Early intervention helps to reduce pain amplification and to minimize one's condition from progressing to chronic pain. This concept is equally understood for injury to other joints in the body, but there was no clear treatment plan for acute head, neck and jaw injury. Until now.
Patients who learn effective head/neck/jaw self-care measures at home can make it easier to prepare for any future onset of pain from an injury or flare-up. Improvement occurs more readily and reinforces attention to the condition until it's fully healed. If untreated, the list of symptoms gets longer, which could spread from localized pain to referred pain, headache or shoulder and neck pain.
In addition to a potentially complex diagnosis, pain becomes difficult to change patients' habits, such as hypervigilance (jaw muscle and neck clenching), compromised posture and other adaptations to the pain and restricted neck and jaw mobility. The longer patients wait, the more distracting their condition, and the more condition to ask for help: a dentist? A physical therapist? Pain medication?
Many patients who visit an Orofacial Pain Specialist for a chronic condition have a long medical history starting with the first instances of hea, neck and jaw pain: wisdom teeth extraction, whiplash, concussion, or a surgical procedure with intubation. We designed the Speed2Treat Home Healing Kit so healthcare providers can help their patient before their conditions manifest as chronic pain.
QuickSplint® is a product that is made for immediate use and does not require specialized tools.This DIY splint provides support and protection of the jaw from further strain, and encourages healing, silimar to a brace for the ankle, knee, neck, and back. Once injured, the jaw is particularly prone to delayed healing and chronic pain due to chewing, speaking daytime/nighttime oral habits, and neuromuscular bracing activity. If this strain continues, there is increased sensitivity to the muscles and joints and chronic pain may develop.
QuickSplint inhibits the full bite force of parafunctional teeth clenching and offers the pericranial musculature an opportunity to relax overnight. Muscle tension is reduced, as is the pain associated with bruxism, headaches and TMD.
If you can start treatment for your patient immediately when they contact your practice or are already in your office, the pain relief, inflammation reduction and muscle hyperactivity are improved.
When a patient goes to the ER for acute pain, if they are medicated this will reduce pain amplification immediately, however, the patient’s habit for muscle-guarding behaviors (jaw clenching and neck strain) has not been influenced by the medication. The Speed2Treat® Home Healing Kit accomplishes an awareness of daytime clenching (a subconscious behavior that needs to be addressed with repetitive daytime exercises) and inhibition of nighttime clenching with the QuickSplint®.
Speed2Treat offers patients a step-by-step care plan that includes the use of NSAIDS to reduce inflammation and pain; hot/cold therapy to reduce inflammation; educational videos, and breath training.
Similar to the gentle exercises performed during the recovery of ankle to minimize muscle contraction from lack of use, the jaw exercises in the 4-Week Care Plan are designed to increase blood flow to the muscles that support chewing.
Acute injury to the orofacial region ranges from jaw and muscle sprain/strain (JAMSS), blows to the jaw, mild whiplash, and concussion. These conditions effect the trigeminal nuclei and upper cervical sensory and motor cell bodies.
Injury can stimulate the trigeminal and upper cervical sensory nerves and can upregulate the motor units of the same nerves, including the muscles of mastication and the upper cervical paraspinal region.
Speed2Treat® Speed2Treat is designed to help reduce pain pathways by instituting proprioceptive change in the orofacial region. The use of the QuickSplint® oral appliance and hot/cold therapy face wrap present an interference to the irritation, and quiets or confuses the sensory input.
Each patient’s pain and stress response vary based on the injury intensity and the injured patient’s history and resiliency factors. We have designed education and coaching to support the patient and mitigate stress. Stress and pain become a vicious cycle, especially if a patient is discharged from an ER with instructions to rest for four weeks following TBI.
Patients typically report intense jaw/neck/head pain and limited range of neck and jaw motion. The majority of patients are expected to fully recover within the first three months. However, for some, pain and disability does not resolve - it persists or can even worsen. These clinical outcome trajectories may be influenced by the fact that TBIs are both a tissue and stress-based injury. Individual resiliencies or vulnerabilities influence the rate of recovery.
