by Clayton A. Chan, D.D.S., M.I.C.C.M.O.
The lower anatomical orthosis is an orthopedic repositioning device, which indicates the start of temporomandibular joint/muscle dysfunction treatment. The success of treatment is dependent on 1) the dentist’s skill and ability to find your optimal physiologic jaw position, 2) the dentist’s occlusal adjustment skills of the orthosis to properly refine the bite surfaces to a correct and comfortable neuromuscular trajectory and 3) the patients cooperation and understand which is a large part of the success (a team approach).
The orthosis when properly designed and constructed will help maintain muscles in a relaxed position and in time will reduce pain. In addition the orthosis should be designed to keep your jaw joints in a favorable and optimal position which will help to decompress the associated biological structures. It is not a cure in and of itself. Its purpose is to reposition the various components of your chewing apparatus into a harmonious, balanced and smoothly functioning system.
This appliance is intended to be worn 24/7 hours a day if properly designed and adjusted by your dentist. The orthosis is not a splint. The orthosis when worn should be comfortable. If its not comfortable, please check immediately with your dentist to have it properly adjusted for comfort.
The following are guidelines and should be considered by both the patient and clinician for the use and wear of the lower anatomical orthosis (orthotic).
- 24/7 for patients that are in pain or patients that are committed to phase II treatment. (Pain patients: removable orthotic; patients that are without or was in pain and has been out of pain can use a fixed semi permanent orthotic.)
- Reasoning: preparing the condyle/disk for the receiving of the crowns with minimum post op adjustments. Allows for joints to remodel and stabilize.
- 22/7 for patients that are not committed to phase II treatment. (Removable orthotic only.)
- Reasoning: If patients are not committed to a finishing phase they might change their mind and only want to wear it at night. Joints will not remodel. It will help muscular pain.
Here Are Some Simple Suggestions When Wearing the Orthosis:
- To become accustomed to speaking with the appliance try talking or singing aloud in front of a mirror.
- You will notice an increase in saliva for the first few days. This is because the salivary glands are fooled by the presence of the appliance and will react as if it was food. Do not become concerned about this if it should happen.
- Be sure to wear the appliance at all times and remove it only to eat and brush your teeth. UNLESS TOLD OTHERWISE!
- Occasionally, through the action of speaking or chewing you may develop some sore spots or cankers in and around your cheeks and tongue. Please notify your dentist if this should happen, so that they can see you and alleviate the cause of these sore spots.
- If it is absolutely necessary to remove the appliance because of discomfort, please be sure to re-insert it 2-3 hours prior your appointment with the doctor. This will enable him/her to easily locate the area requiring attention.
- When you are not wearing the orthosis rinse and place in the case that was given to you. While in container keep the orthosis moist to avoid it from changing shape.
- At all times try to condition yourself to keep your teeth slightly apart, even when wearing the orthosis. Your teeth should only touch when you swallow or eat. Separating the teeth will help your muscles to relax and reduce the stress on the jaw joints.
- You should not experience sore teeth, tongue and muscle pain after getting your orthosis. If you do this is only a sign that further adjustments and refinement is indicated with your dentist. If there are any symptoms they should subside in few days. If symptoms persists after one week pleas call your dentist.
- You should brush after each meal. Since your teeth and gums are covered by the orthosis. Your tongue is unable to remove any food particles that can be lodged under the orthosis. Remove the orthosis to brush the teeth and food particles away is important to prevent the developing of cavities or gum problems.
- Please consult with us if any dental work or care is required. These may change the fit of the orthosis.
The Absolute Dont’s:
- Do not place your splint in your pants pockets, which will cause breakage and or bending!
- Keep your splint away from dogs, cats or any pets!
- Do not place your splint under the napkin while eating at a restaurant; you may never see it again!
- Do not wrap in a tissue/Kleenex!
- When replacing the orthosis in your mouth, do not place over teeth and push into place while biting down, use both fingers with gentle pressure for correct alignment!
- Do not submerge into hot liquid; this will permanently warp the orthosis! You may drink hot liquid!
- Do not leave in a hot car or near a heater.
© 2009 Clayton A. Chan, DDS. All Rights Reserved.
