Under the right circumstances, an appropriately fitted splint is a great tool to control pain. However, there is much debate in the dental world about what the right circumstances are. If there are signs of wearing of your teeth from grinding or clenching, then that is a good indication that you will benefit from a splint, but the clinical reasoning is to protect your teeth from further damage, not to control pain. As expensive as an occlusal splint may be, it’s still cheaper than restorative crowns.
If you search the dental journals for scientific evidence, you can find evidence to support the use of a splint to control pain and just as much evidence that contradicts the use of the splint. We believe that this is because the “one size fits all” approach of prescribing a splint for jaw pain is the reason there is debate about the efficacy of an occlusal splint. Jaw pain has many causes and origins and some origins will respond well to an occlusal splint while others won’t. Prescribing a splint as a first choice treatment without proper assessment and diagnosis of your TMJ to determine the origin is not treating the problem, it’s guessing.
We have two strong clinical indicators on whether a splint is required. Firstly, if we have assessed your jaw and objectively measured some restrictions and weakness and then with treatment, we have successfully corrected these restrictions and weakness, BUT YOUR PAIN IS NOT CHANGING, then we will refer onwards for a splint as the source of the pain is can not be musculoskeletal.
Secondly, we will refer for an occlusal splint if we have successfully resolved your pain with manual treatment, exercises and education, and your pain returns once we have stopped treatment (3 months is our rough timeline). This normally indicates your nocturnal habits (clenching/grinding) or your occlusion are the cause of your symptoms and although we can reduce them with treatment, we will need a splint for long term management.
It is hard to give detailed examples and obviously there are far more details, exceptions and exclusions regarding splints than can be expressed in this format.