Nylon splints deliver improved patient comfort that contributes to increased patient compliance and better overall treatment outcomes.
In recent years, nylon splints have emerged as a highly effective alternative to traditional acrylic splints in dentistry.
From improved patient comfort to enhanced durability, nylon splints offer several advantages over their acrylic counterparts. However, along with the key benefits of nylon splints and their various applications, there are limitations that dentists should consider when opting for nylon splints.
Dr Damian Teo is a seasoned practitioner with nearly a decade of experience using nylon splints. He is Director of the Melbourne Dental Sleep Clinic, and an experienced sleep and bruxism dentist. He also consults out of the Melbourne TMJ & Facial Pain Centre, and previously worked in Darwin’s first official TMJ & Sleep Therapy Centre.
Dr Teo has a Masters of Dentistry from Latrobe University and a Post Graduate Diploma in Dental Sleep Medicine from the University of Western Australia, is a member of the Australasian Sleep Association (ASA), and completed extensive postgraduate training with world-renowned sleep medicine and TMJ disorder specialists.
Dr Teo shares his insights into why nylon is gaining popularity among dental professionals.
The advantages of nylon splints
One of the most significant advantages of nylon splints is their superior comfort. Comfort is a critical factor in the long-term success of any dental appliance, particularly one that patients are required to wear for extended periods, such as overnight splints for bruxism or sleep apnoea.
The superior comfort of nylon splints over traditional acrylic splints is due to two critical factors – an increase in flexibility, and a reduction in overall bulk. Nylon splints can be made to a minimum thickness of 1.5mm versus a hard splint of 2mm and hard soft splint of 3.5mm.
The flexibility of the nylon material contributes to improved patient comfort by allowing the splint to adapt more naturally to the contours of the patients’ teeth and gums.
“The stiffness of acrylic splints can feel very tight on people’s teeth,” Dr Teo explains. “This can lead to complaints from patients about discomfort. On the other hand, nylon’s inherent flexibility allows for a snug yet comfortable fit, which reduces the likelihood that patients will find the appliance too tight or uncomfortable to wear.”
Additionally, dental appliances that are too bulky can cause irritation or even trigger a gag reflex. This can lead to inconsistent use and compromise treatment outcomes. Nylon splints can typically be manufactured to be thinner than acrylic splints. This thinness reduces the overall bulk in the mouth.
“The reduction in bulkiness of nylon splints generally makes it easier for patients to tolerate the splint, especially during sleep when discomfort can be a major issue,” says Dr Teo. “This is an essential factor in ensuring that patients comply with the treatment.”
Strength is another critical advantage of nylon splints. Traditional acrylic splints can be prone to cracking or breaking. To avoid this, acrylic splints are often made thicker, which can exacerbate the issues of bulk and discomfort.
Nylon, however, offers the dual benefits of being both strong and flexible. This combination means that nylon splints do not need to be as thick as their acrylic counterparts to maintain durability. This is particularly beneficial in cases where a splint is needed for both the upper and lower arches, as thinner, more flexible nylon splints are less intrusive and easier for patients to wear comfortably.
This comfort improvement often encourages better patient compliance, which can have a direct impact on the effectiveness of the treatment. For example, in the case of bruxism, consistent use of the splint is essential to protect the teeth from damage caused by grinding and clenching. If a patient finds the splint uncomfortable or difficult to wear, they may not use it as prescribed, which can lead to worsening of the condition and the need for more extensive dental work in the future.
By providing a more comfortable and better-fitting splint, nylon increases the likelihood that patients will adhere to their treatment plan, leading to better outcomes. This increased compliance not only improves the effectiveness of the treatment but may also reduce the number of follow-up appointments needed to address issues such as discomfort or poor fit. As a result, patients can achieve their treatment goals more quickly, leading to a higher level of satisfaction with their care.
Dr Teo adds that the strength of nylon is particularly advantageous in preventing breakage, which is a common issue with acrylic splints.
“Because nylon has that flexibility built into it, it’s much easier to loosen without feeling too tight to the patient,” he notes. “This flexibility not only enhances the patient experience but also reduces the likelihood of needing to repair or replace the splint. This can lead to long-term cost savings for both the dentist and the patient.”
Best-practice applications for nylon splints
While nylon splints are widely recognised for their effectiveness in treating bruxism, their applications extend far beyond this condition. This adaptability is one of the reasons why nylon splints are becoming an increasingly popular choice among dental practitioners.
Bruxism, characterised by the grinding or clenching of teeth, is one of the most common conditions for which splints are prescribed. The traditional approach has often involved the use of acrylic splints to protect the teeth from the excessive wear and tear caused by bruxism.
However, the discomfort associated with acrylic splints can sometimes lead to poor patient compliance, which in turn diminishes the effectiveness of the treatment. Nylon splints, with their superior comfort and fit, offer a better solution. Dr Teo notes that since he has started using nylon splints, patient compliance has improved significantly with faster and more effective results.
Nylon splints are also highly effective in treating TMD – a condition that can cause significant pain and discomfort in the jaw, face, and neck. TMD is often exacerbated by stress or misalignment of the teeth and jaw, and the use of splints can help alleviate these symptoms by providing support and reducing strain on the temporomandibular joint.
