An occlusal appliance, also known as a night guard or splint, is worn over the occlusal, or biting, surface of either your upper or lower teeth. It may be recommended to your for several reasons, such as protection from habitual tooth grinding or clenching, in order to assess your ability to tolerate slightly higher restorations, and as a means of early treatment of TMJ, or temporomandibular joint, pain. For patients who have or have had periodontal disease, it is more beneficial to wear an appliance made for the upper teeth because it may act as retainer and prevent them from splaying, which is when your upper teeth drift, forming gaps between the teeth.
The fabrication and adjustment of the appliance takes several steps that will span over a few appointments. First, the dentist will take impressions of your teeth in order to create stone casts, or models, of your teeth. Then the dentist will use an instrument called a facebow, in order to determine the position of your jaws in relation to one another. This will allow the laboratory technician to mount the stone casts in a way that will duplicate how your jaws relate to one another. The technician will use the stone models and the information garnered from the facebow registration, in order to make your appliance.
At your next appointment you will try the appliance in your mouth, and the dentist will check for fit and comfort. It may take a few minutes for you to notice if it is tight or uncomfortable in any area. If necessary, the dentist will make adjustments to the inner surface of the appliance, so as to allow for more room, wherever it feels too tight.
Next, the dentist will check how your teeth occlude, or close, when wearing the appliance. This is checked with paper that will mark areas where there may be interfering contacts. These will be ground away from the outer surface of the appliance in several steps, until even contacts are established between the appliance and the opposing teeth.
Once you are comfortable wearing the appliance, and your teeth occlude properly against it, it will be cleaned and polished, and you will be instructed to care for it, by brushing it after each time you wear it.
Depending on your treatment, you may be booked for one or more follow-up appointments, for further adjustments and to track the progress of your therapy. Follow-up appointments are similar to the delivery appointment. The appliance is checked and adjusted for comfort, fit and proper occlusion. If the appliance was fabricated in order to prevent you from damaging your teeth through bruxism or clenching, you will continue to wear the appliance until it is determined that you no longer grind or clench. If the appliance was fabricated to test your ability to tolerate a different biting pattern, you will wear it until this is confirmed. If the appliance was fabricated as a means of treating TMJ symptoms, you will wear it until the symptoms subside or, if they do not within 3 months, until other treatment modalities are initiated.