Occlusal splint
introduction
The oral cavity is the portal of entry for the entire digestive tract. Here the food is chopped up, salivated and then transported on. The teeth, the masticatory muscles and the temporomandibular joint play a decisive role. They have to be coordinated. If this is not the case, extensive complaints can arise.
Read about it too Grinding splint
The Temporomandibular joint performs countless tasks in the human body every day. It starts when we have breakfast in the morning, swallow food or talk during the day. It is almost permanently in use and never lets us down. However, it can also suddenly start to pain and to crack.
Some people have these problems especially in the morning after getting up or after getting a new one dentures got. The movements become uncomfortable and everything feels kind of stiff and firm. The cause can be TMJ disease be. A inflammation may have triggered a craniomandibular dysfunction exist or the joint has been damaged in an accident.
The therapeutic measures should be as invasive as possible, so that splints are often used to protect the temporomandibular joint from incorrect loading.
General information on the grinding splint
The bite splint is used to regulate the chewing system. Another name is crunch splint. This term is derived from the clinical picture of crunch, which is supposed to be eliminated by using the splint.
It is an unconscious forceful pressing and rubbing of the teeth during sleep, which leads to the abrasion of the enamel layer. The resulting noise is so loud that the sleep of the spouse is severely disturbed (see also Sleep disorders).
Such behavior can be caused by stress or mental disorders. Therefore, any psychosomatic treatment is recommended. The grinding splint is therefore only worn at night, mainly on the teeth of the lower jaw, and does not eliminate the unconscious clenching, but rather it protects the teeth from grinding.
The pressure generated by the masticatory muscles is extremely high, it can be up to 70 kg. It is therefore understandable that the additional rubbing on the tooth surface over time leads to irreversible wear on the tooth surface. The grinding splint does not destroy the chewing surface but the splint material.
Read more on the topic: Therapy for grinding teeth
Another indication for the occlusal splint are changes due to abnormal bite conditions. They can arise, for example, from the abrasion on the tooth surface caused by grinding, so that the upper and lower teeth no longer fit together properly or if there is no normal tooth position at all and there is no contact between the chewing surfaces. This can also cause pain in the temporomandibular joint as the load on the joint is uneven. The pain can also manifest itself as a headache. The bite splint evens out the irregularities and thus eliminates the discomfort.
Material for an occlusal splint
A bite splint or Michigan splint can consist of different materials depending on the manufacturing process. As a rule, after the impression has been taken, bite splints are made in the dental laboratory with a so-called deep-drawing device and the necessary splint-tooth contact points are then ground in.
Normally, that is, if there are no known incompatibilities, a transparent, thermoplastic material of the PMMA (polymethyl methacrylate) or PETG type is used here.
This plastic has the property of being deformable at temperatures above 100 degrees Celcius and can then be pulled over the tooth model by vacuum. The plastic then cools down again and hardens.
The bite splint can be used after finishing the tooth contacts and grinding them into the splint. The plastics used are CE certified and therefore harmless to health. Since the plastic is not as abrasion-resistant as a normal tooth, the bite splint crunches and has to be replaced. However, this is intentional, as an occlusal splint should always protect the natural teeth.
A distinction should be made between the Michigan splints and the "bleaching splints", here a more flexible plastic is selected, which means that the material is usually the same, but the splint diameter is reduced. However, due to the different applications, this is intentional.
Read more on the topic: Bite splint material
Occlusal splint and CMD
An occlusal splint can also be useful for treating what is known as craniomandibular dysfunction (CMD for short).
CMD is a disease of the masticatory system that is triggered in most cases by a disproportion between the lower and upper jaw. Especially when biting down, the upper and lower jaws of a patient suffering from CMD do not meet in the ideal position. As a result, the masticatory muscles are excessively and incorrectly strained, which can trigger severe pain and swelling. Such an anatomical disproportion can be caused by genetic predisposition and psychological stress.
In addition, traumatic effects on the jaw can also contribute to the development of this disease. In addition, especially those people who have poorly fitted crowns and / or bridges, fillings that are too high or extremely misaligned teeth often have a CMD. The majority of CMD patients report moderate to severe pain in the chewing and facial muscles. The temporomandibular joint is also often affected by pain. In addition, nocturnal teeth grinding and excessive clenching are classic symptoms of CMD. In addition, many of those affected experience frequent dizziness and ear pain or ringing in the ears (tinnitus).
