Disclosure: QuickSplint has provided me with product at no cost in the past. I’m not paid for this post, and the opinions are my own from clinical use.
QuickSplint is a chairside anterior bite plane. In my endodontic practice, there are four indications for it.
1. Diagnosis. Diagnosis is the most common indication for QuickSplint. It’s also the most complex to understand.
2. Managing endodontic post-treatment biting symptoms. Occasionally patients will have post-operative biting sensitivity that lingers beyond a week. In those instances, the most common cause is an inflamed periodontal ligament. Sometimes it’s impractical or undesired to adjust the occlusion enough to let it rest and heal. A couple of weeks of splint therapy can often resolve those symptoms.
3. Trismus. Trismus, or limited opening, can occur both pre-operatively and post-operatively. While it is sometimes a result of the fascial planes responding to the infection, it is most commonly associated with parafunction secondary to an infection. Post-operative trismus can present in the absence of infection. It’s most commonly related to muscle exacerbation from being held open, which can then precipitate post-operative parafunction and the resulting trismus.
4. Management of myofascial crisis. Myofascial pain is fairly common; however, it can escalate to absolute misery. The masseter trigger point can be acutely painful in these instances. Trismus may be present. Pulpal and periodontal pain in multiple teeth is common, as are gingival marginal soreness and discomfort on palpation. In some instances, swelling can be observed in the absence of infection. Often, splint management is augmented with a low dose of a benzodiazepine to help break the parafunctional cycle and de-escalate the crisis.
The rest of this post focuses on the first one: diagnosis.
A clencher walks in with a “toothache.” Percussion is tender on two or three teeth. One tooth screams on cold. Another barely answers. The radiograph is clean. Which tooth is it? Maybe none of them.
This is the problem I built my “Splint Therapy: A Diagnostic Aid in Endodontics” lecture around. Parafunction adds noise to every test we run. A short course of anterior splint therapy takes the noise out, so the tests start telling the truth again. QuickSplint is one of the tools I use to do that.
Diagnosis is a probability game
Differential diagnosis is really the probability of detection. No test we use is perfect, and each one carries a different level of confidence. The radiograph, cold, percussion and EPT each sit somewhere on that scale, and none of them sits at 100.
Two words matter here:
- Sensitivity is how well a test finds the true positives, so the false negatives are few. It is the share of sick teeth correctly called sick.
- Specificity is how well a positive really means the condition you are looking for and not something else, so the false positives are few. It is the share of healthy teeth correctly called healthy.
Get it wrong one way and you have a Type 1 error: a false positive, a false alarm, too much gullibility, a lack of specificity. Get it wrong the other way and you have a Type 2 error: a false negative, a miss, too much skepticism, a lack of sensitivity. In endo, a Type 1 error can mean a root canal on a tooth that did not need one. A Type 2 error means the sick tooth gets missed.
What parafunction does to your tests
Parafunction pushes up the false positives and the false negatives on both percussion and cold. Put another way, it drags down the sensitivity and the specificity of the very tests we lean on most.
So before you trust the tests, look for the clencher.
Signs of parafunction
- Incisal wear
- Noncarious cervical lesions
- Canine wear
- Molar wear facets
- Anterior fremitus
Symptoms of parafunction
- Myofascial pain
- Headaches
- Percussion sensitivity on one tooth or several
- Pulpal inflammation
- Trismus, or pain with limited opening
Correlative factors
- Stress and pain
- New restorations or a change in the occlusion
- Sleep apnea
- Systemic conditions
- Pulpal or periapical inflammation itself
There is literature behind some of these links. In one study of sleep bruxers, noncarious cervical lesions showed up in 39.7% of bruxers versus 12.1% of controls, and 62.1% of bruxers reported tooth hypersensitivity versus 36.4% of controls (Ommerborn et al., J Prosthet Dent 2007). The same group found that people with more sleep bruxism activity tended to report more stress at work and in daily life (Giraki et al., Head Face Med 2010). Those were low to moderate correlations, not proof of cause.
Why an anterior device
NTI stands for Nociceptive Trigeminal Inhibition. The idea behind an anterior device is simple: let only the front teeth touch, keep the posterior teeth apart, and the closing muscles cannot fire as hard.
A 1999 study in the Journal of Prosthetic Dentistry tested a prefabricated anterior bite stop in 30 subjects. With the stop in place, EMG activity of the anterior temporalis, posterior temporalis and masseter dropped during both clenching and grinding (Becker et al., 1999). A 2008 systematic review of the NTI-tss device concluded that it “may be successfully used for the management of bruxism and TMDs” (Stapelmann and Türp, BMC Oral Health 2008). That same review warned about unwanted effects on single teeth and the occlusion, and said to use it only when the patient will come back for follow-up.
