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Old 08-01-2009, 10:50 AM   #1
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Just got splint but pain is worse

My oral surgeon just fitted me for a hard acrylic splint. It's the kind where it sits on my bottom teeth, and she ground down the splint so that only my canines are touching the splint when I bite down. I'm supposed to wear it 24/7 unless eating.

I got it yesterday, wore it all afternoon and through the night and am wearing it today. I just medicated myself for a migraine that has already started forming. Is this normal? I thought the whole point was that if my teeth weren't touching then I'm not clenching and not clenching relieves the pain. I think the pain I'm having is more intense than it would normally be (for this early in the day).

I'm so confused and feel let down because i was so hoping this would solve my problem.

 
Old 08-01-2009, 06:39 PM   #2
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Re: Just got splint but pain is worse

Quote:
Originally Posted by tatumtatum View Post
My oral surgeon just fitted me for a hard acrylic splint. It's the kind where it sits on my bottom teeth, and she ground down the splint so that only my canines are touching the splint when I bite down. I'm supposed to wear it 24/7 unless eating.

I got it yesterday, wore it all afternoon and through the night and am wearing it today. I just medicated myself for a migraine that has already started forming. Is this normal? I thought the whole point was that if my teeth weren't touching then I'm not clenching and not clenching relieves the pain. I think the pain I'm having is more intense than it would normally be (for this early in the day).

I'm so confused and feel let down because i was so hoping this would solve my problem.
Hi--Sorry you've been in so much pain. I've had tmj for almost 20yrs, so I feel for you. Did you start your search for tmj treatment with a surgeon? What treatments have you tried in the past? I have never heard of someone being fitted into a hard splint with only the canines touching. What's probably happening is the position it's putting your lower jaw in your muscles are reacting to, and kind of freaking out, so to speak. I would definitely call the office if you haven't improved in 3-4 days, and let her know what's going on. You may want to seek out a tmj specialist and get their opinion about it. Good luck and I hope you feel better...tmj is the worst.

 
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Old 08-01-2009, 06:49 PM   #3
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Re: Just got splint but pain is worse

What teeth are usually touching with a hard splint? Thanks for your reply, by the way!

 
Old 08-02-2009, 07:01 AM   #4
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Re: Just got splint but pain is worse

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Originally Posted by tatumtatum View Post
What teeth are usually touching with a hard splint? Thanks for your reply, by the way!
HI--Well, the splints that I've encountered have always been full arch, full contact repositional splints. All your teeth should touch, and it's usually worn 24/7, while eating and sleeping. Some neuromuscular dentists will give you a big NTI like appliance for nighttime that keep your back molars from touching, but my dentist doesn't agree with using those. They usually cause more problems than good. Also, if all your teeth aren't enclosed on those things sometimes your teeth will move down and shift to meet the opposing molars. It's just basic common sense. Then unfortunately people will get an open bite and need ortho. or surgery to correct that. Anyways, if you have questions about the splint, please call on Mon. and voice your concerns. After all, you are the patient, and you are paying their fees. We need to be our own advocates 24/7 with tmj, it's sad but there are so many different treatments and theories behind splint therapy and surgery, etc,. I think sometimes people get mislead and end up worse off than when they started treatment. Ok--I'll get off my soapbox now. It's too early for that this morning..

 
Old 08-02-2009, 01:12 PM   #5
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Re: Just got splint but pain is worse

I'm seeing an oral surgeon at Duke in NC. That is who prescribed this splint. I feel like I'm clenching now on my canines that are touching, so I'm fearful that the pressure will start moving them! I notice that when I take my splint out, my bite is totally in a different place and it is very awkward to bite my teeth together... like my bite now stays open. I thought that was the whole point...so I don't clench... like the splint is supposed to be training my bite to do that? But if I'm understanding you correctly, it is not good to have an open bite? I'm so confused. If your teeth are together then doesn't that just mean you'll continue clenching/grinding and the pain will continue?

By the way, I have only had intermittent bouts of headache/jaw pain today...NOTHING like yesterday's migraine, so that's good at least.

 
Old 08-02-2009, 01:38 PM   #6
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Re: Just got splint but pain is worse

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Originally Posted by jmitchell View Post
HI--Well, the splints that I've encountered have always been full arch, full contact repositional splints. All your teeth should touch, and it's usually worn 24/7, while eating and sleeping. Some neuromuscular dentists will give you a big NTI like appliance for nighttime that keep your back molars from touching, but my dentist doesn't agree with using those. They usually cause more problems than good. D
The splint I have is hard acrylic, and it is a full arch and it covers all of my lower teeth (they took a mold to create it). When I say my back teeth aren't touching, i mean that my upper teeth are not touching down on my lower teeth when I bite together. The dr. ground down the top of the splint where my upper teeth were touching my lower teeth except for the canines. Hope that make more sense. I don't know if I described it well enough before.

 
Old 08-03-2009, 06:37 AM   #7
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Re: Just got splint but pain is worse

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Originally Posted by jmitchell View Post
HI--Well, the splints that I've encountered have always been full arch, full contact repositional splints. All your teeth should touch, and it's usually worn 24/7, while eating and sleeping.
I completely agree with jmitchell. I thought the whole point of a 24/7 hard splint was to bring all your teeth into contact and distribute the stress evenly. I would definitely ask your doctor about that. As far pain at the beginning goes, I think it's pretty common to have more pain at first with a repositional splint because you're moving your jaw and all the tendons/ligaments/muscles. The first week was just terrible for me, and I wouldn't say I saw noticeable improvement until month 2.