In order to be able to effectively treat craniomandibular dysfunction (CMD), ideal interaction between dentist, orthodontist, orthopedic surgeon, physiotherapist and osteopath is usually necessary. During therapy, the dentist is responsible for adjusting crowns, bridges and / or fillings so that an ideal bite (occlusion) can be guaranteed.
In addition, experience has shown that a bite splint (so-called functional splint) is particularly suitable to reduce overstressing of the temporomandibular joints and thus to alleviate the patient's symptoms in the long term. Such a splint is placed on the row of teeth and can be removed from the mouth by the patient at any time.
The occlusal splint for the treatment of CMD should be worn by the patient, especially during the night, in order to prevent teeth grinding and the rows of teeth from clenching too tightly. In most cases, it is already possible to counteract the effects of craniomandibular dysfunction (CMD) by wearing the occlusal splint and to ensure that the masticatory muscles are stressed evenly.
A bite splint for treating CMD is usually made only for the lower jaw and attached to the row of teeth. Regular wearing of the bite splint not only alleviates the discomfort in the jaw area, because since the muscles of different body regions interact, wearing the bite splint has a positive effect on the entire body statics. Pain and tension in the neck region, which often occur in CMD patients, are also relieved in this way. For this reason, treatment should urgently be coordinated with a physiotherapist and / or orthopedic surgeon.
Read more on the topic: Craniomandibular dysfunction
Does the occlusal splint help against teeth grinding?
A so-called "grinding splint" is the best way to protect the teeth from the damage caused by grinding. As with pressing, the teeth rub against each other and wear each other out. The teeth lose the relief of the chewing surfaces, which over the years leads to the teeth losing height and the cusps being flattened. If you don't stop this process or slow it down with an occlusal splint, the hard tooth structure is lost and chewing becomes more difficult.
A bite splint is generally made of plastic. So it is softer than the teeth. When grinding, it is not the teeth but the plastic that is rubbed off first. One possible consequence of teeth grinding is pain in the temporomandibular joint. The constant, mostly unconscious “chewing” leads to cramps in the masticatory muscles, which irritate the jaw joint.
If the hard tooth substance wears off, the rows of teeth come together later when the mouth is closed. This means that the mouth can be closed further than it was before. Clearly explained: a toothless person can close his mouth wider than if all teeth were clenching each other. The jaw joint is naturally aligned in such a way that it is in a comfortable position when you clench. However, if the mouth continues to close, the jaw joint wears out and, like any other joint, can cause pain over time.
Alternatives and accompanying therapy to the occlusal splint
In the case of slight problems or simple tension, only splint therapy is usually used first. However, if there are more serious problems or if the applied therapy does not show the desired success, supportive or further therapeutic agents can be prescribed. Physiotherapy, like drug treatment, is part of the pain diagnosis treatment.
Physiotherapy uses therapeutic methods with the help of exercises that are not limited to the jaw and face area, as incorrect posture can also be responsible for TMJ problems.
Medicines that work against inflammation in the joint or make the pain more bearable can also be part of the therapy. By changing your living conditions, which may cause a lot of stress or emotional suffering, you can take the initiative to support the treatment yourself. Relaxation and stretching exercises can be performed in the evening or when you notice that the temporomandibular joint and the muscles involved are very tense at the moment. Alternative healing methods such as acupuncture can also reinforce the desired effect. Surgical intervention is attempted as long as possible using the options just mentioned, but cannot be ruled out in principle.
Does an occlusal splint against snoring make sense?
One reason for snoring is that the lower jaw falls too far back when lying down. The throat muscles thus close the throat and the airway.
There are 2 types of special snoring splints: the tongue is pulled forward so that it does not fall into the throat, or by one Protrusion splint the lower jaw is pulled forward.
A pure bite splint, which only helps against teeth grinding, is actually not enough to bring the tongue or the lower jaw forward. Nevertheless, in individual cases it can happen that the splint is ground in so well that the lower jaw remains in the "normal" position even at night.
If you are further interested in a snoring device, read our next topic: Palate Brace - How is it used correctly?
