05. Oral Occlusal Orthotics
The alignment of your bite is a very important factor in keeping your postural system balanced. If you have malocclusion, you are more likely to have increased tension and torque in your jaw, head, neck, shoulders and even down into your lower body. An oral occlusal appliance can give your brain and body the illusion of a perfectly balanced bite which subsequently reduces any extraneous tension and twist in your postural system. This can help reduce pain, tightness, anxiety, bruxism and even improve sleep.
There are three different types of lower occlusal splints we recommend:
1. Gelb
- A Gelb type splint only covers your molars leaving your front teeth uncovered.
- Pros: Easier to wear and talk with during the day as it is less bulky and generally thinner than a full coverage splint which can make it easier for you to keep your lips closed.
- Cons: With extended use, your molars that are in contact with the splint may intrude and become lower in height which can negatively alter your bite. It is recommended to not use this type of appliance full time for more than 3 months and to not eat with the appliance. After 3 months of full time wear you may use it for sleep and a few hours during the day which should prevent any intrusion.
- When receiving this appliance your dentist should use contact paper to make sure it is appropriately balanced and equilibrated for you.
2. Full coverage/flat plane
- A full coverage or flat plane splint that covers all your teeth.
- Pros: Reflects more of a natural bite with full contact. Does not result in intrusion or extrusion of your bite (teeth getting taller or shorter).
- Cons: Harder to wear and talk with during the day. Is usually thicker than the Gelb style which can make it harder to close your lips.
- We strongly recommend that the features of this splint have:
- Light anterior guidance where you are able to achieve light contact with your front teeth.
- Canine guidance so that when you move your jaw side to side you are able to contact your canine teeth.
- Balanced molar contact upon closure. Your dentist should use contact paper to make sure your contact points are balanced.
3. POD
- A POD splint only covers one side of your teeth
- Pros: Some individuals do best with contact on one side of the bite which provides them essential unilateral neurosensory guidance to help shift their postural system into a more neutral state. Most of the time this is on the left side due to the natural asymmetry of the human body where the left bite is less dominant compared to the right side.
- Cons: If worn excessively (more than during sleep and a few hours/day) it can potentially intrude (make shorter) the built up side which will negatively impact the balance of the bite.
- It is expected with use of this appliance that your cranial bones and postural system below will shift into a more neutral patterned alignment. Thus the appliance will need to be periodically adjusted (especially during the first 3 months of use). Typically, your need for unilateral contact goes away and progresses to bilateral contact. This particularly occurs when concurrently undergoing Postural Restoration (PRI) progressions. It is advised to first proceed with a PRI program for 1-3 months and then retest to determine if you still need an asymmetrical appliance. Usually, as your body becomes more neutral it will test for a bilateral appliance.
How do you know if you would benefit from an oral occlusal appliance?
- Because the primary reason you would be seeking an oral occlusal appliance is to balance and realign your bite, you first need to determine if your bite is negatively impacting your postural system and breathing.
- Perform a few Physical Resonance Tests to get a baseline of how you feel and your current range of motion. Specifically check the neck and shoulder tests or the nasal occlusion breathing test.
- Do the tests before and after trying the following different options below to determine how much your bite is impacting your breathing and tension in your body. If your neck range of motion and/or nasal breathing improves with any of the following conditions we can assume your bite is related to the tightness in your neck.
- Bite Condition options to test:
- Do the following tests. After each one, re-check your Physical Resonance Test to determine if it is better, worse or the same as your baseline.
- Bilateral Molars using:
- Full Coverage Bite Wafer
- Molar Only Coverage Bite Wafer
- Place 1 Q-tip between each set of your 1st molars
- Place 1 Q-tip between each set of your 2nd molars
- Left molars using:
- A unilateral bite plate or a tongue depressor between your left molars
- 1 Q-tip between your left 1st molars
- 1 Q-tip between your left 2nd molars
- Right molars (least common location) using
- A unilateral bite plate or a tongue depressor between your right molars
- 1 Q-tip between your right 1st molars
- 1 Q-tip between your right 2nd molars
- Canines
- 1 Q-tip between each set of your canines
- 1 Q-tip between your left canines
- 1 Q-tip between your right canines
- Bilateral Molars using:
- Do the following tests. After each one, re-check your Physical Resonance Test to determine if it is better, worse or the same as your baseline.
