Dr. Levy's Patient Instructions for
Wearing Your Lower Orthotic

Purpose: This orthotic appliance will help the muscles which are in spasm to relax, and it will reduce facial pain and headaches. It is not a cure in and of itself.

The purpose of the orthotic is to reposition the various components of your bite into a harmonious and smoothly functioning system. When a bad bite exists, as in your case, the teeth which are in control of the jaw tend to twist the muscles of the jaw. This twisting causes muscle spasm and pain. The orthotic allows the jaw to find its proper position by removing the teeth as the dominant factor and letting the jaw muscles function correctly.

In order to break up the old harmful habits of the poor jaw positioning, the orthotic MUST BE WORN as much as possible, but no more than 23 hours/day. You will learn to speak with it, learn to laugh with it, and eventually eat with it. You should wear it full time, twenty-three hours per day, unless instructed otherwise.

Usage: You will readily become acclimated to your orthotic if you follow these simple instructions:

At first, learn to do everything more slowly!

To become accustomed to speaking with the orthotic in your mouth, practice reading very slowly, out loud in front of a mirror. While doing this try over exaggerating your lip and tongue movements, and deliberately pronouncing each syllable.

You will notice an excess flow of saliva for the first few days because the salivary glands will be fooled by the presence of the orthotic and will react as if it were food. Do not be concerned about this as it will soon disappear.

We will inform you if you should wear the orthotic to eat. If so, it is very important that you eat with the orthotic in place. For the first few days, you might want to restrict yourself to a soft diet composed of eggs, hamburger, chicken, fish, soft cheeses, yogurt, soups, pasta, etc. Certain foods should be avoided, such as gum, cough drops, peanuts, and raw vegetables. Do not chew hard candies or ice. Do some of your chewing with your fork and knife; cut everything into small pieces before putting it into your mouth.

Occasionally, through the action of talking or chewing, you may develop sore spots on your cheeks or tongue. Please call us if this happens so that we may see you and alleviate the cause of these spots. In the meantime, rinse with a solution of warm salt water several times. If it is absolutely necessary to remove the appliance because of discomfort, please be sure to re-insert it at least 3-4 hours before your appointment so that Dr. Levy can readily locate the area requiring attention.

If you do take your orthotic out for any reason, be sure to put it into your case. DO NOT leave it lying on the edge of your counter; DO NOT leave it lying around where animals can reach it-they love to chew them; and finally DO NOT wrap it in a napkin-it is too easily mistaken for trash and thrown out!

Make every effort not to strain the ligaments of your temporomandibular joint unnecessarily. Should you find yourself clenching your teeth, try to remember to keep your "Lips together-Teeth apart".

When the orthotic is removed for cleaning, you may notice that none of your back teeth meet one another. This is to be expected, and a sign that you are making progress. What is actually occurring is that the appliance is allowing the jaw to find its proper position. The muscles that suspend the jaw are going out of spasm and regaining their proper length. It is the lengthening of these muscles that creates the separations between the teeth.

While you are under treatment, do not move your jaw from side to side to see if it clicks, grates, or hurts. Do not chew gum and do not grit or clench you teeth. Try to limit the degree of mouth movements for the first three weeks. Then gradually and cautiously increase your range of jaw movements, always staying below the level which causes pain. Repeat to yourself over and over during the day: "Lips together-Teeth apart".

Orthotic Adjustment

The biting surface of the orthotic may be changed whenever you come to the office. Don't be alarmed if you notice that one side is thick while the other side is thin. This difference is due to the poor jaw positioning. When the orthotic is adjusted in the office, thin areas may appear in it, and tiny particles may even break off.

This is nothing to worry about, but simply an indication that the jaw is finding its proper position. After an office visit, a thin area may wear through or snap off. In such a case, remove the orthotic from your mouth, smooth off the rough edges of the broken area with a nail file or emery board, and re-insert the orthotic. One last word of reassurance- When small pieces of the appliance break off, do not be alarmed! It is a good sign; it means the jaw is finding its proper position.

Care of the Orthotic and Teeth: Brush both sides of the orthotic carefully with toothpaste every time you brush your teeth, and rinse it thoroughly in a mouth rinse solution. When brushing your teeth, pay special attention the inner surface of the teeth. Brush them very carefully and then proceed to the other surfaces of the teeth.

Remove your appliance after each meal and wash it off under a tap, and rinse out your mouth so no food collects around the teeth.

Possible Inconveniences: Due to the fact that it takes the tongue a while to become accustomed to the orthotic, food may become lodged in the mouth under the appliance. When this lodging occurs, simply remove the orthotic, dislodge the food and rinse the mouth and the orthotic.

In order to not aggravate the muscles of the neck, jaw, and back, refrain from carrying, pushing, or lifting heavy loads. Avoid raising your arms over your head for extended periods of time (i.e. painting a ceiling).

Dental Procedures

Dental check-ups should be continued as usual. However, we should be informed when any procedures are scheduled, and a few additional precautions should be observed. For example, do not open fully even if the dentist or hygienist asks you to do so. You should vary the amount of jaw opening during the procedure, and request that the dentist or hygienist give you a break every 5 to 10 minutes and support your chin.

General Anesthetic

In the event that you are undergoing surgery, inform you anesthetist that you are undergoing treatment for TMJ and ask him or her to exercise care and caution in administering the anesthetic both pre-and-post operatively.

Following these suggestions will hasten your treatment. We want this appliance to become an integral part of your body, just as eyeglasses and dental bridgework do, and as soon as possible. Only if these conditions are met will your treatment be successful.



Copyright (c) 2008 Stoneridge Dental Care.