Wearing a TMJ Appliance: Pay Attention

THINGS A PATIENT SHOULD KNOW WHEN WEARING AN APPLIANCE:

If the appliance makes your lower jaw move back when you bite down that is also not good, especially if you have ear congestion feelings and or temporomandibular joint clicking, grating and popping sounds when you open and close your mouth. It will trigger other problems in the head and neck and jaw regions.
If the appliance is not properly adjusted and you can’t chew, it will create other problems such as muscle strains and teeth sensitivities as examples. If a tooth becomes sore and very achy whether in the molar regions or in the front teeth regions, beware! The abnormal pressures can be from the imbalanced bite and not because you need a root canal. Be aware. When a tooth begins to hurt a lot and the doctor sees no apical lesion at the apex of your tooth on the x-ray, then most likely it is trauma from the bite. The dentist needs to locate the problem and not assume it is a referral to the endodontist for RCT (root canal treatment). After and RCT will require a post and build up and then the inevitable crown. Try to avoid root canals. Heavy abnormal bite and occluding pressures will cause a severe tooth ache. Pay attention and protect your teeth! It’s your responsibility.
If the appliance is too high (thick) or too low (thin) it can create problems and or slow the process of resolution down. If the appliance is designed to your physiologic vertical resting position you can end up clenching or grinding on the appliance which doesn’t calm the muscles down.
If you feel that the appliance is a foreign object in your mouth after a few weeks of wearing it there is something wrong. It may not be properly adjusted in detail to meet your feelings and comfort.
If you can’t chew food with it comfortably the bite is not adjusted properly. You don’t have to get use to it if the dentist adjusts it properly.
If it gives a person more neck pain or headaches it is not right.
If you are told to get use to the odd feelings because the appliance is new, beware!
If the appliance feels better with it in your mouth then without, you are on the right track.
If it feels worse having it in your mouth then having it out, your body is telling you something is wrong and you need to tell your dentist.
If holes are wearing through your appliance in a very short period of time (faster than usual) I would consider having your dentist help you get an re-evaluation of your cervical/neck alignment along with an evaluation of your pelvis.

Clenching

If you are clenching on your appliance consider the following:

It is possibly due to certain pain medications (psychotropics: anti-depressants, anti-panic, anti-obsessive agents, others) you are taking that can be a contributor to you clenching.
It could be that your bite is subconsciously noting premature contacts are present when the appliance is not adjusted properly thus you continue to grind and clench.
If you are sure your appliance is properly balanced, feels comfortable, you are able to wear your TMJ appliance 24/7 without pain, but you still clench and grind excessively consider the possibilities that your pelvis is out of balance.

Temporomandibular Joints Problems:

If your condyles are positioned posterior and superiorly in your fossa either on one side or both you can experienced a restricted opening of your mouth. That is not right.

If your disc is not reduced (disc is either anterior displaced or medially or a combination, positioned in a way that causes pain and discomfort) your splint (intra oral appliance) will not feel right.

Muscles will feel tight inside and outside of the head and neck regions since your mandible is not properly aligned, thus causing unresolved feelings that the appliance is not right.

It is crucial that your bite, your cervical/neck, occiput and pelvis be aligned and balanced with one another. Your bite is the key to body alignment and postural balance. Not the other way around!

Wearing a GNM Orthotic Appliance:

“Whenever we make an orthotic for the patient, they themselves, out of curiosity, always want to remove the orthotic for some time to see if their symptoms return. Some can go one day, half a day or literally feel the symptoms return immediately upon removing the orthotic. Obviously the third one will want to wear the orthotic 24/7. Cases who tend to lock their jaws frequently may have to wear it 24/7 as well. The others who feel like they can carry on and just wear the orthotic part-time will do so. These are the luckier ones.” – Dr. Susan Go, Delta, British Columbia, Canada (OC GNM trained dentist).

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