Impacts of Loose Occlusal Splints on Joint Disc Displacement Treatment

Disc displacement, occlusal splint?

Hello: I underwent treatment with an occlusal splint at a major hospital due to a displaced articular disc.
Recently, while getting dental work done at a small clinic, the dentist mentioned that the occlusal splint was a bit loose and might need adjustment.
I also felt it was quite loose, as I could easily remove it with my tongue.
Today, I returned to the major hospital for a follow-up and mentioned this to the doctor.
The doctor asked another assistant to adjust it, and unfortunately, a disaster occurred! The splint became stuck and felt like it was fused to my teeth! After trying many methods, they ultimately had to saw off the splint, which took 3-4 hours.

Questions:
1.
What impact does a loose occlusal splint have on the treatment of the articular disc? Is it acceptable to leave it unadjusted?
2.
Since the splint was destroyed, I am now forced to discontinue treatment.
Will my mouth opening, which was previously at three fingers, regress back to one and a half fingers?
3.
The doctor mentioned that the irregularity of my teeth could lead to such unexpected situations during treatment, but I believe this is an excuse, especially since the dental work was also removed.
Is the likelihood of the splint getting stuck high?
4.
What is the substance used to adjust the occlusal splint? Wouldn't adjusting the wire suffice? I feel that using too much could cause it to stick, which seems very risky.
Thank you in advance.

Lin, 30~39 year old female. Ask Date: 2020/09/30

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Lin,
Hello! The occlusal splint treatment for the disc displacement issue has shown excellent results.
A looser fit does not pose a problem for the treatment; however, patients often feel concerned that it might fall out.
The adjustment involves adding resin to enhance retention.
Take care! Wishing you all the best and smooth sailing!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2020/09/30

More Info

The use of occlusal splints in the treatment of joint disc displacement, particularly in the context of temporomandibular joint (TMJ) disorders, is a common practice aimed at alleviating symptoms and improving function. However, the effectiveness of these splints can be significantly influenced by their fit and stability.
1. Impact of Loose Occlusal Splints on Joint Disc Treatment: A loose occlusal splint may not provide the necessary support and stabilization required for effective treatment of joint disc displacement. When a splint is not adequately fitted, it can lead to insufficient contact with the teeth, which may result in inadequate repositioning of the jaw. This can exacerbate symptoms such as pain, clicking, or popping sounds in the TMJ, and may hinder the healing process. In some cases, a loose splint can also lead to compensatory movements in the jaw, further complicating the condition. Therefore, it is crucial to have a well-fitting splint to ensure optimal treatment outcomes.

2. Consequences of Terminating Treatment: If you have had to discontinue the use of your occlusal splint due to it being damaged or improperly fitted, there is a possibility that your condition may regress. The degree to which your mouth opening might decrease depends on various factors, including the severity of your initial condition and how long you have been without effective treatment. If your mouth opening was previously at three fingers and has now reverted to one and a half fingers, it is essential to consult with your healthcare provider to assess the situation and determine the next steps.

3. Potential for Splint Adhesion: The adhesion of an occlusal splint to the teeth can occur, particularly if the splint is not designed or fitted correctly. Factors such as the material used in the splint, the presence of dental work (like fillings), and the overall alignment of the teeth can contribute to this issue. While it is not common for a splint to become permanently bonded to the teeth, it can happen if the splint is left in place for an extended period without proper adjustments. It is important to communicate any concerns about fit and comfort to your dentist or orthodontist to prevent such occurrences.

4. Adjustment of the Occlusal Splint: The adjustment of an occlusal splint typically involves modifying its shape or thickness to ensure a better fit. This can be done using various materials, including acrylic or thermoplastic substances, which can be softened and reshaped. The adjustment process should be carefully managed to avoid excessive application of materials that could lead to unintended adhesion. It is essential for dental professionals to follow proper protocols during adjustments to minimize risks and ensure patient safety.

In summary, the effectiveness of occlusal splints in treating joint disc displacement is highly dependent on their fit and stability. A loose splint can hinder treatment progress and potentially worsen symptoms. If you find yourself in a situation where your splint is damaged or improperly fitted, it is crucial to seek immediate professional advice to explore alternative treatment options and prevent regression of your condition. Regular follow-ups with your dental care provider are essential to monitor your progress and make necessary adjustments to your treatment plan.

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