Stopping splint therapy HELP PLEASE!

[dogbert]

Sorry for long post

So I 5 1/2 months ago I got a splint from my ortho that covers all my uppers. Hes using it to adjust my jaws position so that my bite is stable prior to upper and lower jaw surgery. Let me note that prior to the splint I never really had any tmj issues, at least not any that were detrimental to quality of life. Now 3 moths in I started developing a clicking sound when I talk on my right side, and as the splint got adjusted further I started developing alot of muscle tension and headaches and ear fullness while still accompanied by this clicking which eventually also spread to the left side. My ortho said this was because the splint was changing my bite and thus my jaw position.

Now im in my final year of undergrad, and with my school schedule and the fact that I want to enjoy next summer vacationing and starting my career. So these factors combined with my pain has led me to decide to postpone surgery indefinitely, till I feel im ready. So today I went in hoping to tell my ortho this, and he tells me that not only is the splint IRREVERSIBLE (meaning my bite would not go back to how it was prior to starting splint therapy) but that if I were to stop wearing it I would also increase in discomfort and pain. And when he said this to me every instinct in my body told me he was just coming up with lies to keep me on the road to surgery, because all the research ive done on the internet tells me other wise (aka that my bite will go back to how it was).

So my question is... is he straight up lie to me?

And also, for people who have tried splint therapy and then stopped because of pain. Did your bit go back? And the pain disappear?

[TMJJill]

At various times, I've been in splints for bruxism and for TMJD.

One thing I've learned is that there are a variety of different splints that all have different purposes or similar purposes with differing approaches in function. I've also learned from experience that dentists vary widely in their training and experience as it relates to a proper bite.

I wore a bruxism splint at night for years to protect my teeth from grinding when I sleep. I paid my dentist a lot of money for this splint and trusted him. While it did protect my teeth, it actually contributed to my development of TMJD because of the positioning of my jaw/bite when I wore it.

I also had a couple of other splints that I only wore for very short periods (less than 2 weeks) because they caused me so much pain. It was all a matter of finding the right splints for me.

There really isn't an easy answer to your question of stopping splint therapy. I've seen a lot of information out there that indicates a repositioning splint can make permanent changes to a bite. It sounds like that may be the kind you have in.

I wore a repositioning splint as initial Phase I treatment for my TMJD. When I completed my initial 3-6 months, my dentist sat with me to discuss my options beyond that. He offered to help me wean off of the splint with no other treatment following. This leads me to believe that the changes weren't irreversible at the time. My goal in wearing the splint was to help me find my 'natural' bite and allow for the muscles in my face/jaw to 'relax' from the tight state they had been in when my bite was off.

It may be worth learning about the training your dentist has. It also may be worth getting another opinion. In my case, I found a highly trained functional orthodontist who specialized in treating Craniofacial pain. You can find some who belong to the American Academy of Craniofacial Pain on their website.

For the pain, I highly recommend trying to find someone who can do some manual therapy on you. If you can find someone trained to do oral trigger point releases, that would be great.

There is a really good book that I frequently refer to. I think it may really help you. It is called the TMJ Healing Plan: 10 steps to relieving headaches, neck pain, and jaw disorders by Cynthia Peterson, PT.

[dogbert]

Thanks for the reply! Ya im almost certain I have a repositioning splint. It allows my muscles to move my jaw around and apparently is supposed to allow my condyles to seat.

Just a question... what did you end up doing after your wore the repositioning splint for 3-6 months? Did you stop wearing it/keep wearing it/ or do something else?

[dogbert]

And yes i will be looking for a second opinion. Im gonna ask some orthos if the splint can actually change my bite permanently or not (which to me seems like absolute bogus).

[TMJJill]

Once I found some relief with the repositioning splint, my dentist gave me several choices:

1. Continue to wear the splint.
2. Wean off of the splint.
3. Adjust my bite by getting caps on a few of my back molars. (Teeth that had been worn down due to nighttime bruxism.)
4. Orthodontic braces to adjust bite.

I was having some serious ear problems and significant hearing loss with my TMJD issues. With my discs slipped, my jaw was pushed back 3 mm into my ear, I was very afraid of having more hearing loss occur. I decided to move forward to change my bite with braces. I actually got them off 12 days ago. My total TMJD treatment once I found a well trained dentist was about 3 1/2 years. It took me a bit longer because I had to figure out how to pay for treatment.

I will say that the majority of TMJD patients do NOT need to have their bite changed. I think I was just one of the 'lucky' ones.
That book I recommended does have a lot of really good information and advice.

I think that the need for the splint longer term really depends on your individual needs.

Good luck finding a better solution to your problem. In my opinion, based upon a lot of experience, a well fit splint that is appropriate for your issues should NOT cause you any additional pain or symptoms.