My lecture covers several anterior devices: the NTI-tss, the Pankey tab, a chairside NTI made from VPS, and QuickSplint.
Why do I reach for QuickSplint? It doesn’t lock on the way a Pankey tab can. I’ve had that happen, and it was a bad experience. QuickSplint is made chairside. And in my experience, when it’s made with putty polyvinyl siloxane, it lasts longer than the other options.
What QuickSplint is
QuickSplint is a chairside anterior bite plane for the upper or lower arch. It has two parts: a rigid plastic shell, and a liner of fast-set VPS (heavy-body or putty) that you inject to fit the patient’s teeth. No adhesive. Your assistant can make it in minutes and the patient leaves wearing it.
It is designed for short-term use. The maker says up to about six weeks, mainly at night. Past that, think about a lab-made appliance. They also warn it can contribute to posterior teeth shifting if worn long term.
It is FDA 510(k) cleared. The indications are protection of teeth and restorations from bruxism or clenching, and temporary relief of TMD and bruxism-related pain. The clearance was based on substantial equivalence. No clinical data were submitted.
What it is not
It is not a trauma splint. It will not hold a luxated central in place. The manufacturer says so plainly: do not fit it over loose or broken teeth, and it is not for emergencies involving broken teeth or trauma. For avulsions and luxations, you still want a flexible splint bonded to the neighbors. I covered that kind of case in Decoronation of an Ankylosed Tooth and Trauma, Resorption, and Decoronation.
A case: one patient, two quadrants
This is one patient, tested in the upper right (#2 to #5) and the lower right (#28 to #31).
Before the patient wore a QuickSplint, the upper right was noisy. Cold was + on #2, #4 and #5 but +++ on #3. Percussion was ++ on both #2 and #3, and within normal limits on #4 and #5. Two tender teeth and one exaggerated cold response.
The lower right looked quieter. #31 did not respond to cold, while #28 to #30 were +. Percussion was within normal limits on all four.
After a course of QuickSplint wear, the upper right evened out. Percussion was within normal limits on #2 to #5, and cold was a plain + on all four. Nothing pointed at any one of those teeth anymore.
In the lower right, #31 still did not respond to cold while #28 to #30 stayed +, and percussion was still within normal limits. At a subsequent treatment appointment, percussion on #31 came up +++, with #28 to #30 still within normal limits. #31 turned out to be necrotic and cracked.
With the noise gone from the upper right, the one tooth that was actually sick stood out. It’s not uncommon for infected teeth to upregulate parafunction. That is why pulpal and periapical inflammation is on the list of correlative factors above.
That is the point of splint therapy as a diagnostic aid. It raises the sensitivity and specificity of our tests and lowers the false positives and false negatives on percussion and cold.
The follow-up
We typically wait two weeks and follow up with a phone call. If symptoms persist, we retest. If all symptoms resolve, we hand off to the general dentist for a full-arch, lab-fabricated splint.
If their symptoms localize or intensify, don’t wait the full two weeks. Bring them in for retesting.
How it is made
The maker’s steps are simple. Have the patient bite on the empty tray to see how it sits. Fill it to overflowing with heavy-body (putty) VPS, including the midline slot. Seat it, have them bite gently, and let it set. Trim the excess with a blade. Check that you have even contact on both sides with no posterior contact.
I usually place it on the upper arch, as shown in the photos.
Where it does not belong
Skip it, or be careful, with missing teeth, loose or broken teeth, a history of joint problems, or limited or excessive opening (the maker lists under 25 mm or over 60 mm). If the patient has joint pain loading the splint, stop and re-evaluate.
Versus a lab-made appliance
A lab-made guard fits better and lasts longer. It also takes weeks and costs more. QuickSplint is the bridge. It is for today, not for forever.
That is why, when all symptoms resolve after the two-week follow-up, we hand off to the general dentist for a full-arch, lab-fabricated splint.
What the evidence says
For QuickSplint itself, not much. A PubMed search for “QuickSplint” and “quick splint” turned up no studies of the product. The supporting evidence is for anterior bite stops in general, like the Becker EMG study and the NTI-tss review above. I could not find any study that tests an anterior device as a diagnostic aid for pulp or periapical testing. That part rests on clinical reasoning and cases like the one above.
The bigger picture on splints for TMD is also cautious. A 2024 Cochrane review of 57 trials found the evidence on occlusal interventions for TMD inconclusive and very uncertain (Singh et al., Cochrane 2024). Treat QuickSplint as a low-risk, short-term tool that helps you read your tests, not as a proven cure for anything.
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This is education, not a substitute for your own clinical judgment.