How Splints Fit Into a Treatment Plan

Hi, everybody. My name’s Dr. Leonard Hess. I’m one of the senior faculty members here at the Dawson Academy, and I’d like to spend a few minutes talking with you about where occlusal splints work into a treatment plan when we’re talking about doing larger or more complicated treatment plans. Let’s really take a moment and break our splints down into two predominant types of appliances.

SRS or CR Splint

One would be a full coverage SRS splint, or what is commonly called a CR splint. This is going to be an appliance that we’re going to utilize to test the five requirements of occlusal stability in a reversible manner to help us to treat the joint. Always remember that if we have an unstable joint, or we’re having internal derangement in the temporomandibular joint, that anything that we change the patient’s occlusion is not going to be stable.

The purpose of a full-coverage splint would be to get the joint, change it from a red joint into a yellow joint so we can start to predictably do our treatment, and we want to be able to do that in a reversible manner and we want to be able to treat the joint to get it to the point to where we can load it without any signs of tension or tenderness, and then we can move forward to start to make permanent occlusal changes for the patient.

Anterior Deprogramming Device

The other type of splint that we will commonly use is an anterior deprogramming device. Three examples of this would be:

• Lucia Jig
• NTI
• Dual-Arch Dawson B-splint

Predominantly, we’re going to use these to treat muscle. If we have really active lateral pterygoid muscles or sore muscles on mastication, an anterior deprogramming device is going to be a great option for us. This will demonstrate to a patient that if we are able to reduce the muscular activity, can we reduce their muscular symptoms? We want to be able to deprogram the lateral pterygoid and decrease the influence that that muscle is having at the joint level, so we can predictably obtain a reliable centric relation by record.

Those are the two predominant type of splints that we would use in a complete care type of setting, and I hope this little quick tip will help you in the future and I look forward to seeing you farther down the road at another Dawson Academy course.

Learn more about applying occlusal splints in Dr. Hess’s one-day course, Demystifying Splints: Going Beyond the Nightguard.