Short answer: A TMJ splint is a custom-made, hard acrylic appliance worn over the teeth, also known as an occlusal splint. It aims to reduce the load on the jaw joint and chewing muscles by temporarily balancing the bite. It is used for conditions such as jaw joint pain, joint noises and teeth clenching, usually at night. The type and how long it is worn are decided by the dentist after an examination.
One of the treatments most often recommended to people who see a dentist with complaints such as jaw joint pain, noises when opening the mouth or muscle fatigue in the morning is a TMJ splint. A TMJ splint is a custom-made hard appliance worn over the teeth, and it aims to help the jaw muscles and joint rest in a more balanced position. In the literature it is also called an occlusal splint. In this article we explain what a TMJ splint is, how it differs from a night guard, with which it is often confused, when it is used and how to care for it.
What is a TMJ splint?
A TMJ splint is an intraoral appliance, usually made of hard acrylic, that sits between the upper and lower teeth, temporarily adjusts the bite and is used to reduce the load on the jaw joint and chewing muscles. It is most often worn on the upper jaw, sometimes on the lower jaw, and has a surface that covers all the teeth.
The biting surface of the splint is flattened so that the teeth in the opposite jaw touch it at the same time and evenly. This removes premature contacts between the teeth, lets the muscles work in a more relaxed position and spreads the pressure on the joint. There are several types designed for different purposes:
- Stabilization splint: This is the most commonly used type. It covers all the teeth, creates a flat biting surface and aims to relax the muscles.
- Anterior repositioning splint: It is designed to hold the lower jaw slightly forward for a certain period. It is used for a limited time and with close follow-up in some types of disc problems inside the joint.
Which type is chosen is decided by the dentist based on the source of the complaints and the examination findings.
How does a TMJ splint differ from a night guard?
A TMJ splint is a hard appliance made with an adjusted bite to treat jaw joint and muscle problems; a night guard, on the other hand, is a simpler protector mostly used to protect the teeth from wear caused by clenching and grinding. Because both can be worn at night, they are often confused.
- Purpose: The primary job of a night guard is to protect the teeth and restorations. A TMJ splint targets muscle and joint balance.
- Material: Night guards can be soft, semi-hard or hard. TMJ splints are usually hard acrylic; soft materials are not preferred for joint treatment because they can increase clenching in some people.
- Bite adjustment: The surface of a TMJ splint is carefully adjusted in the mouth by grinding it according to the contacts of the opposing teeth. With a night guard, this adjustment is more limited.
- Follow-up: A TMJ splint is checked and readjusted at set intervals depending on how the complaints progress.
Over-the-counter guards that are shaped after softening in hot water are not custom-made and therefore cannot replace joint treatment. Long-term, unsupervised use of appliances that cover only part of the dentition or only some teeth can cause the teeth to move in unwanted directions.
When is a TMJ splint used?
A TMJ splint is used as part of treatment for various conditions that strain the jaw, mainly jaw joint disorders (temporomandibular disorders), pain in the chewing muscles, and clenching and grinding. It may be considered for the following complaints:
- Pain in the jaw joint or in front of the ear
- Clicking, popping or grating noises when opening and closing the mouth
- Fatigue and tension in the jaw muscles in the morning
- Pain spreading to the temples, the side of the face or around the ear
- Limited mouth opening or the jaw occasionally getting stuck
- Tooth wear, fractures and sensitivity caused by clenching
A TMJ splint is usually recommended not on its own but as part of a comprehensive approach. Avoiding hard and chewy foods for a while, not chewing gum, applying heat, jaw exercises, stress management and, when needed, physical therapy are the other components of this approach. If the source of the complaints is not only the teeth and jaw, cooperation with other relevant specialties may be needed.
Its relationship with orthodontic treatment
In some people with a bite problem, orthodontic treatment may be considered after the joint complaints have been brought under control with a splint. However, it is not accurate to say that correcting the bite resolves joint disorders in every case; this decision depends on the examination findings and how the complaints progress.