Bite splint for tinnitus
The trigger for tinnitus is 20% in the cervical spine. Due to the interaction of the masticatory muscles and the temporomandibular joint, many functional disorders are also transferred to the cervical spine and vice versa. Especially in patients with craniomandibular dysfunction, i.e. a proven TMJ disease, the bite splint leads to muscle relaxation. If the cause of the tinnitus is tension in the cervical and thoracic muscles, such a relaxation splint can relieve the tinnitus.
As already written above, the reason for tinnitus is only 20% in the muscular head area, which means that not every tinnitus can be treated with a splint. However, it should be taken into account during therapy.
Caution: In rare cases, a bite splint can lead to tinnitus. The reason for this is a muscular misalignment of the masticatory muscles if the splint is incorrectly ground and the muscles cramp.
Also read: Treat tinnitus
What to do if there is pain or pressure from the occlusal splint?
An occlusal splint should not act like braces and actively move the teeth, but it can still act as a “retainer” after orthodontic treatment. Because the teeth are constantly shifting in the course of life and are kept in shape by the splint and thus counteract the migration process, pain can occur. If the pain is severe, you should consult the treating dentist. He can then make a new splint with the current tooth position.
If the splint only presses on a single tooth, this can also be ground a little free in the dental practice so that the splint does not fit too closely to the tooth. The splint can also press against the gums. It may be too long or there are small plastic tips sticking out. The dentist should remove these areas and polish them smooth.
If you have the feeling that the splint is crooked and the opposing teeth are not evenly supported, the correct clenching of the teeth must be ground in again.
If all teeth do not bite evenly on the splint, this means that some teeth receive more, others less force. The temporomandibular joint is not loaded equally on both sides, so that pain occurs again. On the other hand, the load is too great for some teeth. The teeth that are less strongly supported can grow longer (Elongation) and thus change the toothing over a longer period of time.
See also under: Pain from an occlusal splint
Production of the occlusal splint
The manufacturing process for such a grinding splint or bite splint is relatively simple and in most cases it is covered by the health insurance company.
The attending dentist takes an impression of the jaw with alginate. Alginate is a frequently used elastic, irreversible impression material in dentistry, which is obtained from seaweed and seaweed.
Now you have an individual tooth impression of the patient's jaw, which is poured out with plaster by the dental technician in order to produce a model. There are different ways of creating an occlusal splint.
Either by means of deep-drawing foils, hot and cold polymers or light-curing plastics. The process using deep-drawing foils is the most frequently used, as it is the easiest and fastest to carry out and the material is most likely to meet the desired requirements. The occlusal splint should be biocompatible, last a long time, not damage the existing teeth or tissue and do justice to the benefits (absorb forces, etc.).
What does an occlusal splint cost?
Bite splints usually do not cost the patient anything. Therapy with an occlusal splint is a health insurance benefit, i.e. the statutory health insurance companies pay for the individual production of a centric splint. The situation is usually the same with private health insurance companies.
In the case of private health insurance (PKV), the dentist calculates according to the fee schedule for dentists, the GOZ, in which the prices / costs are determined.
The simple rate of costs according to GOZ can be calculated up to 3.5 times the rate without justification. From 3.5 times, a reason must be given. For higher sums, a private agreement about the treatment and the fee must be signed by the patient.
The statutory health insurance benefits do not include special work steps or diagnostic procedures that are often offered. These have to be paid for privately and thus there can be costs when making a Michigan splint.In principle, the patient can insist that such individual diagnostic procedures or work steps are dispensed with.
There is, for example, the diagnostic method
- Face bow. The patient's individual upper jaw position in relation to the skull is registered here. As a result, the dynamic tooth-to-tooth contacts are mapped in the model in more detail.
- electrical recording of the temporomandibular pathways
- the use of a custom tray for taking impressions.
What all the methods have in common is that they aim to transfer the individual patient situation to the working models in greater detail. Each patient can individually decide in a discussion with the treating dentist for such private additional services, whether such additional services are necessary always depends on the individual patient situation.
When do you need a new occlusal splint?
There are no time limits as to when the rails should be replaced. If the occlusal splint is cleaned and cared for regularly, it can last a long time.
However, if you should have pain because the splint no longer fits the position of the teeth, possibly due to longer periods of non-wearing, a new one should be made. Since the teeth are more stable and resistant than the plastic of the splint, the splint will wear out over time and become too thin or even bitten through. Even then, a new occlusal splint should be made.
