How do mouth guards work for TMJ Pain?

The use of mouth guards, also known as oral splints or oral appliances, are commonly used for temporomandibular disorders (TMD). TMD is a collective term that embraces a number of clinical problems that involve the masticatory muscles, the temporomandibular joint (TMJ) and the associated structures. Therefore, even though TMJ is commonly used to describe disorders in this area, the rehabilitative and dental communities are moving towards the use of TMD.

In most instances, patients who come to me for TMD already have an appliance, either prescribed from his/her dentist or tele-shopping online. This is usually the first course of action and in many instances, the appliances help with pain and protecting the teeth. But in others, it doesn’t help so much with pain and that is what leads a patient into my doors.

How do mouth guards work for TMJ Pain?

There is continuing debate about the exact mechanism of action of oral splints.

With that said, there are many mechanisms that we think cause the change in TMD following use of a mouth guard:

  • Muscle relaxation/habit-breaking for patients with increased parafunctional or muscle-tightening habits

  • Protection of teeth and jaws, particularly where teeth clenching and grinding may lead to damage of teeth

  • Normalizing periodontal ligament proprioception, by utilizing a splint to spread the forces placed on individual teeth

  • Repositioning of the jaws and condyles into centric relation.

If the usage of an oral appliance is not working great for your pain, then talk to your dentist or reach out to a local (or even us) physical therapist who can treat TMD. You may be surprised how well a few sessions of manual therapy and even exercise (if applicable) to the craniofacial and cervical regions can help your pain!

I like to end this post with an interesting conclusion, one of which surprised me as a healthcare provider as I thought the use of mouth guards for TMD had better evidence considering how popular it is!

A recent high level medical research study made the following concluding statement:

From this systematic review, no clear evidence to support the provision of splints for the various sub-types of TMD or bruxism. However, the body of evidence that this conclusion is based on is of very low certainty.

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