Splint Therapy: Time Is On Our Side

By: Will Kelly DMD
Article Originally Appeared on PankeyGram.org

My experience with splint therapy was like most dentists prior to developing the skills taught at Pankey. In fact, my appliance was not really therapy at all. Perhaps just a shot in the dark “helmet” that protected teeth against collisions with very little intention.

Throughout the years there have been many facets of my experience I value greatly in guiding patients to health using plastic.

Splint Therapy and Appliance Design

Appliance design is a provisional analog (that is, a practice replacement) for any changes we make to the teeth and ultimately the stomatognathic system. The splint is a great diagnostic tool that is capable of healing, but it’s also an iconic part of the behavioral interaction between the provider and the patient.

Aside from physically being an orthotic analog, the splint is a training tool, maybe even the greatest reversible “do-no-harm” in our profession. Case by case, each patient experiences changes and familiarizes themselves with my touch and caring.

Month by month and year by year dentists educate themselves and develop an understanding of bite relationships by using therapy. This happens case by case too, much like waxing cars and painting fences for Mr. Miyagi. As the experiences compile, sometimes our questions do as well. Sometimes we turn to our mentors for answers, much like the Karate Kid.

For the learning dentist, different parts come together when bringing splint therapy from the classroom to the operatory. There is the initial understanding of the “why” that can be conceptualized in theory, but not realized in practice until the “how” of the technical piece arrives through experiential understanding.

Each provider comes into their own by developing skills to have patients relate needs and eventually invite them confidently to enter appliance therapy.

Time Is on Our Side

Early in my career, I became frustrated with splint therapy. In the clinical area, it was working. In theory, it made sense to me that I should be able to take the appliance back through well-articulated CR casts and ultimately to my patient’s mouth.

Turned out, that patients treated with splints were not beating down my door for definitive dentistry. Like Mick Jagger, I Couldn’t Get No Satisfaction. A decade later, I have experienced something magical happening and am singing a new Rolling Stones song in my head, Time is On My Side. (Yes it is!)

Time and Splint Therapy

Perhaps I was not waiting on my patients or more than likely they were waiting on me.

I have hundreds of splints on unrestored patients who visit me a couple of times a year. They bring along the plastic to have it ultrasonically cleaned, sometimes tweaked, sometimes repaired.

There was a time when I believed the transition to treatment was a given once the appliance was well-adjusted on a patient willing to trust me with their investment in therapy. (I mean geez, that happens every time for the folks who taught me how to make one, right?) The presentation of the next phase was a conversation that probably sounded a whole lot like a sales pitch and generally fell flat on its face.

Time is on our side. I’ve grown to realize the virtue of patience and listening. Specifically, I listen for compliments, appreciation of the appliance, and sometimes simply a statement of dependency on the plastic. Sometimes this takes years. This is the time to ask, “Would you like to discuss dentistry that can make your teeth feel this way?” Sometimes they outright ask me.

Time is on our side. Appliance therapy is a seed. Our caring attention is a well-nurtured garden. Patients will bloom when they are ready.

Dr. Will Kelly

Dr. Will Kelly

Dr. Will Kelly is an experienced leader and trusted provider in the field of Esthetic Restorative Dentistry and Dental Implants. He is passionate about great results and has pursued training and understanding the complexity of advanced, well-designed dentistry throughout his career. This willingness to operate a practice based on a high standard of care requires a dedication to practice dentistry differently, separating himself from the average and traditional dental model. Dr. Kelly has developed a practice philosophy that creates a unique experience for patients seeking ideal results. Dr. Kelly is a creative individual with passion for art that transitioned childhood talent in drawing, painting, and sculpture into the art of dentistry. After attending the School of Design at North Carolina State University, he pursued the profession of his father seeing the possibility to apply his passion for creation, imagination, and critical thinking toward dentistry. Dr. Kelly is full of curiosity and views dental health care as an opportunity to improve the lives of others. He challenges himself to stay in front of this medical discipline which has endless possibilities to provide health and wellbeing. His dedication to being an innovator in an ever advancing body of knowledge and technology in modern dentistry is greatly appreciated by those he serves.