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New Tmd Mouth Splint and can it help ear fullness?

I have popping in both joints and both easr are always full, I'm never able to pop them at all. I know it's probably my eustachian tubes blocked from my jaw but it's so annoying. I just got a mouth splint today from my dentist, who said he considers a mouth guard and splint the same thing and calls them the same thing. However, I hear they are different. The one he gave my is an acrylic flat one to try and take pressure off my muscles and even out my bite. I've been wearing it all day and when I bite down on it the front starts to kinda try and pop like it wants to come off.I had braces before but lost my retainer for a few months, and that's when my jaw went crazy, my jaw used to click a little but now I have many other problems. He wants to see me back in two weeks, should I go in sooner though to make sure it's adjusted properly? Overall, what are the differences between splints and mouthguards, are they help full, and how do I tell if he's given me the right kind. Also, does it take away the ear fullness?!!
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replied June 16th, 2012
Experienced User
Hi there,

To my knowledge the ear fullness and pressure comes from the structures of the TM joint. This is how a doctor described it. They are enclosed in a kind of capsule, like the mickey mouse balloon inside a regular balloon that you see at Disney. When there's an issue with the TMJ, swelling occurs within the capsule and you experience feelings of fullness and pressure, much like you have.

Do you have a misaligned bite? If so, what type of splint do you have? I'll add a rundown of types of splints at the end of this posting. In my understanding the flat plane splint relaxes the muscles but doesn't do any serious repositioning.

It worries me a bit that your dentist thinks splints and mouthguards are the same. It also worries me that you aren't welcome to go in for adjustments when your jaw requires it rather than when they are scheduled.

Did you find an excellent modern neuromuscular dentist? With tons of post-grad experience and a proven history of treating TMJD successfully? The number of folks who get mis-treated by dentists and end up in more pain, and not being helped but harmed it staggering. I did a full year of treatments with the wrong NM dentist until I found someone good who sorted me out.

Successful splint therapy should help with the ear fullness once your jaw finally relaxes in a healthy position and the TMJ structures are no longer under pressure. The key to all this is a top notch dentist - don't settle for less!

Hope things work out for you - let me know how things work out or if you have any questions!

Hang in there!
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replied June 16th, 2012
Experienced User
Here are the splint types:

*Stabilization or flat plane splint. This one covers all the upper teeth. Because it's flat, it helps minimize tooth grinding and it works to decrease pain by relaxing your sore jaw muscles. It doesn't help with clenching since the lower teeth are still able to touch it. Because of the clenching factor, some people find their condition worsened by this splint.

*Modified Hawley splint. This guy fits on the upper jaw and touches only the six lower front teeth. It totally prevents the back teeth from touch and stops both clenching and grinding. A concern is that the back teeth will shift so it's usually only worn at night.

*NTI-tss (Nociceptive Trigeminal Inhibition Tension Suppression System). I think this one is less common... It goes over the upper front teeth and is supposed to stop tooth clenching and grinding. The fact that it goes over a few teeth can really stress out those teeth and possibly cause problems. It comes off at night because it's so small that there is a choking risk.

*Repositioning splint. This is the lower splint that is commonly worn by people on this site. It's called repositional because it moves the lower jaw forward or backward. It's purpose is to reposition the jaw into a healthier position and find the optimal position for your bite. For this reason it is the most aggressive form of splint treatment and it can take a good 4-6 months to start feeling results. Usually once this optimal position is found, you will experience a decrease in symptoms as your jaw is finally more comfortable. Then the NM dentist will use orthodontics (braces) to make this position permanent. At this stage, there are other options, but braces is the most common.
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replied June 16th, 2012
Thank you! The dentist I went to was just my regular dentist who I believe is still new in treating tmd. The splint I have is just a flat splint, so do you not think this would work? All he said he's trying to do since my bite is off, is to use this to relax my muscles and then try and change my bite permanently. All I want is to be back to normal and more than anything else, have my ears back to normal, I literally haven't been able to pop them in over a year. Do you have any suggestions for finding someone competent enough to help me. I live in maryland, where did you find your doctor if you don't mind me asking?
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replied June 16th, 2012
Also, if the splint does work and make my ears open up, do you have any idea how long this should/could take? Should I expect to see these results with in days, weeks or more to tell if it's working?
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replied June 16th, 2012
Also, the flat splint is worn on the bottom and is acrylic.
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replied June 17th, 2012
Experienced User
Hi there sickoftmj,

By the way, I am sick of TMJ too! Happyily I am mostly on the recovery side now, but that was after years of being in pain unnecessarily and getting the wrong treatments, by the wrong dentists.

