Myofascial pain dysfunction syndrome is a common complaint in dentists’ offices around the world. But are you better off getting muscle relaxants and Ibuprofen, or is it worth it to go to the trouble of getting a night guard for your teeth? A recent study answers the question.

Forty patients from age 17 to 55 took part in the study. The men and women were randomly divided into two groups of 20 each, Group A and Group B. Study participants in Group A were given commercially available analgesics and muscle relaxant (Ibuprofen, Paracetamol and Chlorzoxazone), while the patients in Group B were asked to wear a soft occlusal splint at night.

Occlusal Splints
Commonly called bite splints, bite planes or night guards, occlusal splints are removable dental appliances molded to fit a patient’s upper or lower teeth. Harder, more durable splints are made from heat-cured acrylic resin, while less-expensive and softer splints are comprised of soft acrylic or light-cured composite.

Maxillary splints are worn on the upper teeth, while mandibular splints set on the jaw. Either or both can be used, but for this study the more common maxillary splints were employed.

Over a period of three months, all patients were evaluated on the Global Pain Impact (GPI) scale, the Visual Analog Scale, their maximum comfortable mouth opening, their number of tender muscles, and temporomandibular joint (TMJ) clicking and pain at rest and while moving. Evaluations were done at diagnosis, one week after therapy started, and then at one-month intervals for three months.

Splint vs. Drug Results
The results of the study were dramatic. Group B, the splint group, showed a progressive reduction in GPI (pain) scores, fewer tender muscles, less TMJ clicking and soreness with a variety of jaw movements, as well as significantly greater mouth opening as compared to Group A, the group taking drugs.

Patient compliance was better in the occlusal splint therapy group, although some patients complained about dryness of mouth, a squeezing sensation from the appliance, and a feeling of queasiness, all of which resolved within a few days. Four of the drug patients reported mild gastrointestinal distress, which disappeared when the drugs were discontinued.

However, the long-term effects of various NSAIDs (such as Ibuprofen) cannot be ignored. Nausea, upset stomach, ulcers, bleeding and perforations are a known side effect, and the drugs are contraindicated in patients taking diuretics or anticoagulants, and in patients with severe renal disease. Because of these limitations, it’s important to look for alternatives when considering treating chronic pain treatment.

The soft occlusal splint therapy tested in this study was not only a more effective myofasical pain treatment, but also safer when compared to extended drug use in patients with myofascial pain dysfunction syndrome. Advantages to the splint therapy also included cost-effectiveness over time, better patient compliance, and the possibility of reversing results.

Soft occlusal splint therapy in the management of myofascial pain dysfunction syndrome: A follow-up study by Venkatesh Naikmasur et al, Department of Oral Medicine and Radiology, SDM College of Dental Sciences, India, in Indian Journal of Dental Research, 2008, volume 19, issue 3, pp 196-203.