Article
Authors' Response
We thank Mr Everatt for his letter criticizing our article. His concerns relate to our description of anterior bite plane type splints in general and to the use of the SCi splint in particular.
It was not the purpose of the article to criticize or promote any particular splint. Similarly, it was not the purpose of our article to describe in detail features of any particular splint. We recognize that the SCi product range includes a wider variety of splints than the type mentioned in the article. We are grateful to Mr Everatt for highlighting that, although SCi splints are relatively small, there have been few if any cases of SCi type splints having been swallowed or inhaled.
The purpose of the article was to describe different types of splints (classifying them by the way they made contact with opposing teeth) and to examine the evidence relating to their effectiveness in managing bruxing and TMD.
We acknowledge that any unreferenced opinions included in our article are just opinions, however our conclusions are based on best evidence including systematic reviews.
Our conclusion in respect of bruxism was that the effects of splints on bruxism are not well understood. The article notes studies showing variable individual responses to splints. Reference was made, however, to a study that showed SCi had a strong inhibitory effect on clenching compared to a stabilizing splint.
Our conclusion in respect of use of splints for TMD was that there is no evidence for the therapeutic superiority of any form of splint. Practitioners must be aware of the relative advantages and disadvantages of different types of splint. Part-contact splints in particular can produce occlusal changes in some patients. Follow-up appointments for all patients who have been provided with occlusal splints should include assessment of the occlusion to ensure that there are no adverse changes.