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The Process for Occlusal Splint Therapy

This video is an excerpt from the April 2015 Dawson Faculty Office Hours with Drs. Leonard Hess and Rajeev Upadya. To watch the full office hours and to sign up for future office hours, visit the Videos and Webinars page

The following is a transcription of this video excerpt. 

Question: Describe your process for splint therapy

Dr. Leonard Hess: Ok that's a great question. If we have somebody we are suspecting has an intercapsular issue, which would be a medial pole issue, then we place them in a full-coverage orthotic splint (an SRS splint) so that we are meeting the requirements of occlusal stability; we are getting even contact, canine guidance and protrusive guidance.  That patient will go into splint therapy where we monitor them on a regular basis to see if the splint needs to be adjusted. As the joint becomes healthier, the splint almost becomes a bandaid. As we adjust it, we should see the joint to start to seat into the fossae again completely. We should be able to nurture the joint back into good health.

How do you choose what occlusal splint?

If it is somebody that the complete examination is pointing toward having a muscular type of issue and I want to calm down the muscles so that I can feel confident doing occlusal therapy, then the B-Splint is an invaluable tool. I make a lot more B-Splints than full coverage splints because I have a lot more patients that have musclar problems versus internal derangment type of issues. 

So if I think it's muscular, I put them in the B-Splint and the B-Splint is either going to calm down those muscles very quickly or it's going to show me it's intercapsular. You are very rarely fooled if you do your complete examination properly, though. 

To recap: I'm thinking muscular or intercapsular based on what I find in the complete examination and then go down a different path based on what I find there.

Dr. Leonard A. Hess maintains a comprehensive-focused private practice in Monroe, North Carolina. Growing up in the mid-west, Dr. Hess attended Indiana University for his undergraduate education. His doctor of Dental Surgery degree was obtained from Northwestern University Dental School in Chicago, IL. Dr. Hess is a member of the American Academy of Cosmetic Dentistry, American Equilibration Society, ADA, AGD, NCDS, and CDS. Locally, Dr. Hess has served on the peer-review board for his ADA district. He has also served on the Board of Directors of SPCC College in Union Co. As a senior faculty member of the Dawson Academy, Dr. Hess has demonstrated a passion for learning and teaching from the very start of his career. In the past six years Dr. Hess has taught hundreds of hours of hands-on continuing education throughout the country. From study clubs to the AACD national meeting, Dr. Hess has helped thousands of his peers incorporate functional esthetic care into their practices. Dr. Hess currently evaluates and tests new products for manufacturers such as Whip-Mix, Septodont, Heraeus, Kerr, and Dentsply. In addition, Dr. Hess is a frequently featured author in Advanced Esthetics and Interdisciplinary Dentistry, Inside Dentistry, Contemporary Esthetics and Restorative Dentistry, and Vistas. Dr. Hess resides with his wife and son in Weddington, NC. Outside of dentistry he enjoys spending time with his family, golf, aviation, traveling, skiing, and auto racing.