• orthodontics
• whitening
• bite splint therapy
• oral cancer screening
• dental implants
• periodontal disease
• preventive dentistry
• pit & fissure sealants
• radiographs (x-rays)
• wisdom teeth

bite splint therapy

Information for Patients regarding Bite Splint Therapy 2004

What is Bite Splint Therapy?

Incorrect working of the jaw joints, called the Tempero-Mandibular Joints (or TMJ's for short), and the way the teeth fit together, can lead to all manner of symptoms which will have been discussed with you. Bite Splint Therapy is a precise process where a piece of plastic is carefully constructed to fit precisely into your mouth only, and is set with a bite which is sympathetic to the function in a healthy manner of your jaw joints. The bite splint is usually made of either clear or tooth-coloured plastic, and is usually worn full-time except for eating.

There is a distinction between

• treatment for a problematic joint
• treatment for problematic muscles

How long should I wear the Bite Splint for?

The bite splint is intended to provide relief to the muscles aand/or the joints from the problems normally caused by the way your teeth meet. Accordingly, it is critically important that you wear the plate full-time during the diagnostic period, usually the first three months. It is obviously permissible to take it out for eating, and although we would always advise you not to take it out for social events, you may feel differently! However, the spirit of the pattern of wear is that it should be worn full-time, in order to offset the many hundreds of times per day that you swallow and clench your teeth together, for example.

How long will the treatment take?

We would normally expect to fit a Bite Splint and see a change in the pattern of your symptoms over a period of the first month. At the end of the first month it is likely we will then enter a period of watching the TMJ's and muscles gradually settle down. At the end of three months it will normally be apparent that we can move to the next stage.

What happens after the Bite Splint?

The Bite Splint normally provides us with an indication of where your bite should exist and how the teeth should interrelate. Accordingly, we use the bite splint to guide us as to how we modify the teeth whether by reshaping and adjustment, in a process called equilibration, or whether by restoration or definitive bite change using orthodontics.

It is important to appreciate that it may not be possible to say what is right for you at day 1. At the end of the initial treatment period, it is usually possible to plan your longer term rehabilitation.

Nutritional Support

You may have your own systems of nutritional support in place. If we are to expect inflamed joints to heal effectively, it is necessary to ensure that the body's natural fuels are available to rebuild the various tissues - muscles, ligaments, bone etc. Our recommendation would be that you consider a period of 3 months effective nutrition supplementation. Separate information is available.

Cross referral to SoT Chriropractors

Many children we see exhibit a history of trauma during childhood, sometime minor, or sometimes a major fall from a bike etc. There may be a history of a difficult birth, or known neonatal feeding problems.

In adults, often we are trying to influence boney relationship, which have been in place for many years.

It is our experience that many for of tension can exist in the system of complex cranial and facial bones. With this in mind you are commend you to seek the specialist opinions of a chiropractor that understands cranial manipulation, at the least; ideally we can recommend the name of a chiropractor of the Sacro Occipital Therapy group of practitioners.

The Procedures

The nature of careful and accurate Bite Splint Therapy is that it is time consuming.

Aside from the consultation leading to the decision that Bite Splint Therapy is appropriate, the visits or reviews involved are usually structured as follows. Where the distances are great between patient and practice, telephone follow up may be undertaken.

• Impressions and careful jaw records
• Fitting, re-lining, and bite adjustment of bite splint
• Day one, post-operative review
• Day eight, post-operative review
• Three week post-operative review
• Six week post-operative review
• Twelve week post-operative review

What can I expect?

It is quite simple. If our diagnosis is correct, your symptoms will change for the better, In many circumstances you will be cured of the pain and discomfort that you have described to us, often without need to resort to any medication. This often cures a problem with which you may have lived for many years. It is difficult to describe the emotional lift that comes with freedom from headaches, discomfort in your face and TMJ's, sleeping well, and relief of the other various symptoms which you may have noticed. It is a refreshing improvement in quality of life.

However, Bite Splint Therapy is a step on the way to a longer-term treatment plan, rather than in itself, the major treatment on it's own. It is not our intention that you should be committed to wearing a Bite Splint forever and a day.

What comes after Bite Splint Therapy?

At the end of your Bite Splint Therapy when you are free of symptoms and signs, we would then expect to reassess your circumstances and reassess your biting relationship. It will then be apparent whether we need to take you forward into a process of bite adjustment, equilibration, or whether we should consider restorative dentistry to provide a proper biting relationship as indicated by the bite splint. Indeed, orthodontic correction of the bite relationship may be indicated

After Bite Splint Therapy Possibility No.1 - Equilibration

It is likely that at a detailed level of analysis the individual bite contacts will not be correct. The result of this is that the heavy forces of biting or mastication are distributed along an inclined axis to the tooth rather than the preferred long axis of the root. Your diagnostic casts will also reveal the excessive grinding contacts that exist.

In order to plan your dentistry as accurately as possible. We undertake the following protocol at the conclusion of the initial period of therapy:

• Review of signs and symptoms
• Renewed bite records using wax or other accurate materials
• Re mounting of casts on jaw simulator and re-evaluation of the bite
• Trial adjustment of the bite on the casts to achieve the physiologic ideal
• Review of possible restorative requirements and consultation with you
• Equilibration of the teeth in the mouth, using the Trial Adjustment as the guide for this process, over 2-4 visits
• Review over 3 months of tooth settling movement, or 'bounce-back'

The benefit of this procedure can be to reduce the tendency to night grinding or clenching, to reduce any predisposition to headaches of dental origin. It is also designed to ensure that the Tempero-Mandibular Joints have a best opportunity for long-term healthy function. This is achieved by ensuring that the dynamic tooth contacts allow the protective reflexes of the jaws to become fully operational.

A maximum guideline fee might be of the order £895

After Bite Splint Therapy Possibility No.2 - Orthodontics

We may advise you that it is necessary to reset your bite relationship completely. A complex orthodontic plan is demanding, and likely costly. The sense of awe at the commitment can only be balanced by an understanding that you have got better. So it is not appropriate to try and second guess a plan for you or the cost.