Cleaning an occlusal splint
The bite splint, also known as the grinding splint, is intended to protect us from shedding our teeth and jaw joint during the night crunch Too much stress and possible damage to the tooth and joint.
In order for the occlusal splint to fulfill this function for as long as possible, thorough cleaning is necessary in order to free it from plaque, residue, deposits and bacteria.
Since the splint is preferably worn at night, one is recommended Cleaning in the morningthat you get on well with the morning Brush teeth can combine. To do this, you take the bite splint, a little toothpaste, water and an extra toothbrush. Now you scrub the rail clean to get rid of the residue. As on our teeth, the bristles can thoroughly clean all areas of the splint.
Then you rinse them off with lukewarm water.
Then you dry them thoroughly and keep them in a box until the evening. Often the dentist gives you such a box when you make the splint. It is important that the occlusal splint is not wet during the day due to cleaning or saliva, as otherwise the bacteria can spread well and there is a risk of unnecessary germs entering the oral cavity in the evening when the splint is inserted to procrastinate.
Besides this daily cleaning, it is recommended at least once a week to carry out a special cleaning with suitable and commercially available cleaners. These are available in drug stores, health food stores and pharmacies.
They can come in the form of a tablet that is dissolved in water, or they can be a ready-made liquid into which the bite splint is placed. With these cleaners, it is important that the splint is not left in the liquid for too long or over the day. Because these can attack the plastic, weaken it or cause unsightly discoloration.
Usually two hours are enough to produce a good cleaning result. Even after that, the splint should be rinsed thoroughly with lukewarm water to remove all loosened residues. It can be useful to brush again with the toothbrush and toothpaste, as the cleaning agents usually have an unpleasant taste, which is neutralized as a result.
Subsequent drying and storage in a box complete the cleaning process. Due to the careful maintenance, the occlusal splint fulfills its function for a long time and retains its "Feeling of freshness". Alternatively, there is also a home remedy, which can be found in every kitchen, with which you can clean the bite splint in a cheaper way, namely vinegar. In particular, cleaning agents, which use the form of effervescent tablets and thus clean the splint with oxygen, are usually considered to have a harmful effect on the plastic.
When using vinegar, one takes 1/3 white household vinegar and mixes this with 2/3 water. Alternatively, you can also buy ready-made vinegar solutions. Here, too, it is important that the occlusal splint does not lie in the vinegar bath for too long. 1-2 hours are recommended. After the vinegar bath, the splint should be rinsed thoroughly and cleaned with a toothbrush and some toothpaste. This removes any loosened residues left on the rail and neutralizes the sour taste.
Summary
The occlusal splint is used to treat diseases of the chewing system. It is made of plastic and adjusted by the dentist to compensate for misaligned teeth or to avoid damage caused by unconscious nocturnal grinding. The splint cannot cure these diseases, it can only eliminate the consequences.
The occlusal splint, also known as the relaxation splint or grinding splint, is usually the first means of choice Temporomandibular joint problems. It is relatively thin, transparent and made of plastic.
Either it is placed on the row of teeth in the upper jaw and on the row of teeth in the lower jaw, with a production for the lower jaw being carried out more frequently.
It is used shortly before going to bed, sometimes there are splints that have to be worn during the day, but then exceed the function of a normal grinding splint.
Their task is to ensure that the rows of teeth are no longer unconsciously pressed against each other and movements are carried out in the process. The resulting force is diverted to the plastic splint and no longer stresses the teeth. The temporomandibular joint remains in a comfortable position and is not pathologically stressed.
Bones, joints and muscles can relax, stiffening can be released and excessive strain can be avoided. A constant overload not only causes problems with the jaw joint, but also problems with the tooth and tooth support apparatus. For example, there is a Craniomandibular dysfunction before, the benefit of the splint is that the masticatory muscles and the joint can relax and are not continually incorrectly stressed.
It also supports the decompression of the temporomandibular joints. A purely physiological movement of the temporomandibular joint is the goal. In the long term, it will Bruxism prevents a harmonious interaction between teeth, jaw joints and muscles. This prevents further damage to the temporomandibular joint and alleviates current symptoms. The earlier you put on splint therapy at the first signs, the better the chances of success.