How is a TMJ splint made and how long is it worn?
A TMJ splint is custom-made in a laboratory from an impression or digital scan of the teeth and adjusted to the bite in the mouth when it is delivered; how long it is used ranges from a few weeks to a few months depending on the type of complaint.
- Examination: The jaw joints and muscles are examined by hand, mouth opening is measured and joint noises are listened to. If needed, a panoramic X-ray or advanced imaging is requested.
- Impression and bite record: An impression or digital scan of the upper and lower jaws is taken, and the position of the jaws relative to each other is recorded.
- Fabrication: The splint is made from hard acrylic in the laboratory.
- Delivery and adjustment: The splint is placed in the mouth, its contacts with the opposing teeth are marked with colored articulating paper, and it is adjusted until even contact is achieved.
- Check-ups: At check-ups, more frequent in the first weeks and then at set intervals, the surface of the splint is readjusted.
The splint is mostly worn at night while sleeping. For people who clench during the day, the dentist may also recommend wearing it at certain times during the day. How long and how often it is worn must be decided according to your dentist's recommendation; whether to stop wearing the splint completely once the complaints have resolved is also decided at a follow-up appointment.
How do you care for a TMJ splint?
A TMJ splint should be rinsed with cold or lukewarm water after each use, cleaned gently with a soft brush and kept in a dry, ventilated storage case. Proper care both extends the life of the splint and prevents bacterial buildup.
- Do not use hot water; acrylic can change shape with heat.
- Abrasive toothpastes can scratch the surface of the splint; plain soap or a cleaner recommended by your dentist can be used instead.
- Brush your teeth before putting in the splint.
- Do not leave it wrapped in a napkin; most splints are lost or accidentally thrown away this way.
- Keep it somewhere pets cannot reach.
- If you notice a crack, a break or a change in how it fits, contact the clinic before continuing to use it.
Having the splint checked regularly also makes it possible to monitor whether there are any unexpected changes in the teeth or the bite. You can find answers to other practical questions about splints and intraoral appliances on our frequently asked questions page.
What should you keep in mind while using a splint?
The most important thing for people using a TMJ splint is to wear it regularly and to report any new change to their dentist. After taking the splint out in the morning, you may feel a brief difference in how your teeth fit together; this feeling usually passes quickly. However, if you notice a change in your bite that lasts all day, increasing pain while wearing the splint or a new joint noise, the splint may need to be readjusted.
When should you see a dentist about jaw joint complaints?
If your jaw pain has lasted for several weeks, if you feel your jaw locking when you open your mouth, or if you wake up in the morning with noticeable muscle fatigue, it is a good idea to have an assessment without delay. At our clinic in Oran, Çankaya, the jaw joint and bite are examined and the possible sources of the complaint are assessed; whether a TMJ splint is suitable for you and other supportive steps are planned together.
Frequently asked questions
Does a TMJ splint completely relieve jaw pain?
A TMJ splint can help reduce muscle- and joint-related complaints in many people, but it is not enough on its own in every case. Better results can be achieved when it is used together with steps such as changing habits, exercises and stress management. The response varies from person to person.
Can a ready-made guard from the pharmacy be used?
Ready-made guards are not custom-made or adjusted to the bite, so they cannot replace joint treatment. When used for a long time without supervision, they can cause unwanted tooth movement. It is recommended to ask your dentist before using one.
Does a TMJ splint affect speech?
Because the splint is usually worn at night, it does not affect everyday speech. In cases where it needs to be worn during the day, a slight difference in speech may be noticed in the first days. For most people this difference fades quickly.
How often should a TMJ splint be checked?
Check-ups are more frequent in the first weeks after delivery and then take place at intervals determined by how the complaints progress. At check-ups, the surface of the splint is readjusted and changes in the jaw joint are assessed.
