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Articles

A New Look at an Old Bite Splint

A Passion for Healing

Healing Ministry of Dentistry

PDFs

The Bicuspid Buildup as an Alternative in Phase II Treatment of Craniomandibular Dysfunction

The Biscuspid Buildup: As a Diagnostic Aid in TMJ and Muscular Dysfunction—A Followup Study

A New Look at an Old Bite Splint

For Dentists

Occlusal Screening, Tests, and Bite Splint Adjustments

For Dentists


Occlusal Screening Procedures

  • for occlusal/ temporomandibular joint dysfunction
  • initial screening for new patients
  • patients recycled in a preventive practice (as on recall)
  • for primary evaluation in an institutional setting

Modified Half Minute Test

Seven Screening Questions

  1. Do you clench, grind or brux ( gnash) your teeth?
  2. Do you have frequent headaches neck or shoulder pain?
  3. Do you have clicking, popping or gravel-like sound in your jaw joint?
  4. To your teeth or jaws ever feel "tired" or sore when you wake up?
  5. Do you have loose or sensitive teeth?
  6. Do you now, or have you ever had, pain in your jaw joint or in the sides of your face?
  7. Do you have frequent ear pain, ringing or stuffiness in the ears?

Maximum Opening (in mm)

Palpate:

  • JOINTS
  • AUDITORY CANALS
  • LATERAL PTERYGOIDS

* The seven questions illuminate a patient's subjective awareness of any dysfunction of the TMJ system.

* Maximum opening measured inter-incisally can indicate hypomobility (35 mm or less), hypermobility (56 mm or more), or normality (40 to 55 mm).

* A soreness or pain reaction to palpation of the temporomandibular joints externally may indicate joint and/or muscular involvement. A soreness or pain on palpation through the auditory meatus may indicate an inflammatory condition in the fossa.

* Palpation from the auditory canals on opening and closure can reveal abnormal condylar movements.

* Tenderness of the lateral pterygoids to palpation is indicative of dysfunction.

POSITIVE RESPONSES INDICATE THE NEED FOR A COMPREHENSIVE CRANIOMANDIBULAR ASSESSSMENT

COURTESY : Dr. Joseph Gantz


Bite Splint Instructions

For the dentist in adjusting:

  1. Relieve palatal posterior undercut areas on the right side of the appliance more than the left so it fits on the patient's model fairly easily. Then insertion is made by you or the patient on the right palatal side first to engage the linguals of the teeth, then the left side of the appliance snaps into place or may needs further adjustment to clear undercut areas of the left palatal area. On the distal of the upper left cuspid acrylic relieve about the thickness of a fingernail. The space you created between the cuspid and acrylic becomes a grabber for the patients to remove the appliance with their left hand. See the full color drawing on splint construction for further instructions.
  2. Using articulating paper, check for high spots and grind the flat plane so as many as possible of the lower anterior teeth (6) contact allowing free excursion in all lateral directions. The amount of bite opening should be determined phonetically having the patient read something so they do not contact when speaking. Naturally, phonetics will be somewhat difficult because of the acrylic behind the front teeth. Make sure there is no acrylic posterior contact during centric occlusion, or during lateral excursions doing jaw movements.

For the patient in wearing:

  1. Wear primarily at night or during other periods of obvious distress like driving or during tense daytime periods. Some patients wear of the guard almost all the time after accommodation to speaking if there has been a radical reduction of symptoms, with symptoms returning when splint not worn.
  2. A toothpick can be used as a splint substitute being held in the same position between the front teeth, during stressful situations like driving etc.
  3. Keep in the case when it is not being worn.
  4. Do not put in a tissue, napkin, or handkerchief it will be lost or thrown away.
  5. Do not place bite splint wear it is exposed to animals, especially dogs who love to eat or chew up bite splints or other appliances.