What is a bite splint?
A bite splint is a dental appliance typically made out of acrylic that covers the teeth on one arch and can be made to manage a number of different dental conditions. Bite splints can be made out of hard or soft dental acrylics. They are typically custom-made but there are over-the-counter varieties as well. The design of any particular bite splint depends on the patient’s tooth condition and bite, as well as the desired outcome. Bite splints can go by a number of different names depending on the application – including bite guard, bite plane, bite plate, night guard, or occlusal splint.
When are bite splints used?
- Temporomandibular joint (TMJ) disorders
Often referred to as simply TMJ, temporomandibular joint disorders is not one specific condition but rather a group of conditions of the jaw joint and chewing muscles. Some symptoms which are often experienced by patients with TMJ may include pain to chewing in the teeth or jaws, joint sounds such as clicking or popping, inability to open the mouth very wide, difficulty in chewing hard foods, or a change in the bite where the teeth do not line up as they once did. Bite splints are often used as a first line step in diagnosing and managing the symptoms of these conditions. See our TMJ page for more information.
- Tooth grinding/bruxism
Bruxism is the medical condition that refers to excessive and unnatural tooth grinding, oftentimes at night. Though patients who grind their teeth may sometimes experience tooth or jaw soreness, there are often no experienced symptoms at all other than the slow and continued wear of teeth and dental restorations. Many patients are not aware at all that they grind their teeth. Excessive tooth grinding can put added force on the jaw joint or muscles, leading to TMJ disorders described above. It can also be a sign of other conditions such as sleep apnea. Bruxism is very common, with some reports showing that up to 1/3 of the population showing signs of tooth grinding. Bite splints are an excellent way to cover and protect the teeth to prevent further wear and breakdown of the teeth. Furthermore, by correctly positioning the teeth and jaws, bite splints can help prevent the development of TMJ.
Tooth clenching is another common finding in patients. Tooth clenching often does not lead to the same amount of tooth wear as bruxism, but puts added force on the jaw joint and muscles and can lead to TMJ symptoms. Tooth clenching can often be found in patients suffering from stress. Bite splints can help reduce the forces of clenching to protect the teeth and jaws.
- Periodontal (gum) disease
Bite splints are often used in patients who have periodontal (gum) disease to help reinforce the teeth. Because periodontally involved teeth do not have as much bone or gum support, they are especially susceptible to clenching or grinding forces.
- Post-orthodontic retention (IE retainer)
Bite splints are really a specialized form of a retainer. They are made from similar materials as orthodontic retainers, with the main difference being that they also cover the tops of the teeth. Bite splints are often used after orthodontic treatment in patients who have had a history of clenching or grinding.
- Temporary tooth replacement (essix)
An essix retainer is a specialized kind of splint that is clear and allows the placement of an artificial tooth in an area of a missing tooth. Essix retainers are often used as a temporary way to replace a tooth during implant treatment.
- As a diagnostic measure – find source of pain, diagnose TMJ
An often underappreciated indication for bite splints are as a diagnostic aid in patients with certain TMJ disorders or unknown source of mouth or jaw pain. By allowing the jaw joint to rest in its most comfortable position and by removing grinding as a source of pain, bite splints are very useful for confirming or ruling out certain sources of pain. In this way, bite splints can often be both the method for diagnosing and for treating the associated pain.
What are the benefits of bite splint therapy?
Benefits of bite splints include:
- Protection of teeth and dental restorations from wear or breakage
- Reducing biting forces on dental implants
- Relief of certain types of muscle or joint pain
- Prevent unwanted movement or shifting of teeth
- Increased comfort
How do bite splints work? – CR, jaw settle, splint teeth and protect
Bite splints can be designed in a number of different ways and can be made to fit either the upper or lower arch, depending on the condition the splint is being used to treat. Most bite splints do share a few things in common however. They are made to allow the jaw joint to relax into its most natural and comfortable position – in dentistry we call this the centric relation position. By building the splint to allow the jaw to settle to this position, strain is taken off the muscles and ligaments that support the temporomandibular joint. For patients who grind their teeth, having the splint material covering the tops of the teeth allows for a protective layer that protects the teeth. In this way, the acrylic is allowed to over time wear down instead of the patient’s irreplaceable tooth enamel. Finally, bite splints link the teeth together so that the spacing and relationship to one another stays constant over time. This helps greatly when bite splints are used as an orthodontic retainer or to splint teeth affected by periodontal (gum) disease.
But I heard bite splints are thick and uncomfortable?
This is not true at all; in fact properly made bite splints can be quite comfortable and relatively thin, much thinner than over-the-counter or athletic mouth guards. Furthermore, our doctors have completed extensive training at the renowned Pankey Institute, where we learned the best techniques and indications for each splint design and how to use this knowledge to benefit our patients.
What are the benefits of a custom-made versus over-the-counter bite splints?
Custom bite splints have a number of advantages when compared with over-the-counter alternatives. They are generally thinner, more comfortable, and have greater chance of success for conditions such as TMJ, tooth grinding, or when used as a diagnostic device. Over-the-counter bite splints are typically made from a softer material that is made at home by softening in boiling water and then fitting to the teeth. There is evidence that soft splints can actually exacerbate certain conditions. In patients who grind their teeth, some evidence shows that the grinding tendencies themselves can actually increase by putting soft material between teeth. And since the over-the-counter bite splints do not provide a properly adjusted biting surface, there is evidence that TMJ pain may actually get worse because of incorrect positioning of the jaws. The situations in which over-the-counter splints work well include as tooth protection for patients with bruxism or as temporary protection while restorative work is being completed. In most situations, however, custom-fit bite splints are preferred for their better functionality and longevity.
How is a custom bite splint made?
Bite splints typically take two visits to complete. At the first visit, records are taken that provide accurate models of the patient’s teeth along with information about the patient’s bite. Using these simple but important records, models of the patient’s teeth are later placed on a 3-D bite simulator and the splint is then fabricated and readied for the delivery appointment.
At the second visit, the bite splint is tried-in and fit directly to the patient’s teeth to assure it is stable and comfortable. Then the biting surface of the splint is adjusted and polished for proper function. We review with the patient the best way to clean and maintain the splint for longevity.
When a bite splint is used to manage TMJ pain, there may be follow-up appointments to make further tweaks to the splint and monitor for improvement in the patient’s symptoms.
How do I know if I would benefit from a bite splint?
Dr. Jason Doublestein, Dr. Michael Wierenga, and Dr. Katelyn Trierweiler along with our dedicated staff here at 44 West Dental Professionals are trained to consider each individual’s unique situation and are happy to discuss if bite splint therapy would be beneficial for you. Give us a call at (616) 530-2200 to set up a consultation today.