken of your teeth and sent to the lab, where they will fabricate the dental splint to intimately fit around your teeth. Once is it is made and sent back to the dentist, the splint is placed in your mouth and assessed for a balanced bite. If needed, it is adjusted so that you bite evenly against the opposing teeth.  Over time, the dental splint may wear down with use and require replacement. Regular review with your dentist will help to keep your teeth and all its surrounding structures at optimum health.

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