If I can pass along anything that I have learned along this crazy road, I'm happy too. Listen, I don't want to scare you but it's pretty risky to have a regular dentist or one inexperienced in treating TMJ issues doing your splint. Correcting a bite is super tricky and absolutely requires the best equipment and the most experienced neuromuscular dentists with a proven history of success... I have spent the better part of two years keeping up with posts on this site. I can't tell you the number of people who have worsened their situations by getting splint therapy from a dentist who didn't do it properly. And the risks are high frankly as you can potentially not only cause more pain, but ruin your bite and put more stress on affected areas.

People with TMJD are in a very unique situation. Most illnesses occur within a standardized industry and have best practices. TMJ does not. In fact, for political and financial reasons effective modern practices such as splint therapy continue not to be accepted by government and traditional dentistry - the result is that we are left in the dark and often pay money out of pocket to end up in more pain.

This link explains the difference between nightguards and splints as well as the difficulty of incorrect splints:

http://www.austindental.com/more/splint.sh tml


If you truly have a bite issue, splint therapy done by a nm dentist with successful experience and post-grad education can really help. Do you know exactly what your bite issue is?

In my case, my bottom jaw was trapped too far back and it was also too low. There was no resting place for my top jaw and over time this caused the muscles to get really stressed out until I got the full blown TMJD picture. (A botched root canal, infection and a bad mouth guard to prevent bruxing also helped precipitate the full blown picture).

Has your dentist explained to you the specific nature of your bite issues and how she/he plans to address them? Did the dentist use a jaw-tracking device and tensing to help find the optimal starting bite position for your splint? What is the plan for after the splint? Did the dentist take the time to educate you on the specifics of the process?

My nm dentist allowed me to come in whenever my splint needed adjustment. As soon as things got painful, he was there to make the necessary adjustment and guide my jaw into a better position. I think this is another sign of a good nm dentist - they understand the importance of adjusting as soon as your jaw is distressed so that you can get to that healthy bite position faster, and in less pain.

If you are unsure about this dentists experience, I would definitely get a second opinion from someone who you've researched and really knows their stuff. If you PM me, I can tell you how I went about doing this.

As for how long it'll take to heal your specific issues - it's impossible to say. Most folks generally find the first 4-6 months in splint therapy to find the optimal bite position and once it's found, the jaw can rest and symptoms begin to decrease. I'd say this is more for severe cases - some people can find relief earlier than this - in 2-3 months. I hope you are in this last group!

Hope this helps! Let me know if you have any other question -

Bijou
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replied June 17th, 2012
Experienced User
Hi again,

I hear your frustration! I've experienced the same run-around, which besides being so frustrating is extremely costly and leaves you in pain for longer than need be. This is sadly a common occurance for people with TMJD because there are no industry standards and published, formalized best practices yet. Arghh it makes me frustrated just thinking about it! Those of us with bite issues shouldn't be paying out of pocket for the only treatment that helps (splint then orthodontics) but this is the way it is for now. I'm sure it'll change in the future but who knows when that day will come! Ok, I'll end my rant for now and say that I've been where you are sitting and there is a way out, so stay hopeful! The thing is that it's easy to get mis-treatment (either the wrong treatment or a the right treatment done badly), so we have to be super careful and do a ton of research.

Did you have any TMJlike issues before the braces? Were the braces to simply straighten teeth or were they supposed to change your bite as well?

Jaw clicking and popping is an obvious sign of disfunction, so I think it's a bit concerning that your dentist let it go on for so long. TMJ issues often start with popping/clicking in one ear and then eventually spread to the other, along with more serious TMJ issues if they aren't treated properly in the first place. Many people go years, unknowingly doing damage, because they think it's normal to pop their jaws. Any dentist that isn't alarmed by this sign of disfunction is questionable, in my opinion.

