Openai/69357ba5-899c-8006-b1f7-01afc4acae67

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gpt-5-1

User: Are oral splints which can be bought in the supermarket advisable ?

Are oral splints which can be bought in the supermarket advisable ? Dont they change the occlusion to a position which might be unwanted ?

Assistant: Short answer: Supermarket/night-market boil-and-bite splints are generally not advisable for long-term use — especially…

Short answer: Supermarket/night-market boil-and-bite splints are generally not advisable for long-term use — especially for someone with your dental background and occlusal awareness — because yes, they can change the occlusion in an undesirable way and even worsen joint/muscle problems.

Here is the detailed explanation:

Supermarket or “boil & bite” night guards are not custom-fitted and therefore:

Because they are thick and uneven:

• They force the mandible into a random, non-physiologic position
• This can alter habitual occlusion
• In some people, this creates or worsens TMJ symptoms (clicking, deviation, muscle tension)

Soft EVA guards (most OTC types):

• Encourage more clenching, not less
• The material “gives way”, stimulating the chewing reflex
• Can lead to more masseter hypertrophy and morning tension

A therapeutic splint must have:

• Stable, even contacts
• Proper anterior guidance
• Disclusion of posterior teeth during movement

OTC splints cannot provide this — they introduce random contacts.

Yes, especially with prolonged nightly use.

Possible consequences:

• Posterior open bite after prolonged anterior contact
• Shift of the mandible due to uneven thickness
• Extrusion of unopposed teeth (long-term)
• Changes in muscle memory (myocentric shift)

Even dentists avoid soft splints for themselves because of this.

Only temporarily, for:

• Short-term bruxism protection during stressful episodes
• Emergencies when waiting for a custom guard
• Patients with intact occlusion who need very short term protection

But still not ideal.

As you know from your prosthodontic/implantology background:

A hard, custom-fitted, full-arch maxillary stabilization splint (Michigan splint / Minnesota splint).

It:

• Creates an even occlusal table
• Positions the mandible neuromuscularly
• Protects restorations and implants
• Does not randomly alter occlusion

Given your clinic setup with in-house lab and CAD/CAM, you can easily produce a splint that:

• Has perfectly even contacts
• Is adjusted chairside
• Can be milled in PMMA or printed in rigid resin

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| --- | --- | --- | --- | | | | | | | | | | | | | | | | | | | | |

- Compare Michigan, Tanner, Fox, or Kois deprogrammer

• Provide a clinical guideline for which splint type is ideal based on symptoms (e.g., bruxism, disc displacement, muscle pain)
• Draft a patient information sheet for your clinic
• Show CAD/CAM milling recommendations for splints

Would you like that?

User: Are they boil& bite splints advisable for patients with severe erosions ?

Are they boil& bite splints advisable for patients with severe erosions ?

Assistant: Generally, no — boil-and-bite splints are not advisable for patients with severe erosions.

Generally, no — boil-and-bite splints are not advisable for patients with severe erosions. In fact, in severe erosion cases they can do more harm than good.

Let me explain clearly and clinically:

✅ Why boil & bite splints are not suitable for patients with severe erosions

1. Severely eroded dentition is already unstable

Erosion reduces:

• Occlusal vertical dimension (OVD)
• Enamel support
• Functional tooth height

A boil-and-bite splint:

• Has uneven thickness
• Is soft or semi-soft
• Allows the mandible to “find its own path”

➡️ This can further collapse or shift the OVD, which is the opposite of what an erosion patient needs.

2. These patients often need controlled mandibular repositioning

Patients with advanced erosions frequently have:

• Overclosed bites
• Loss of anterior guidance
• Posterior wear facets
• Increased muscle load

Boil-and-bite splints provide zero control of:

• Vertical dimension
• Even occlusal contacts
• Centric relation position
• Disclusion during lateral/protrusive movements

➡️ This increases muscle hyperactivity and TMJ load.

3. Soft splints increase clenching

Most boil-and-bite splints are soft EVA.

Soft material:

• Stimulates the jaw to chew
• Leads to increased bruxism
• Can worsen muscle tension and wear

With erosions, you already have weakened enamel/dentin → not ideal to increase forces.

4. They can change the occlusion even faster

Because erosion patients have:

• Thin enamel
• Flattened cusps
• Reduced vertical support

Even slight changes in mandibular position from a soft OTC splint can cause:

• Posterior open bite
• Shifts in centric occlusion
• Changes in muscle memory

➡️ Risk of permanent occlusal changes.

✅ What IS advisable for severe erosions

1. Hard, custom-made stabilization splint (Michigan-type)

Properties:

• Even, flat, hard occlusal table
• Controlled OVD
• Proper canine/anterior guidance
• Disclusion of posterior teeth

2. Consider splint-supported OVD increase

Erosion patients often require:

• Testing an increased OVD
• Evaluating muscle comfort
• Preparing for full-mouth rehab

A proper splint can act as:

• A diagnostic tool
• A protective night guard
• A trial increase of vertical dimension

3. Possible second splint for daytime (thin, hard)

If the patient heavily parafunctions.

🦷 Clinical Guideline (practical)

| Condition | Boil & Bite OTC | Custom Hard Splint | | ------------------- | ------------------ | ------------------ | | Mild wear | ⚠️ Short term only | Yes | | Severe erosions | ❌ Never | Gold standard | | Loss of OVD | ❌ Contraindicated | Indicated | | Muscle pain/bruxism | ❌ Often worsens | Yes | | TMJ symptoms | ❌ Wrong choice | Yes |

If you want, I can also help you with:

✓ When to use a Kois deprogrammer versus Michigan splint in erosion cases ✓ How to set the OVD for splint therapy ✓ Protocol for full-mouth rehabs after erosive wear

Would you like deeper clinical guidelines?