Issues with Dental Occlusal Splints: A Patient's Concern

Issues with Occlusal Splints

Hello, Doctor.
I would like to ask you about an experience I had.
I previously had an occlusal splint made for my upper jaw.
During the fitting, I felt a bit uncomfortable and didn't wear it properly.
Later, when the doctor asked me to put it on again, I might not have positioned it correctly, and the doctor applied some force.
As a result, I felt like the skin in my upper jaw was pinched, and then I started to bleed.
When I looked at it with my phone at home, I noticed that the circular area on the upper left jaw was bleeding.
Is that a salivary gland? The bleeding stopped afterward and hasn't returned.
Is there any concern regarding the bleeding from the salivary gland? Thank you for your response, Doctor.

V, 40~49 year old female. Ask Date: 2017/09/28

Dr. Zhu Guanyu reply Dentistry

Hello, generally speaking, the type of occlusal splint you are using relies on the curvature of the dental crown as the retention source, which means the retention is not very strong and it is easy to remove.
For your initial self-fitting, it is recommended to use a mirror to adjust the direction and to keep your mouth corners open to avoid pressing against the buccal mucosa, which could even lead to bleeding.
As for deep involvement with the salivary glands, that is relatively rare.
Thank you for your message! Wishing you safety and health.
Sincerely, Dr.
Kuan-Yu Chu, Director of Dentistry, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2017/09/28

More Info

It sounds like you are experiencing a complex set of dental issues, particularly related to the use of an occlusal splint. Based on your description, it seems that during the fitting of the splint, there was some trauma to the area, possibly affecting the salivary glands or surrounding tissues. Let's break down your concerns and provide some guidance on how to address them.

Understanding Occlusal Splints
Occlusal splints are dental devices designed to help with various issues, including teeth grinding (bruxism), jaw clenching, and temporomandibular joint (TMJ) disorders. They work by creating a barrier between the upper and lower teeth, which can help alleviate pressure on the jaw and reduce discomfort. However, if not fitted properly, they can cause discomfort or even injury to the oral tissues.

Possible Causes of Your Symptoms
1. Trauma to Oral Tissues: It sounds like the splint may have been improperly positioned or adjusted, leading to trauma in the upper left quadrant of your mouth. This could involve the mucosal tissue or even the salivary glands, which are located near the upper jaw. If the splint was pressing against these areas, it could cause bleeding and discomfort.

2. Salivary Gland Involvement: The area you described as "flowing blood" could indeed be near a salivary gland. The major salivary glands (parotid, submandibular, and sublingual) are located in the oral cavity, and trauma to these glands can lead to swelling, pain, and bleeding. If the bleeding has stopped and you are no longer experiencing pain, it might not be a serious issue, but it’s essential to monitor the situation.

3. Infection or Inflammation: If there was any injury to the mucosa, there is a risk of infection, especially if bacteria enter the wound. Signs of infection include increased pain, swelling, redness, or discharge. If you notice any of these symptoms, it is crucial to seek medical attention.

Recommendations for Management
1. Immediate Care: Since the bleeding has stopped, continue to maintain good oral hygiene to prevent infection. Rinse your mouth gently with warm salt water to promote healing. Avoid any irritants such as spicy or acidic foods that could exacerbate the area.

2. Follow-Up with Your Dentist: It’s essential to return to your dentist to discuss the issues you experienced with the occlusal splint. They can assess whether the splint needs adjustment or if a different type of splint would be more appropriate for your needs. Make sure to inform them about the bleeding incident and any ongoing discomfort.

3. Monitor Symptoms: Keep an eye on the area for any changes. If you notice persistent pain, swelling, or any discharge, it’s important to seek dental care promptly.
4. Consider a Second Opinion: If you feel that your concerns are not being adequately addressed, it may be beneficial to seek a second opinion from another dental professional, particularly one who specializes in TMJ disorders or oral surgery.

5. Pain Management: If you experience discomfort, over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain and inflammation. However, consult with your healthcare provider before taking any medication, especially if you have underlying health conditions.

Conclusion
In summary, while it sounds like you may have experienced a minor injury to the oral tissues due to the occlusal splint, it is essential to follow up with your dentist for a thorough evaluation. Proper fitting and adjustment of the splint are crucial to avoid further complications. If symptoms persist or worsen, do not hesitate to seek immediate dental care. Your oral health is important, and addressing these issues promptly can help prevent more significant problems in the future.

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