Well-made appliances for extended use usually require a laboratory for fabrication and require delivery by a licensed dentist. Dentists will select the acrylic material to be a hard or soft material, will chose the thickness of the appliance, whether the appliance is designed to be worn on the upper or lower arch, and other considerations that reflect the patient’s condition, ie., is there a TMJ disorder, does the patient brux, does the patient have sleep disordered breathing, etc.
Most over the counter devices are "boil-and-bite" appliances that are full arch - they cover all of the teeth in the upper or lower jaw. Because they are designed for molding in hot water, most boil-and-bite appliances are made of pliable acrylic. Depending on how hard a person clenches at night, and the severity of the case, some patients who wear a soft appliance over time can habituate to the appliance in such a way that it no longer serves the purpose of inhibiting the clenching behavior.
We work with physical therapists and chiropractors who had been advising their patients to pursue a “boil-and-bite” appliance found in pharmacies. We DO NOT recommend this option. A patient in pain does not want to confront vast selections of OTC products with various claims; they do not want to choose an appliance, only to have it fail and blame themselves for choosing the wrong appliance.
The QuickSplint® is designed to be ready to go without requiring expert adjustments. It is also designed to specifically inhibit the posterior teeth to be in contact. This is achieved by the partial coverage design.
We do not advocate the QuickSplint as an extended use device, due to a risk called “supra-eruption”. This can occur when a partial coverage device is worn 24/7 or worn at night for an extended period. Supra-eruption occurs when a person’s posterior teeth “erupt” or lower and become longer than the anterior teeth; the result is the person may develop an “anterior open bite” where the front teeth do not meet when the person bites down.
We have taken care in the choice of materials of QuickSplint and in the product labeling to make sure that every patient knows that QuickSplint is not appropriate for extended wear or 24/7 wear. Your patient can wear QuickSplint at night for a few days, up to 6 weeks. If you are not a dentist, please instruct your patient to bring their QuickSplint and the Pain Tracker to their next dental appointment.
Either one (referred by dentists as the “arch”.) The putty doubles as a liner that works around different jaw sizes and shape of the teeth. Oftentimes, a patient has a preference, so we encourage the user to try the tray on both arches to see what feels the most comfortable when they close their mouth down on the tray.
Acute displacement is rare. If your patient presents with jaw pain with no prior history and the QuickSplint® oral appliance worsens the situation, please advise your patient to discontinue use. QuickSplint® Explain to your patient that this is/was a conservative, cost-effective trial low-cost of an appliance that may help a TMJ expert diagnose whether the patient has a more complex problem.
Jaw popping is a clinical finding, not a disease. It is estimated that 50 to 70% of the US population have jaw popping at some point in their lives, without pain or progressive dysfunction.
No. Your patient needs to go to the ER or an Orofacial Pain Specialist (see FaceMyPain.com for a provider near you).
No, in our experience the patient’s acceptance of future treatment is enhanced as a continuation of the proven effective treatment thatQuickSplint® provides.
Studies show that 80% of patients who brux are not aware of this behavior. Independent of a head, neck or jaw injury, often at the end of the 4-Week Care Plan, patients will realize that they need to discuss their bruxism with a dentist. In turn the dentist will determine an appropriate long-term device designed to protect the teeth and their supportive structures from abnormal forces that create breakdown and tooth wear. Some patients will report that there are brux marks on the surface of the QuickSplint after 30 days use.
In the 4-Week Care Plan outlined in the Kit, if a patient has experienced no improvement or their condition is worse at the end of 2 weeks, it is recommended that they discontinue use and pursue evaluation by their healthcare provider, or find an appropriate expert at FaceMyPain.com.
It is difficult to generalize results because of the individualized nature of each persons pain experience, their prior history of trauma or pre-existing conditions, and the fact that the term TMJ disorder is an umbrella term representing 30 TMJ-related disorders, whiplash and concussion share common pain amplification characteristics with TMD and yet have been considered separate diagnoses.