Pain from a bite splint

A bite splint is a dental appliance made of plastic and adapted to the individual dental arch of the patient. For this reason, an impression of the jaw has to be taken before fabrication (impression). Afterwards the jaw model is cast in the dental laboratory on which the bite splint is made.

Bite splints are mainly used in dentistry to treat diseases of the jaw joint. The classic indication (reason) for the use of such splints is excessive teeth grinding (technical term: bruxism) at night. Therapy with a bite splint serves to alleviate excessive and/or incorrect loading of the teeth and the temporomandibular joint, the effects of which can in some cases severely restrict the quality of life of the patients concerned.

Such incorrect loading can, for example, lead to the occurrence of frequent headaches or muscle pain in the area of the temporomandibular joints. These problems can be treated particularly effectively by wearing a bite splint regularly. In general, it is not necessary to make a separate occlusal splint for the upper and lower jaw, because wearing it in one half of the jaw is usually sufficient to achieve the desired therapeutic success. Since excessive emotional or physical stress often leads to teeth grinding, relaxation techniques are very useful in addition to splint therapy.

How can pain occur when wearing the bite splint?

The application of a bite splint usually causes no pain. On the contrary, wearing a bite splint regularly reduces the symptoms of jaw malocclusion enormously. Headaches caused by stress rapidly decrease rapidly under therapy and problems in the area of the jaw joint are effectively reduced.

In many cases, these problems can even be completely eliminated. At the beginning of the treatment there may only be a partly strong feeling of pressure, which decreases with increasing wearing time, as the teeth and their supporting apparatus have to get used to the splint. In the case of bite splints, which cause pain in the gum area, wearing should be stopped for the time being and an appointment with the dentist should be made.

Since the splint is usually too long or has sharp edges in such a case, irritation or injury to the gums can occur with further use. In addition, over a longer period of time there may be a strong pressure load and thus the gums may recede. This in turn can lead to exposed tooth necks and pain.

In such cases, the consumption of hot and/or cold food and drinks becomes increasingly unpleasant. For this reason, the occlusal splint must be corrected afterwards. As a rule, sanding down the protruding edges is completely sufficient.

In some cases, however, a new occlusal splint must be made. A bite splint is actually there to relieve pain in the region of the jaw joint, muscles and teeth, but it is not unusual for users to complain of toothache caused by this plastic splint. Patients’ complaints usually occur in the morning after wearing the splint and affect individual teeth or groups of teeth.

The quality of the pain corresponds to a strong pressure pain and is increasingly uncomfortable for the patient, as it appears more frequently when chewing. If the pain occurs on individual teeth or groups of teeth, this indicates that the splint was not optimally ground in during insertion. The aching teeth have too much contact and must compensate for all the force exerted by the masticatory apparatus at night.

As a result, not only the individual teeth hurt, but also the entire periodontium, since the affected teeth are always pressed into the tooth socket with increasing force. This can overload the periodontium and cause inflammation. Furthermore, the nerve inside the tooth can also become inflamed and die as a result of the excessive load.

Consequently, the patient feels a strong throbbing pain in this case. Grinding off the splint afterwards usually cannot save the tooth after an inflammation of the pulp and a root canal treatment is the mandatory therapy to alleviate the discomfort. In general, as soon as complaints occur after the insertion of a new bite splint, the dentist should be consulted immediately so that the splint can be optimally ground in and the pain disappears quickly and permanently.

The temporomandibular joint is often the focus of attention when it comes to pain in the head and neck area. The making of a bite splint is supposed to alleviate the discomfort, but in some cases wearing the splint is not successful. If the arthrosis of the temporomandibular joint (due to the deformation of the joint surfaces or the joint disc) is already very advanced, splint therapy alone cannot relieve the pain.

In these cases, minimally invasive surgery is first attempted to minimise the discomfort of the temporomandibular joint. If this is unsuccessful, a surgical transplantation of an artificial joint must be carried out as a form of therapy or supported by means of transplants such as the fibula transplant. However, complete symptom relief is possible.

The occlusal splint can also cause problems with the temporomandibular joint if it is not made to fit the individual optimally. This can occur because the patient did not bite properly when the impression was taken at the dentist during the bite registration. When taking the bite, the aim is to determine the normal, non-displaced jaw closure so that the splint does not interfere with the patient’s wearing of it and is loaded evenly.

Also a bad insertion due to wrong grinding can lead to an overloading of a temporomandibular joint, so that strong pain occurs. The pain occurs mainly in the morning after wearing the splint, but can be quickly minimized by subsequent grinding and the correct bite situation.