Use and abuse of bite splints.

Bite splints are often used in the treatment of patients with oral parafunctions, temporomandibular joint (TMJ) dysfunction, or temporomandibular disorders. The most common reasons for prescribing a bite splint are to protect the teeth in patients with bruxism, to improve jaw-muscle and TMJ function, and to relieve related pain. The risk for negative side effects is small in conservative bite splint treatment. Complications from long-term use of splints, however, can be severe and irreversible. The risks are especially high when mandibular advancement splints, or splints that make contact only with parts of the opposing dentition, are used for more than 4 to 6 weeks without appropriate supervision. As a general rule, a dentist should not encourage a patient to use any type of splint for more than a few months except for cases in which the teeth need to be protected because of persistent oral parafunctions. Appropriate record keeping, including signed consent forms, is necessary; when neglected, it becomes difficult for the dentist to defend himself from false accusations of malpractice.