But again, putting all of that jaw stress on just 2 teeth isn't good. Are your canines the only ones touching because that's the way it's "supposed" to be, or is it because you're not used to the splint and your teeth are sitting on it in a funny way? If it's the latter, I'd give it a week for the jaw to start finding it's new home. If it's the former, that sounds really fishy to me and I'd ask your doctor for an explanation of why it's supposed to be that way.

 
Old 08-03-2009, 07:18 AM   #8
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Re: Just got splint but pain is worse

Quote:
Originally Posted by tatumtatum View Post
I'm seeing an oral surgeon at Duke in NC. That is who prescribed this splint. I feel like I'm clenching now on my canines that are touching, so I'm fearful that the pressure will start moving them! I notice that when I take my splint out, my bite is totally in a different place and it is very awkward to bite my teeth together... like my bite now stays open. I thought that was the whole point...so I don't clench... like the splint is supposed to be training my bite to do that? But if I'm understanding you correctly, it is not good to have an open bite? I'm so confused. If your teeth are together then doesn't that just mean you'll continue clenching/grinding and the pain will continue?

By the way, I have only had intermittent bouts of headache/jaw pain today...NOTHING like yesterday's migraine, so that's good at least.
Hi--I didn't explain myself correctly about an open bite. An open bite is when your very front teeth shift and move, (outward), causing them to sort of stick out, so to speak. You can google open bites caused by splints and I'm sure you will find a picture on the web of one. This is totally different than what you are feeling as far as you saying you can't put your teeth together comfortable anymore, and it feels weird. This is caused by your muscles being trained to be in a different position from whatever splint you are wearing at the time. In my case, they are trying to reposition my lower jaw and then over time correct what my old orthodontist screwed up.
Again, please question what your oral surgeon is doing with this splint he gave you that only has your canines touching. That has to be putting a lot of stress on those teeth, especially if you are clenching at night. From all the research I've done on tmjd, I've never heard of this type of splint, and honestly if I were you I would question this and get a second opinion from a tmj specialist about that. Most will do consult for you, and if you have x-rays, bring everything with. I think you said it was a lower splint, but if you're canines are just touching, your top molars might errupt down to try to meet that splint. Just be cautious. I hope I explained myself ok ....let me know if you still have questions, you can PM me if you want..
PS--Try to look for a tmj specialist who belongs to the American Academy Association for Functional ORthodontics--and these 2 as well--The American Academy of Craniofacial Pain, and Orofacial Pain..

Last edited by Jill 227; 08-03-2009 at 07:24 AM. Reason: forgot something..

 
Old 08-03-2009, 07:56 PM   #9
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Re: Just got splint but pain is worse

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Originally Posted by shrewdkitten View Post

Are your canines the only ones touching because that's the way it's "supposed" to be, or is it because you're not used to the splint and your teeth are sitting on it in a funny way? If it's the latter, I'd give it a week for the jaw to start finding it's new home. If it's the former, that sounds really fishy to me and I'd ask your doctor for an explanation of why it's supposed to be that way.
Yes, that is how the splint is supposed to be. When I say the canines are touching... they are only touching the splint. Meaning, my bottom canines are not touching my upper canines directly. They have plastic between them. Both upper and lower are biting onto the splint (the lower ones biting up from under the splint).

When my dr. fitted me for this, she had me bite and grind with black paper between in all spots, and then she ground down all the parts on the splint that the upper teeth were touching... except the canine sections.

I called her today and told her I've been having pain and I feel that I'm clenching down on my canines now. she said that putting pressure on the splint with my canines won't bother anything, and that pain is to be expected the first week as my jaw sits in this new position. I assumed pressure on anything (whether it be other teeth or plastic) would be bad. But maybe not?

 
Old 08-04-2009, 09:44 AM   #10
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Re: Just got splint but pain is worse

Quote:
Originally Posted by tatumtatum View Post
Yes, that is how the splint is supposed to be. When I say the canines are touching... they are only touching the splint. Meaning, my bottom canines are not touching my upper canines directly. They have plastic between them. Both upper and lower are biting onto the splint (the lower ones biting up from under the splint).

When my dr. fitted me for this, she had me bite and grind with black paper between in all spots, and then she ground down all the parts on the splint that the upper teeth were touching... except the canine sections.

I called her today and told her I've been having pain and I feel that I'm clenching down on my canines now. she said that putting pressure on the splint with my canines won't bother anything, and that pain is to be expected the first week as my jaw sits in this new position. I assumed pressure on anything (whether it be other teeth or plastic) would be bad. But maybe not?
It kind of sounds like a modified NTI appliance to me. Be careful because the longer you wear splints, the more apt you are to need your bite changed somehow because regardless of what some dentists tell you, your teeth CAN shift, and your muscles will adapt to that new position. I would ask your surgeon exactly what goals she is trying to achieve by using this particular splint, and what her long term plan is. Using a splint for a few weeks won't change your bite, but when you get into the months and beyond, you are now in full time splint therapy, and you are looking at major changes in your mouth. I would research different types of splints so you get a better idea of what they do---for instance , an upper splint sometimes is used by tmj specialists because their theory behing using these is it will let your jaw naturally go to the natural resting position over time, and your body will adapt to this position. The only problem with that, I think is if you are truly trying to create a new jaw position for the mandible, this does absolutely nothing because it lets it slide all over the place. Some people have gotten worse from upper splints. The problem with tmj treatment is that every doctor has his or her own theory behind how to treat you, and may only use 1 type of splint for every patient. We need to find someone who uses all schools of thinking in his practice, and doesn't box everyone into his so called opinions and set ways of practicing. It's very frustrating, to say the least.

 
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