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Splint Therapy for TMJ

Austin TMJ Splint Therapy Provider - Tor Gotun, DDS - Austin Smile Creations


The Different Splints Used


Diagnostic Splint


The diagnostic splint is a full arch maxillary (upper jaw) splint with an anterior ramp (front teeth resting on a 10° flat plane) balanced to approximate centric relation (joint seated in the desired location). The purpose of this splint is to test a person’s ability to use and benefit from a splint. The splint itself is produced by Dr. Gotun on models derived from your teeth by taking a set of alginate impressions. He also uses a tool called a face bow to relate the teeth to your joints. Finally, he takes a bite model using softened wax to accurately relate the upper and lower jaws. The models are mounted on a semi adjustable articulator (SAM 2). The result is a splint made of clear, thermally adapted plastic that snaps onto your upper teeth. The appliance is tolerated with no problems by most patients. The procedure takes two ½ hour appointments. The adaptation phase for each patient varies from no time to a week depending on each patient’s sensitivity level.

The fabrication of a diagnostic splint is preceded by:

a. General oral exam.
b. Limited TMD exam.

 

Night Time Splint

The night time splint is a full arch maxillary (upper jaw) splint with a full arch ramp (all posterior teeth resting on a plane with equal contact on each individual tooth) balanced to approximate centric relation (joint seated in the desired location). The splint itself is produced by Dr. Gotun’s laboratory affiliate on models derived from your teeth by taking a set of alginate impressions. He also uses a tool called a face bow to relate the teeth to your joints. Finally he takes a bite model using softened wax to accurately relate upper and lower jaws. The models are mounted on a semi adjustable articulator (SAM 2) to produce the appliance of a heat cured, clear, very hard and durable material that snaps onto your upper teeth. The purpose of this splint is to allow a patient to rest comfortably at night as a result of the appliance’s ability to distribute clenching or grinding forces equally throughout the muscles of the masticatory system (generally speaking, the muscles of your face controlling the function of your jaw). The splint also eliminates the neurological feedback to your brain of the upper and lower teeth’s relationship to each other. This facilitates the initiation of a neuromuscular balance of the masticatory system and thereby limits the resulting discomfort of biting your teeth together subconsciously. The appliance is tolerated with no problems by most patients. The procedure takes three to four 1-2 hour appointments. The adaptation phase for each patient varies from no time to a week depending on each patient’s sensitivity level.

The fabrication of a night time splint is preceded by:

a. General oral exam
b. TMD exam
c. Cone Beam CT scan presently done by ImagDent using an iCAT radiographic volumetric scanner
d. Radiographic interpretation by a oromaxiofacial radiologist
e. The mouth needs to be free of pathology (cavities, gum disease and other pathology) to obtain a predictable outcome

 

Full Time Splint

The full time splint is a full arch maxillary (upper jaw) splint with a full arch ramp (all posterior teeth resting on a plane with equal contact on each individual tooth) balanced to approximate centric relation (joint seated in the desired location) much like the night time splint. The splint itself is produced by Dr. Gotun on models derived from your teeth by taking a set of alginate impressions. He also uses a tool called a face bow to relate the teeth to your joints. Finally, he takes a bite model using softened wax to accurately relate upper and lower jaws. The models are mounted on a semi-adjustable articulator (SAM 2). The result is a splint made of clear, thermally adapted plastic that snaps onto your upper teeth. The purpose of this splint is to allow a patient to rest comfortably 24 hours a day as a result of the appliance’s ability to distribute clinching or grinding forces equally throughout the muscles of the masticatory system (generally the muscles of your face controlling the function of your jaw). The splint also eliminates the neurological feedback to your brain of the upper and lower teeth’s relationship to each other. This facilitates the initiation of a neuromuscular balance of the masticatory system and thereby limiting the resulting discomfort of biting your teeth together subconsciously. The appliance is tolerated with no problems by most patients. It is worn 24-7 and the teeth are not allowed to touch during the whole course of splint therapy without the splint in place. The duration of treatment is 6 weeks to 6 months. There is an adjustment and measurement appointment about once a week during the total treatment. The end result is a repositioning of the jaw to a functional and comfortable position that is followed by whatever treatment is necessary to maintain this relationship indefinitely. The initial fabrication of this splint is the same as the night time splint. The subsequent appointments last anywhere from 15 to 30 minutes. The adaptation phase for each patient varies from no time to a week depending on each patient’s sensitivity level. After a stable position is obtained and pain, popping and crepitation symptoms are at an acceptable level, final treatment is planned after a pantographic analysis (a 100% duplication of jaw function onto a fully adjustable articulator) is performed. This could include any of the following treatments or a combination:

a. Equilibration (adjustments of teeth by grinding on the biting surface of the teeth)
b. Crowning of teeth
c. Braces
d. Orthognatic surgery (surgical approximation of upper and lower jaws)
e. Joint surgery

 

If you have any questions, concerns, or would like to schedule an appointment, please contact us at Austin Smile Creations.

