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Riley P, Glenny AM, Worthington HV, et al. Oral splints for patients with temporomandibular disorders or bruxism: a systematic review and economic evaluation. Southampton (UK): NIHR Journals Library; 2020 Feb. (Health Technology Assessment, No. 24.7.)

Cover of Oral splints for patients with temporomandibular disorders or bruxism: a systematic review and economic evaluation

Oral splints for patients with temporomandibular disorders or bruxism: a systematic review and economic evaluation.

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Treatment options for people experiencing temporomandibular disorders (pain and/or restricted movement in and around the jaw joint) include splints, which are removable appliances, often similar to a mouthguard. They are provided to patients to help ease pain in the mouth, face or jaws. They are also used to manage the symptoms of temporomandibular disorders, such as frequent headaches/migraines, clicking jaws, restricted mouth-opening or tooth wear from the grinding of teeth (bruxism). There are many types of splints.

This research looked at the evidence addressing the primary question of whether or not splints work (regardless of type of splint) in reducing the pain associated with temporomandibular disorders and/or tooth wear, and if they offered value for money. Patients were involved in the research to ensure that the question and the outcomes that were measured were appropriate.

A systematic review of the literature was undertaken to find all randomised controlled trials including patients with temporomandibular disorders or bruxism. Online databases of research publications were searched, and these searches were checked, to identify relevant trials. All stages of the review process were undertaken to the highest standards by two people, independently and in duplicate, using well-respected and recognised Cochrane methods. We conducted a value-for-money assessment, comparing the trial data with the costs of splints to see if splints are a cost-effective use of NHS funding.

There was no evidence that splints reduced pain when compared with not wearing a splint or when compared with a minimal treatment (like jaw exercises, advice or education) in patients with temporomandibular disorders. The evidence was assessed as being of very low quality; therefore, it remains unclear whether or not splints are good value for money, or if they should be paid for by the NHS.

This research showed that more well-conducted trials on temporomandibular disorder patients are needed.

Copyright © Queen’s Printer and Controller of HMSO 2020. This work was produced by Riley et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.
Bookshelf ID: NBK553651


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