Effectiveness of exercise therapy versus occlusal splint therapy for the treatment of painful temporomandibular disorders: a systematic review and meta-analysis.

Researchers compared two common treatments for painful temporomandibular disorders, or TMD, which is jaw joint and muscle pain that affects how people chew and move their mouth. They looked at six randomised controlled trials involving 498 patients, about half of whom received occlusal splint therapy (a custom-fitted dental device) and half who did therapeutic exercise. When they pooled the results, exercise therapy did not appear better than splint therapy for reducing pain.

The two approaches also produced roughly equivalent improvements in how widely people could open their mouths and move their jaws side to side. The authors were cautious about their conclusions, noting that the number of studies was small and the differences between treatments were tiny, so no clear winner emerged from the current evidence.

This study looked at whether exercise for your jaw and face muscles works better than wearing a custom splint (a thin plastic device that fits over your teeth) when you have painful TMD. Researchers found that both approaches seemed to help people in similar ways, with neither one standing out as significantly better for pain relief.

Both also appeared to improve how wide you could open your mouth and the range of side-to-side movement in about the same degree. The honest truth is that the research so far is not detailed enough to say one treatment is clearly preferable to the other, which means your own experience, comfort, and what fits your life may matter as much as what the studies show.

Your healthcare provider can discuss what might work best for your specific situation and what your preferences are.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This meta-analysis identified six RCTs comparing exercise therapy to occlusal splint therapy for painful TMD, with roughly equal group sizes (247 exercise, 251 splint). The primary finding was non-superiority of exercise over splints for pain reduction, with a weighted standardized mean difference of only 0.29 and a confidence interval that crossed zero (95% CI, 0.62 to 0.04).

Mandibular mobility measures across four dimensions (maximum opening, bilateral laterotrusion, protrusion) showed equivalent outcomes between groups, with minimal effect size differences. The authors appropriately highlighted methodological limitations, including small overall sample sizes in the pain subanalysis and trivial standardised mean differences for both primary outcomes.

The evidence does not support preferential selection of one modality over the other based on current data, and the authors rightfully called for additional high-quality RCTs before stronger conclusions can be drawn. This null finding itself is clinically informative for shared decision-making, though it leaves space for individual patient factors and clinical judgment.