Temporomandibular joint disorder (TMJ) is tricky to diagnose and treat, and the way that most dentists approach treatment can actually make the condition — as well as snoring and sleep apnea — worse. At the Michigan Center for TMJ & Sleep Wellness, we are fully aware of the crossover between these conditions and provide quality treatments that help both.
The Most Common TMJ Treatment
The most common TMJ treatment used today is the flat plane bite splint. This bite splint is intended to help put the jaw in a healthy position, reduce bruxism (teeth clenching and grinding), and prevent damage to the teeth.
The flat plane bite splint is fitted to the upper teeth, but smooth on the bottom. In theory, this allows the lower jaw to slide freely past the bite splint so the jaw finds its comfortable position, and the thick plastic prevents damage to the teeth.
Flat Plane Splints Can Worsen TMJ
Research shows that flat plane splints don’t stop bruxism. Instead, they can make it worse. They don’t prevent the contact of your back teeth together during sleeping, and they can lead to worse displacement of the jaw joint.
Although theoretically, the flat plane splint should allow the lower jaw to move freely forward and back, in practice the flat plane splint actually pushes the lower jaw backward. Pushing the lower jaw backward can lead to worse displacement of the jaw joint disk. A person with clicking and popping in the jaw joint may experience a locked jaw and even more progressive damage to the jaw joint.
The Impact of Flat Plane Splints on Sleep Disordered Breathing
The backward movement of the lower jaw is also bad for snoring and sleep apnea. Since the jaw is the primary support for the throat and tongue, when the jaw moves backward, the airway can become more obstructed.
Studies have shown that sleep apnea and snoring can get worse when a person wears an occlusal splint. One study showed that some patients saw their apnea/hypopnea index (AHI) worsen by more than 50%. Overall the respiratory disorder index (RDI, another measure of how much your breathing is interrupted during sleep) increased by 30% when wearing a bite splint.
A more recent study confirmed this impact, but showed a much smaller effect.
Treating TMJ and Sleep Apnea Together
Since TMJ and sleep apnea are closely related, they can and should be treated together. Before you start sleep apnea treatment, it’s important that your sleep dentist perform a comprehensive TMJ diagnosis.