“The flexibility of nylon splints allows them to better conform to the patient’s mouth, which provides a more even distribution of pressure across the teeth and reduces the stress on the jaw muscles and joints,” says Dr Teo. “This can lead to a significant reduction in pain and discomfort for patients suffering from TMD.”
Sleep apnoea – a potentially serious sleep disorder in which breathing repeatedly stops and starts – is another area where nylon splints have proven to be beneficial.
Traditional sleep apnoea splints made from acrylic are often large and bulky, which can make them difficult for patients to tolerate. The bulkiness of these devices can lead to discomfort, poor compliance, and reduced effectiveness.
Dr Teo recalls his experience with patients who struggled with acrylic sleep apnoea splints. “The biggest complaint people had with the acrylic sleep apnea splints was that they were just too bulky to comfortably fit in the mouth.”
Dr Teo says the introduction of thinner and more flexible nylon splints has significantly reduced these complaints. He says patients typically find the nylon splints easier to wear, which improves compliance and, consequently, the effectiveness of the treatment.
In addition to these applications, nylon splints can also be used in other dental treatments where a protective or supportive device is needed.
For example, they can be employed in orthodontic treatments to maintain the position of the teeth after braces have been removed and reduce the risk of post-orthodontic relapse.
Limitations of nylon splints
Despite the many advantages of nylon splints, there are certain situations where acrylic may still be the preferred material.
One of the primary considerations is the need for additional retention, particularly in patients with missing teeth. Retention is crucial in ensuring that the splint stays securely in place, and while nylon splints are generally effective, they lack the ability to incorporate clasps or wires that can be used with acrylic splints.
“With nylon splints, you can’t really add clasps or wires onto it to help retain onto teeth,” Dr Teo explains. “This can be a significant limitation in cases where retention is a challenge.
For patients with a significant number of missing teeth, acrylic splints may offer better retention because they can be customised with clasps to secure the splint more effectively. This customisation is particularly important in complex cases where the stability of the splint is crucial to the success of the treatment.
In such cases, the ability to modify the splint with additional retention features can make a significant difference in the outcome. This would typically make acrylic a more suitable choice.
Another important factor to consider is the potential need for relining. Over time, changes in the patient’s oral structure, such as tooth movement or the placement of new crowns or fillings, can affect the fit of a splint. Relining is a process by which the inside of the splint is remoulded to fit the updated contours of the patient’s teeth and gums.
While acrylic splints can be easily relined by adding cold cure acrylic, this is not possible with nylon splints. “You can’t reline nylon. You need to remake the splint from scratch,” says Dr Teo. “This can be a drawback in cases where frequent adjustments are anticipated.”
The inability to reline nylon splints means that dentists must carefully assess the likelihood of needing future adjustments before choosing nylon for a patient. In cases where significant dental work is planned, or where the patient’s oral structure is likely to change, acrylic may be the more practical choice.
The need to completely remake a nylon splint in the event of a poor fit or necessary adjustments can also lead to higher costs, both in terms of lab fees and the time required to produce a new splint.
Workflow considerations for nylon splints
From a workflow perspective, the use of nylon splints can lead to significant time savings and increased efficiency in dental practices. Dr Teo has observed that the process of inserting and adjusting nylon splints is generally faster and requires fewer appointments compared to acrylic splints.
“This efficiency is largely due to the improved fit and comfort of nylon splints, which often require minimal adjustments once they are inserted,” he says.
The insertion process for nylon splints is typically quick and straightforward. Dr Teo says he rarely needs to make adjustments at the time of insertion, which is a significant departure from his experience with acrylic splints.
“It typically takes me approximately five minutes to insert a nylon splint without the need to make adjustments,” he explains. “In contrast, acrylic splints often require multiple adjustments during the insertion process to address issues such as tightness or discomfort, which can extend the appointment time and necessitate additional follow-up visits.”
The reduced need for adjustments also has implications for patient satisfaction and practice efficiency. Patients appreciate the convenience of having a splint that fits well from the start, without the need for multiple visits to achieve the desired comfort level.
This not only improves patient satisfaction but also reduces the overall workload for the dental practice, allowing practitioners to see more patients or focus on other aspects of patient care.
Moreover, the workflow for creating nylon splints aligns closely with that for acrylic splints, which typically makes it easy for practices to incorporate nylon into their existing processes. The steps involved in taking impressions or digital scans, sending them to the lab, and receiving the finished splint are essentially the same, with no need for additional training or equipment.
This seamless integration into the existing workflow makes nylon splints an attractive option for practices looking to improve efficiency without disrupting their current operations.
The final word
In conclusion, nylon splints have become a valuable tool in modern dentistry. Their improved comfort, strength, and flexibility make them a superior choice for many applications, from treating bruxism to managing sleep apnea.
The reduced need for adjustments and follow-up appointments further enhances their appeal, making them a time-efficient option for both dentists and patients.
However, it is essential to consider the specific needs of each patient, as there are situations where acrylic may still be the more appropriate choice, particularly when retention or the ability to reline the splint is a concern.
By understanding the benefits and limitations of nylon splints, dentists can make informed decisions that lead to better patient outcomes and more efficient practice management.
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