A bite appliance, also known as an occlusal splint or night guard, is a custom-made removable device designed to fit over the upper or lower teeth. These tools manage issues related to the jaw and the teeth’s biting surfaces. The goal is to stabilize the system of muscles, joints, and teeth that make up the masticatory system. This protective measure requires a professional dental assessment to ensure optimal fit and function.
Defining Bite Appliances and Their Primary Goal
The purpose of a bite appliance is to establish a therapeutic relationship between the upper and lower jaws. These devices are crafted from a hard acrylic resin, or sometimes a combination of hard and soft materials, to provide a durable fit. The custom appliance acts as an interface, ensuring that when the jaws close, the force is distributed evenly across the arch of the teeth.
A primary goal of this therapy is to protect the teeth from excessive forces generated by unconscious jaw movements. The appliance helps stabilize the temporomandibular joint (TMJ), which connects the lower jaw to the skull. By creating a temporary, more ideal bite position, it encourages the surrounding muscles to relax, alleviating strain. Unlike orthodontic aligners, the intention of most bite appliances is not to move the teeth but rather to shield them and promote muscular rest.
Common Conditions Treated
Bite appliances are frequently prescribed for two major categories of conditions: bruxism and Temporomandibular Disorders (TMD). Bruxism involves the involuntary grinding or clenching of teeth, which often occurs during sleep or subconsciously throughout the day. The appliance acts as a physical buffer, absorbing the intense pressure generated by clenching and preventing direct, damaging tooth-on-tooth contact.
Chronic bruxism can cause serious damage, including the wearing down of tooth enamel, fractures, and increased tooth sensitivity. By minimizing this wear and tear, the appliance preserves the integrity of the natural teeth and any existing dental restorations. The cushioning effect also reduces the transmission of destructive forces to the jaw joint and surrounding bone structure.
Temporomandibular Disorders encompass issues affecting the jaw joint and the muscles controlling jaw movement, often resulting in pain, clicking sounds, or limited jaw opening. Appliances assist in managing TMD symptoms by allowing the jaw muscles to de-program from their strained patterns. This allows the temporomandibular joint to settle into a more relaxed position, relieving chronic muscle strain and inflammation.
The reduction in muscle hyperactivity can help mitigate secondary symptoms, such as tension headaches and facial pain. A dentist carefully determines the appliance design based on the specific diagnosis, aiming to restore harmonious function to the jaw system.
Types of Appliances Based on Function
Bite appliances are categorized by their mechanism of action, which dictates their therapeutic role. The most common type is the Stabilization Splint, also known as a flat plane or Michigan splint, which covers all teeth on one arch. This device provides a flat, smooth surface that prevents the teeth from locking into a specific bite, encouraging the jaw muscles to relax and find a neutral, comfortable resting position. Stabilization splints are primarily used to treat general muscle soreness and nocturnal bruxism, and they are considered a reversible treatment.
A second category includes Repositioning Splints, used less frequently for specific diagnostic or therapeutic purposes. These appliances are designed to temporarily force the lower jaw into a new, predetermined position relative to the upper jaw. For example, an Anterior Repositioning Splint might be used to encourage a displaced TMJ disc to return to its proper position, often by posturing the jaw forward. Due to the potential for permanent changes to the bite, these splints are worn for a limited time under close professional supervision.
The third type is the Anterior Disclusion Appliance, such as the Nociceptive Trigeminal Inhibition Tension Suppression System (NTI-tss). This smaller appliance fits only over the front teeth and is designed to prevent the back teeth from touching. By separating the posterior teeth, the device drastically reduces the intensity of clenching forces, as the jaw muscles cannot generate maximum force on the front teeth alone. This limited contact is effective in reducing migraine-type headaches and muscle pain associated with severe clenching.
Caring for Your Appliance
The process of receiving a custom bite appliance begins with a dental consultation, followed by taking physical impressions or digital scans of the patient’s teeth. These models are sent to a lab where the custom device is fabricated, ensuring it fits the unique contours of the mouth. A fitting appointment is then scheduled for the dentist to make any necessary adjustments to the fit and the bite surface before the patient takes the appliance home.
Long-term maintenance is straightforward but requires consistency to ensure the appliance remains hygienic and effective. The device should be rinsed immediately after removal and cleaned daily using a soft-bristle brush with mild hand soap or non-abrasive toothpaste. It is important to use cool or lukewarm water, as excessive heat can cause the acrylic material to warp, destroying the custom fit.
The appliance should never be left out, as this allows bacteria to accumulate and the material to dry out and potentially crack. Instead, it must be stored in a ventilated case after being thoroughly air-dried. Regular follow-up appointments are necessary, as the fit must be checked and adjusted periodically to accommodate subtle changes in the bite or to address signs of wear on the device.