 

Testimonials.

Read what people are saying about us.

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Testimonials

If you are reading this testimonial, I assume you are looking to alleviate pain in one or more of your teeth or to improve your smile cosmetically. Either way you can save yourself some time, stop right now and go make an initial evaluation appointment with Dr.Gotun and his staff at their cozy, comfortable office with a relaxing peaceful view of Eanes Creek. You can search the 1200 or more listings in the Austin area and the BEST you could hope for would be to find another dentist equally as skilled and talented as Dr.Gotun. I do NOT think it is possible to get BETTER quality dental work than what you will get at this office.

The one thing that made everything so simple for me was the photographs. During the initial exam Dr.Gotun takes a series of photographs of your teeth along with x-rays. You then get to see your teeth on a laptop screen, in color, up close and larger than life. If you can live with what you see then you can count your blessings and Dr.Gotun will let you be on your way, unless of course you would like to schedule a cleaning!

In my case I could see the damage, decay and buildup from many years of poor oral hygiene and neglect. In addition to the problem teeth that brought me to the dental office I could easily see that most of my teeth were in need of some type of restoration work. Dr. Gotun has my permission to show all of my records to anyone interested in seeing them. I am sure you will be as amazed as I still am at what Dr. Gotun was able to accomplish considering the very poor condition my teeth were in at the start of the process.

The cost was substantial in my case due to amount of work that was required. However, the work was spaced out over several years which made the cost much easier to budget. Dr.Gotun was not on my dental insurance plan, so I accessed some savings and my credit to finance the work and paid it off like any other significant asset I have purchased. My teeth are the most rewarding investment I have ever made.

If I could give anyone one bit of advice other than my story, it would be “do NOT let dental insurance be the major factor that guides your decision-making”. I was never happy with any of the experiences or results I had when I tried to use the dentists that were covered under my plan. I am proof that 12 years on with regular flossing and brushing, the investment in your restoration work done by Dr.Gotun can still be yielding satisfaction and compliments from friends and random strangers.

I have never gone to bed without flossing and brushing after seeing those photographs in my initial visit. Good luck and I hope to be reading your success story here sometime in the future.

Chuck M. Austin, TX

Dr. Tor Gotun probably saved my life and he's added some years to it. You don't usually say that about your dentist, but I believe it in my case.

More than 10 years ago, after many years of neglecting my teeth and an unhealthy life style, I went to Tor, my neighborhood dentist, even though he wasn't on my State of Texas dental insurance network.

I soon learned of the challenges to getting my gums and teeth back to a healthy status. The way Tor explained it, I knew it was complex and that Tor had the skills and vision to get me there, as long as I did my part. I also knew it would take time and not be cheap.

Now, years later, I still have most of my original teeth and only a few very nice, state-of-the art crowns. I am following Tor's advice for taking care of my teeth and gums, including his regular cleaning schedule. What my dental insurance didn't cover, I was able to use Austin Smile Creations' association with Care Credit to finance the costs without any interest charges as long as I pay off balances within a year of each charge.

By the way, we had only one procedure that didn't work out as planned, but Tor made good on it and the solution turned out as good or better.

As a bonus, all of Tor's top flight members are both professional and personable, always considerate of my needs, interests, and schedule.

Bottom line, Tor is better than my expectations. He pays attention to more than just how my mouth looks; he's concerned about my overall health and how my life-style affects, and is affected by, the health of my teeth and gums.

Bill H. Austin, TX

I have been going to Dr. Gotun since he used to have his practice on William Cannon Drive ( 20 years now). Now he is located in Bee Caves. He is an excellent dentist.

The thing I like best about Tor Gotun is he is relatively pain free when administering his shots to numb your mouth. Dentists I have had before always seemed to be a bit heavy handed in this activity.

He is very up to date with modern dental technology. He can make a crown or cap in his office at the moment of your appointment and have you leave with a fully functioning mouth. I have friends who use other dentists who must wander the city of Austin for at least a week with a hollowed out molar stuffed with gauze as they await their topping to arrive by mail to their dentist's office.

The staff is very friendly, and Dr. Gotun will never talk down to you. He is very good at explaining why he is doing something or why he wants to do a procedure. He may have gotten two of my wisdom teeth, but I will still try to hold onto the remaining two regardless of his explaining the safety factors of hanging on to them as you get older.

Randy S. Austin, TX

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Austin Smile Creations
2724 Bee Cave Rd
Austin, TX 78746
Phone: (512) 329-5555 URL of Map
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