A bite splint, the little guard some people wear at night, is one of the most common things offered for jaw pain and clenching. Hands-on manual therapy is another. This review asked a fair question that a lot of patients wonder about: how do the two actually compare?
The authors gathered nine randomised controlled trials with 426 people, 180 who had manual therapy and 246 who had splint therapy, and pooled the results for pain, mouth opening, disability and quality of life.
People often arrive having already tried a splint and want to know what else can help. This review gives us a clearer, evidence-based way to talk through the options.
Hands-on techniques for the jaw, face and neck, including soft-tissue work, joint mobilisation and stretching of the muscles that move the jaw.
A custom dental splint or bite guard worn to change how the teeth meet and to take load off the jaw joint and muscles.
The two approaches came out closer than you might expect, with manual therapy having the edge on some measures.
For pain intensity there was no clear winner between the two, though splints edged ahead for muscle-driven (myogenic) jaw pain.
Manual therapy came out ahead for maximum mouth opening, with a medium-sized effect in its favour.
Manual therapy showed a large effect for reducing jaw-related disability compared with splints.
Neither approach clearly beat the other on overall quality of life.
Manual therapy and bite splints were about even for pain, but manual therapy did better for jaw movement and disability. The authors suggested the two can work well together, rather than being either-or.
This is encouraging for hands-on care. It suggests manual therapy holds its own against a common dental option, and may do more for how freely the jaw moves and how much it interferes with daily life.
It also points to teamwork. The authors recommended combining approaches, which fits how we like to work alongside a person’s dentist so the muscle side and the dental side are both looked after.
Supports hands-on treatment of the jaw and neck muscles as a genuine option for TMD, on par with or better than splints for movement and disability.
Backs manual therapy for improving jaw function, ideally coordinated with dental care.
Reinforces massage of the jaw and neck muscles as part of settling jaw symptoms.
Complements needling of tight jaw muscles within a wider manual therapy plan.
This was a modest set of studies, nine trials with a few hundred people, and some were small. The authors flagged a risk of publication bias for the pain results and limited long-term follow-up, so we should read the findings as promising rather than the final word.
Jaw pain has many drivers, so the best plan is usually individual and coordinated with your dentist or doctor where dental factors are involved.
Across nine trials, manual therapy matched bite splints for pain and did better for jaw movement and disability in people with TMD. Far from being rivals, the two look like useful partners in a jaw-pain plan.
Manual Therapy Techniques Versus Occlusal Splint Therapy for Temporomandibular Disorders. Villar-Aragon-Berzosa V, and colleagues. Dentistry Journal, 2024. Please confirm the full citation at the source before publishing.
