Why does your splint need adjusting? What those follow-up appointments are for?

You have been fitted with a splint, sometimes called an occlusal splint, bite splint or night guard, and your clinician has asked you to come back so the team can make a few adjustments. If the splint was made to fit your teeth in the first place, you may be wondering why it needs adjusting at all. It is a fair question, and the short answer is that fitting the splint and balancing the splint are two different things.

What is a splint and what is it doing?

An occlusal splint is a custom appliance worn over the teeth, usually at night. It is most often used to manage problems affecting the jaw muscles and joints, grouped together as temporomandibular disorders, and to protect the teeth from the forces of grinding and clenching.

It works by giving the teeth a smooth, even surface to meet on. This allows the jaw muscles to relax, helps the joints settle into a comfortable position, and spreads the load of clenching evenly rather than concentrating it on a few teeth. For the splint to do this well, the way your teeth contact its surface has to be right, and that is what the adjustments are about.

Why isn't the splint finished the day it is fitted?

The splint is made to fit your teeth precisely, but how your teeth meet on its biting surface cannot be perfected in a single visit. When a splint is first placed, some points take more contact than others, which is normal. The goal is even contact across the whole surface, with the jaw able to move smoothly without catching on any high spots. Reaching that point usually takes more than one appointment.

Why does the bite on the splint change over time?

When you start wearing a splint, the jaw muscles that have been tense or overworked begin to relax. As they relax, the jaw settles into a slightly different and more comfortable position than it held before. The contacts that were even at fitting are often no longer even once the jaw has repositioned.

This is expected, and it is usually a sign the splint is doing its job. It also means the splint needs to be rechecked and refined to match where your jaw now sits, which is why the adjustments happen over a series of short visits rather than all at once.

What does the team actually adjust?

At each visit the clinician checks how your teeth meet on the splint, typically using thin marking paper that leaves coloured marks on the high points. Those high spots and uneven contacts are then gently refined so that contact becomes even and the jaw can move smoothly across the surface. The fit of the splint on your teeth is also checked at the same time, so it stays secure and comfortable to wear.

What happens if the splint is not adjusted?

A splint with uneven contacts can be uncomfortable and can keep the jaw muscles working harder than they need to, which works against the reason it was made. In some cases an unbalanced splint can allow teeth to shift slightly over time, or it may simply fail to relieve the symptoms it was meant to settle. Adjustment is the step that turns a splint that fits well into one that works well.

How many adjustment appointments will I need?

This varies from person to person. Some people need only one or two reviews, while those with more involved jaw symptoms may need several over a few months as things gradually settle. The appointments are usually brief. As your bite on the splint becomes stable and your symptoms improve, the visits become less frequent and eventually space out to routine reviews.

What should I do between appointments?

Wear the splint as directed and pay attention to any changes, such as how comfortable it feels, whether your jaw symptoms are improving, or whether the splint seems to sit differently than it did. Bring the splint to every appointment so it can be checked and adjusted. If it becomes uncomfortable or feels like it no longer fits properly, contact the practice rather than waiting for your next scheduled visit, and please do not try to adjust or file the splint yourself.

To learn more, call us on (08) 9376 6789.

IMPORTANT: This content is for general information purposes only. It does not constitute medical or dental advice. Readers should consult a qualified health professional regarding any personal health concerns.