The Effects of Covid-19:

Occlusal Guards for TMJ and Bruxism

Written by Andrew Sedler, COO

Written by Andrew Sedler, COO

Written by Andrew Sedler, COO

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Covid-19 is a public health emergency on a global level. It has substantially changed our way of life. To help curb the pandemic's spread, unprecedented measures have been imposed that directly changed people's everyday behaviors.

Businesses have been forced to close; people have been asked to stay home. Face masks have become commonplace, as well as practicing social distancing. These measures have changed virtually every aspect of people's lives, creating uncertainty.  People are fearful of contracting the coronavirus, dying, losing a job, or being able to pay for basic necessities.

In turn, people have experienced increased anxiety and stress.

Covid-19 has a wide array of side effects such as long-term breathing issues, rashes, neurological issues, and loss of smell and taste, to name a few. A less known effect of the coronavirus is its impact on oral health.

It has been reported that since the pandemic began, an increase in tooth fractures, cavities, and jaw pain has been observed worldwide. In fact, a study from the Journal of Clinical Medicine cites a significant increase in facial pain, including jaw pain that has been linked to jaw-clenching as well as grinding of dentition. This has been attributed to high levels of anxiety and stress that many people have experienced since the beginning of the pandemic.

One of the best ways to help people protect dentition and relieve jaw pain is through the use of occlusal guards.

The stress described above can cause bruxism and clenching, leading to temporomandibular joint (TMJ) and muscle pain. TMJ issues can manifest in jaw soreness, clicking, and headaches.

This can affect a person's ability to eat, and for some, the onset of insomnia is present. In addition, bruxism symptoms include clenching, grinding, flat teeth, fractured teeth, and overall oral pain.

To help patients weather this unprecedented time, a conservative approach to managing bruxism and protect the oral environment is through splint therapy.  Because TMJ is approached differently from one clinician to the next, Burbank Dental Lab is committed to understanding each of the treatment philosophies and fabricating the appropriate occlusal guard needed to support a specific treatment plan.

BiteSoft

One of Burbank Dental Labs' most widely prescribed occlusal guards is the BiteSoft appliance.

Since the design moves the bruxing force to the anterior, the posterior disclusion allows for relaxation of the facial muscles and reduced muscle stress. Also, the use of this appliance keeps the mandible in a down and forward position, which helps to relieve muscle pain and opens the airway.

Other benefits of BiteSoft include:

  • Protects against breakage of dental restorations and natural dentition
  • Reduces orofacial pain
  • Eliminates posterior clenching
  • Reduces the intensity of bruxism by up to 70%
Talon Splint

The Talon Splint is a dual-laminated guard that offers both hard and soft elements.

These splints feature a thermoplastic layer that allows for natural occlusal adjustment and a hard acrylic layer. The polymer can be warmed in water to provide a custom fit. The material can be warmed each time the patient wears it to create a perfect fit with each application.

The soft layer also reduces pressure points and allows the patient to adapt quickly. At the time of try-in, there is less time needed to make adjustments.

This customization provides comfort, which helps to improve compliance in wearing the appliance.

The benefits of the Talon Splint include:

  • The comfort of the appliance improves compliance.
  • The fit improves retention.
  • The splint design creates proprioceptive responsiveness with the opposing.
  • Patients can speak without any interference.

There are other types of occlusal appliances available. Some appliances are fabricated with hard rigid materials, while others are made from softer materials. In general, the hard appliances are known to have better fits, are easy to adjust, and last longer.

The softer appliances are more challenging to adjust, show more wear, and offer a less precise occlusal fit. However, the softer splints may work better to distribute the heavy loads associated with parafunctional activities. The Talon Splint provides the best of both the hard and soft attributes in one appliance.

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Occlusal Appliance Workflows
Occlusal Appliance Workflows

To ensure a comfortable, well-fitting occlusal guard, some critical steps will significantly improve the final results. When an occlusal guard is ill-fitting and uncomfortable, it is usually the result of distortions in the impressions, issues with the bite, or a poor mounting.

To create excellent fitting guards, the following steps should be followed:

  • Use a custom tray to ensure it fits the mouth properly.
  • Use either a polyether or polyvinyl impression material for multiple pours.
  • Don’t skimp on the amount of impression material used.
  • Make sure to use an adhesive so the impression won't separate for the impression tray.
  • Make sure the dentition is dry before taking the impression.
  • Take a bite either like a Lucia Jig or George Gauge.
  • Capture an accurate horizontal plane by using a facebow or Kois Facial analyzer.

With the appropriate information provided, the case can be mounted and will be a very accurate representation of the patient's occlusal scheme. If accurate information is provided, then the appliance will be fabricated to this level of accuracy.

There is no question that the current coronavirus pandemic has thrust many people into high levels of stress and anxiety. The mental toll has yet to be fully understood. It is no wonder that many dental offices are reporting higher levels of parafunctional issues like bruxism and clenching in their patients.

Burbank Dental Lab Laminated Success Guide

The important issue is identifying the symptoms and providing solutions that will help manage the issue to protect patients from further harm and pain.

Call or chat with us. We are ready to help answer any questions regarding occlusal guards.

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of the future
is here!

Burbank Dental Lab has three new state-of-the-art Carbon M2 printers. We are very excited about the options that these cutting-edge printers will allow us to offer our dental clients. Here are some of the advantages that these printers will begin to deliver to you and your dental practice.

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Carbon offers a highly dependable 3D manufacturing solution for many dental applications with its breakthrough Digital Light Synthesis™ technology, enabled by a wide range of dental materials.

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