The reason I asked about jaw tracking device and tensing is because it sounds like you have a repositional splint. I am trying to ascertain whether your dentist is qualified by finding out if he has spent the money on proper equipment used by other experienced nm dentists to treat TMJ. There is a best practice when it comes to splint therapy and it involves using K7 jaw tracking and a tens machine. Everyone on these sites who is with a good nm dentist in repositional splint therapy for bite issues has a fairly similar procedure. It's important to know whether your dentist has had the post-graduate training in splint/orthodontic treatment and whether he's using the necessary technology/machines to do so safely and effectively.

Basically the K7 jaw tracking is meant as an important guide to find the optimal position for your bite. Before taking this measurement, it's necessary to deeply relax your facial muscles with the use of an ultra low frequency (ULF) tens machine. If this important step is missed, the measurement will be skewed and your orthotic will be fitted to a muscularly tense face in an unhealthy position. Once in splint therapy, an inexperienced nm dentist will rely only on the K7 tracking device to make adjustments but a good one will use this in conjuction with his/her personal expertise/training along with cues from the patients jaw to make the orthotic adjustments needed to find your healthy bite. I believe the K7 also helps track the specific measurement of the healthy bite position so that your dentist can have exact measurements rather. My nm dentist and most other good ones, have a home version of the ulf that they lend out to patients so they can tens at home while going through splint therapy. I eventually bought one because I found it helpful. If your facial muscles don't relax, it can be hard for your jaw to settle into a healthy position.

Your dentist is correct in saying that splint therapy should indicate whether or not the bite is the issue. Once your jaw gets a chance to rest into a healthy position after a good bite position is found (often 4-6 months of splint therapy), you should feel a reduction in symptoms and then you know that a healthy bite position is solving your issues. Now, if your splint therapy is not properly done by an inexpert dentist, it's possible that you won't find relief in splint therapy but that isn't because you don't have a bite issue - it's because your bite issues hasn't been treated by PROPER splint therapy!
Sadly, there are some cases where people without bite issues are put through splints and braces as well - again due to an inexpert dentist.

So if you have a repositional splint and your dentist is not following the procedure I've outline, I'd be very alarmed. If all your dentist did before setting you up with this splint is measure between your ear and nose, I'd be very concerned. I don't want to scare you...I just don't want another person to be harmed in the process of paying for help. And sadly this happens all the time with TMJ.

Now I'm a case where I looked desperately for help with the wrong dentists and expensive night guards that made things worse. I was in bed with crazy pain and symptoms for nearly two years. Now I finished splint therapy, which was tough for the first 5 months but then I had a huge turnaround. I'm now into my braces and still improving, and I've got my life back. There is hope for all of us - we just need to do exactly what your doing...looking for information and doing the necessary research to get the proper treatment.

I'm pulling for you! I'm also around if you have other question...

Bijou
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replied January 2nd, 2013
Hi. I am new to this board Smile i have been reading your posts, they are so helpful In my case, i went to the ortho in order to push my jaw to the front but mostly beacuase of aesthetic purposes didnt really have much pain. Had an mri done and it showed my jaw was pretty disaligned. I started with the repositioning splint and I can say the last month has been hell! i have had symptoms I had never felt before like strong neck pain which radiates to the head on the left hand side, slight dizzyness, slight earache and popping sounds. Is it normal to have the symptoms worsen in the beginning? I thought maybe I should stop the treatment but actually feel worse without it...i have done research on my ortho and he is one of the best in my area, he is even a professor of orthodontics at the local University. Just wanted to read some of your comments to see if this is normal. Thanks!
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replied May 2nd, 2013
TMD
it is so weird that have neck and head pain, I have been wearing a repositioning appliance for a few months now and my head hurt really bad at first and he said that was normal. now months later when I wear it my head feels so tight it hurts all day. and then when I don't wear it my hurts also. I never had head pain before any of this appliance stuff. after going for another opinion I was told to see a neurologist because of my mouth pain. year ago had 2 root canals and ended up having both those teeth extracted. my whole left side feels like a numbing feeling when i don't wear the appliance. I am so tired of being in mouth, facial pain. I'm afraid to go back for another adjustment also
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replied May 3rd, 2013
Experienced User
I am with a dentist who is actually moving my jaw forward with an appliance that has been glued to the top of my mouth. As the top jaw moves forward, the bottom has followed along. I am actually developing a jaw! and at the age of 31...its crazy. The tightness in the neck, shoulders is the hardest part..the muscles have so much to change.
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