The Cheapest Splint Is Rarely the Least Expensive

Let's be blunt about something the profession doesn't discuss enough: the price on the lab invoice is not the price of the treatment.

A Talon® splint costs more than a conventional acrylic splint or a vacuum-formed dual laminate. That's true. But comparing splints on invoice price alone is comparing the wrong number.

The number that matters is what happens at delivery.

Two things happen because of the Talon material, and the second follows from the first.

There is no internal adjustment. With a hard acrylic splint, the appliance often doesn't go completely to place on the first try. Something blocks full seating — an undercut, a contour, a variation in tooth position — or it binds interproximally and hurts. So before you evaluate anything, you're working on the inside of the appliance: mark the tissue side, relieve the tight area, reseat, mark again, until it's both fully seated and comfortable. That's chair time spent before you've touched the occlusion, and it produces nothing. The resilient Talon surface gives sufficiently to seat around those contact points. It goes to place fully and comfortably on the first try.

And there's a corollary worth knowing before it happens to you: if a Talon doesn't seat, stop. With a rigid splint, relieving the inside of the appliance is normal technique, so you keep working until it goes to place. With a Talon, that instinct will cost you. The material already accommodates ordinary variation — so if you still need to adjust internally, the discrepancy isn't minor, and it almost always means the records were inaccurate. Grinding won't rescue that appliance. It was built to records that didn't represent the patient, and it isn't going to fit properly no matter how long you work on it. Take new records and have it remade. That costs a few minutes. Continuing to adjust costs the rest of the appointment and still doesn't get you an appliance you want to deliver.

And because it's properly seated, the occlusal adjustment is minimal. This is the more valuable of the two. An appliance that isn't seating all the way will hit high — its occlusal surface isn't where the lab built it to be, so the relationship with the opposing arch is simply wrong. It makes no sense to start adjusting the occlusion at that point, because you're adjusting an appliance that isn't where it's supposed to be. Grind it, it settles further, the contacts change again. When the appliance seats fully and comfortably, that circular problem never starts. The occlusion you're checking is the real occlusion, and the adjustments needed for appropriate contact with the opposing arch should be minimal, and are frequently unnecessary.

Worth noting: this holds with or without a construction bite — and it's particularly true when you send one. The construction bite makes sure the appliance is designed to the relationship you want. The material makes sure it actually arrives at that design in the mouth. Different problems. You get the material's benefit on every case, and when the two are combined, delivery becomes genuinely uneventful.

Now the arithmetic.

Dentist production runs somewhere around 500 dollars an hour. Ten minutes of chair time is about 83 dollars. Fifteen minutes is 125. Thirty minutes is 250 dollars of production, gone, on one appointment.

The entire price difference between a Talon and any other splint we make is erased by fewer than fifteen minutes of chair time. Against our conventional acrylic splints, fewer than ten.

Ten minutes of seating and occlusal adjustment isn't a difficult delivery. It's an ordinary one.

Which means that on a great many cases, the less expensive appliance is the more expensive appliance — and you pay the difference in the operatory, out of your own production, rather than on the lab invoice.

To be fair: the less expensive appliances we make aren't poor appliances. They have real indications, and we make them for that reason. But when you're doing therapeutic splint work where seating accuracy and occlusal precision matter, saving a modest amount on the appliance and paying it back several times over in chair time isn't thrift. It's penny wise and pound foolish.

My approach to helping doctors has always been the same: best care for the patient, delivered economically, with the dentist making a good living doing it. An appliance that seats, needs little adjustment, and actually gets worn serves all three at once.

The Talon isn't the cheapest splint. It's frequently the least expensive one.

Read the full economic and clinical case in our Talon Splint Practice Building Bulletin. 

Written by Dr. Rob Veis, DDS. President of SML