Interpreting Your Results
For any of these conditions, you may also be a candidate for an expansion based oral appliance therapy or orthodontia. Refer here to learn more.
Indicators for a full coverage appliance:
- Tests improve with:
- Full Coverage Bite Wafer
- Any Canine contact points (indicates canine guidance preferred over a flat splint)
- Molar Only Coverage Bite Wafer
- Any bilateral molar pattern using tongue depressors or Q-tips
Indicators for a Gelb/Molar only coverage appliance
- Tests improve with:
- Molar Only Coverage Bite Wafer
- Any bilateral molar pattern using tongue depressors or Q-tips
- Tests worse or not better with:
- Full Coverage Bite Wafer
- Any Canine contact points
Indicators for a POD appliance appliance (unilateral molars)
- A unilateral bite plate, tongue depressor or Q-tips on one side of your molars (most of the time this is the left)
- If you test best with unilateral contact this result may change after undergoing Postural Restoration (PRI) progressions so it is advised to first proceed with a PRI program and then retest if you still need an asymmetrical appliance. Usually, as your body becomes more neutral it will test for a bilateral appliance.
An oral occlusal appliance may also be referred to as an occlusal splint, mouth guard or bite plate. Ideally you would have this custom made.
-
- Typically, dentists prefer to make these appliances to fit on your top teeth (maxillary arch). However, we strongly discourage upper splints as they nearly always lock up the head and neck.
- We recommend you request from your dentist that the appliance be made to fit your lower teeth (mandibular arch). If your dentist won’t make you one for your bottom teeth then go find one that will.
- Dentists with specialized training at the Pankey Institute tend to fabricate well balanced lower oral orthotics. However, theoretically, any general dentist should be able to generate a balanced splint for you.
- When your dentist delivers your appliance it is absolutely essential that it is balanced appropriately. Sometimes the slightest extraneous contact point can result in your postural system tightening up vs relaxing which is what the whole point of the splint is. They should be using articulating paper to do so. Before equilibrating, it is essential to get your postural system neutral. The Short Seated Wall Reach is a reliable technique to accomplish this which can be done right in the dental chair.
- For those that cannot afford a custom appliance, the Airwaav over-the-counter splints can suffice for some and are self-molded at home. As with a custom appliance, get your system as neutral as possible before taking the impression using Short Seated Wall Reach.
- There are 3 versions of which you may need to experiment with to find the one that works best for you.
Other Important Considerations for Oral Occlusal Appliances
It is recommended to have a lower (mandibular) appliance vs an upper (maxillary) appliance.
- Upper (maxillary) appliances tend to lock up the bones of the head and neck. This is because the palate is meant to subtly shift which is not permitted as an upper appliance restricts this motion.
It is normal and often necessary to require adjustments over time
- It is normal and often necessary to require adjustments to your splint over time, especially during the first 3 months. This is because the simulation of the neutral bite coaxes the rest of your postural system to shift into more neutral alignment. As this happens, the alignment of your bite also shifts meriting further adjustments.
Hard acrylic material is preferred over soft material so that it best mimics teeth hardness.
- This makes it less likely to be chewed.
What is not recommended
- We do not recommend any type of oral appliance that only has your front teeth in contact such as an NTI. This type of appliance may reduce tension in your jaw but creates neck tension.
It may be helpful to work with a provider with PRI training
- Working with a provider with training from the Postural Restoration Institute (PRI) who has experience integrating with dentists can help guide you in this process along with making sure the rest of your postural system remains as neutral and aligned as possible (this influences the bite) when working with an oral splint. For additional help consider a 60 min consulting session to support you.
- The Postural Restoration (PRI), Fundamental Movements and the Face and Mouth Integration sections of the Master Guide will help you along this trajectory.
You may require additional or other interventions.
Browse the following 8 options or you may use your testing technique to determine if any pertain to you.
Enjoy these other related Master Guide items to Resonate Health:
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This content is being provided for informational purposes only and is not a substitute for medical advice. This content has the potential to produce healing and detox responses. Please consult your medical doctor or professional if you have medical concerns. If you experience any discomfort or adverse effects discontinue.
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