Published on 17 June 2021

in collaboration with Dr Raphael Bettach, dental surgeon

Dental aligners are more and more talked about and seem to impose themselves as an orthodontic treatment that is at the same time modern, effective and very discreet. But there are several types of dental aligners with very different functions: what are their uses? Should we be wary of the gutters offered on the net? The answers of Dr Raphael Bettach, dental surgeon.

What is a dental splint? A dental splint is a dental appliance, removable, which is made on measure to perfectly match the shape of the patient’s teeth.

“ The word gutter is generic and concerns several things at the same time. There are several types of aligners with very specific functions ”, specifies Dr Raphael Bettach, dental surgeon. When some are worn all day, others only at night, and still others only for a few minutes a day.

There are 5 main types of dental aligners with very specific roles and uses.

Orthodontic aligners What’s this ? The purpose of these aligners is to correct the positioning of the teeth, when they are badly aligned, overlapped, or spaced too far apart. It is therefore an orthodontic treatment, in the same way as dental appliances or braces. “ Orthodontic aligners must be changed every days by the patient over a period of ‘one or two years on average. Each new aligner makes it possible to correct the dental alignment a little more ”, explains the specialist. The patient therefore receives a kit of aligners that he must change every two weeks until the end of the treatment. These gutters are very comfortable and almost undetectable. The practitioner must nevertheless receive the patient regularly in order to check the progress and the good progress of the current treatment.

When should you wear it? Orthodontic aligners must be worn at all times except during meals and tooth brushing .

Price and reimbursement? “The treatment lasts an average of 17 To 24 months and it is billed per semester on average at the price of 2021 Euros, or 5200 euros for 2 years of treatment ”, specifies the dentist.

Partial reimbursement is provided by social security for patients under 15 years only. Above 16 years, only mutuals can help depending on the contracts.

Occlusal splint What’s this ? Dental occlusion is the way in which the teeth come into contact with those of the upper arch and those of the lower arch. The purpose of the bite guard is to treat diseases related to grinding of the teeth or poor contact between the two jaws.

“The most frequent indication is that linked to bruxism, which corresponds to uncontrolled and involuntary grinding of the teeth during the night ”, explains the dental surgeon.

By preventing occlusion, the splint protects the teeth from excessive abrasion, but also limits all other symptoms: headaches, joint pain etc.

The bite guard may also be prescribed for patients who suffer from temporomandibular joint pain – the pain that allows the lower jaw to move, open and close the mouth – due to a time difference between the lower and upper jaws: “ when they close their teeth, their TMJ is no longer in its resting position, which in the long term causes pain in the jaw but also in the cervical or even dorsal vertebrae ”, describes Dr Bettach. The splint is then used to rest the patient’s jaw.

How long and when should he wear it? Occlusal splints are mainly worn at night.

Price and reimbursement? The price of the bite guard is 172. 70 euros , supported at 64% by social security. The rest is generally taken care of by complementary mutuals.

Whitening gutter What’s this ? It is offered to people who wish to brighten their teeth. “It is a whitening product based on hydrogen peroxide which will be applied to the teeth using a dental splint ”, explains the dentist. Generally the first application is made in the office to explain the manipulation to the patient, then the following ones are made by the patient at his home.

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It is imperative that there is a prior consultation for a possible search for cavities, cracks of the teeth or significant gum problems that could contraindicate the tooth whitening technique.

How long and when should it be worn? Dentist-prescribed whitening trays are usually worn for one hour a day for two weeks .

Price and reimbursement? The average prices for gutters and bleaching products are 380 To 800 euros , without social security coverage.

Fluoridation gutter What’s this ? Fluoridation trays are prescribed to patients treated with radiotherapy on the face. “Radiation therapy tends to damage the salivary glands and affect their production of saliva, which makes the oral environment more conducive to development of caries ”, describes Dr. Bettach. The fluorination tray is filled with a fluorine-based product, which limits the risk of cavities during the treatment period of radiotherapy.

How long and when should it be worn? Fluoridation splints are worn for 5 minutes each evening for the duration of the radiotherapy treatment and some times after treatment.

Price and reimbursement? Fluoridation trays are generally made by the hospital stomatology department, and fully covered by social security.

Athlete’s gutter (mouthguard) What is it? Commonly known as “protect- tooth ”, the athlete’s mouthpiece protects the teeth when playing certain sports at risk of impact: football, rugby, hockey, basketball and of course all combat sports.

It is compulsory for most combat sports (boxing, taekwendo, Thai boxing…) and very strongly recommended for all others.

How long and when should it be worn? Finally, the athlete’s aligners must be worn during the sports session to protect the teeth shocks.

Price and reimbursement? They are billed between 300 and 800 euros depending on the complexity of the case and the sport practiced.

Gutters are thermoformed gutters, made from the patient’s dental impression made in the office which will serve as a mold for making the gutters. Thermoforming is carried out in the laboratory, with more or less flexible materials and more or less thick depending on the type of gutter.

“In orthodontic treatment, the aligners must be changed every two weeks so that ‘there is a progression of alignment. The patient therefore receives a kit of 17 gutters for one year, which he must therefore wear in a very specific order ” explains the dental surgeon.

9441804 Beware of products sold on the internet and without medical follow-up! More and more bloggers and influencers are praising the merits of alignment gutters accessible online, with kits impression for the teeth to make oneself, all without any medical follow-up.

“The prescription and the development of alignment gutters is exclusively the recourse orthodontist or dental surgeon: it’s a real professional job ”, insists Dr Bettach.

“When we shoot too fast or too hard on the teeth, the roots are damaged and atrophied. The risk in the long term is to damage or even lose some of his teeth ”, adds the specialist, for whom gutters badly adapted and without medical follow-up often do more harm than good.

In addition, once the orthodontic treatment is finished, when the teeth are finally aligned, it is essential to offer the patient post-treatment retention to stabilize the acquired result and prevent recurrence.

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