Chin Sling :: A Revolutionary New Treatment
The Chin Sling is a revolutionary new way to treat malocclusion caused by TMJ (Temporo Mandibular Joint Syndrome) without invasive dental work. A large proportion of malocclusion cases may be due to TMJ and not to a genetic misalignment of the teeth. After an initial planing, the "Chin Sling" provides support to the jaw, encourages normal wear of the teeth, and helps build muscle.
Attending animal dentist: Dr. Loïc Legendre.
Read his online article: Malocclusions in guinea pigs, chinchillas and rabbits.
- See also: Forum Thread
On this page: Pinta's advice regarding dislocation of the jaw.
To purchase a chin sling and for veterinary and physical therapy consultation contacts, please have your vet or animal dentist email Pocket Pet Concepts Inc. at email@example.com
My 3-year-old guinea pig with malocclusion was getting his molars planed about once a month. Despite regular dental maintenance, Willie continued to lose weight. I began observing him while he ate and while he didn't eat, and noticed his mouth was hanging slack - always slightly ajar. A recheck with Dr. Legendre showed his bite to be perfect. I remembered Dr. Legendre telling me about his collection of guinea pig and chinchilla skulls with maloccluded teeth and worn down bones at the jaw (mandible). This led me to believe the problem might be the jaw (ligaments or muscles), not the teeth.
We took Willie to see an animal physical therapist, Cynthia Webster. She doubted the jaw slackness was due to ligaments and suspected a muscle problem: As he aged, his jaw muscles had become slack, making it difficult for him to chew and allowing his molars to overgrow. His muscle response was proved with an electric prod and it was concluded that he required therapy to stimulate muscle tone and something to hold his jaw in place. Something flexible, breathable and rigid.
I got some scrap neoprene, Velcro, and designed a Chin-Sling for jaw support. Twice a day we stimulated his jaw muscle with an electric toothbrush massage. 2 minutes each side and 1 minute under chin to stimulate the tongue muscle. The difference was remarkable. His mouth no longer hung slack. And he was a different pig. Active and lively. Cynthia Webster believes he had a chronic headache from his slack jaw and now that the muscles had been stimulated and his jaw had support, his headaches, or jaw ache, had disappeared allowing him to eat with no pain.
Willie was first diagnosed with malocclusion in November, 1999. He required planing every 4 weeks until January, 2000, when he began wearing his Chin-Sling. He has not required any dental work since that time. His malocclusion has been controlled by wearing a Chin-Sling nightly. He is almost 5 years old now (Aug,2001).
Below is a history of Willie's malocclusion and treatment with the Chin-sling.
11-30-1999 - the first intimation that there was a problem
On Sunday when Willie had his weekly weighing, we noticed there was a weight loss trend. Since the beginning of Sept. he had gradually lost 4 ounces. Looking further back, we saw that he had lost 2 ounces from May to August. In total, he'd gone from 2lb.13 oz. in May to 2lb.7 1/2oz. on Sun. None of the other pigs were showing any weight loss (except for a couple who were on meds. for a while). He was eating (although obviously not enough to maintain), his front teeth looked good and aside from his chronic asthma seemed the picture of health.
So we took him into the vets to have his back teeth checked. Yep, they needed grinding. Apparently there was even a bit of tongue entrapment happening. This is what was slowing down his eating. We caught it early. The vet was happy with his tooth alignment and thinks it will be fairly easy to maintain his molars.
We will have to watch him and most likely he'll require grinding every 4 to 6 weeks but he is already eating. Ate a Critter Berry with gusto.
posted 12-28-1999 01:37 AM
Today Willie went in for his checkup. He'd lost a couple of ounces over the month. The vet has been examining some skulls with malocclusion and has noticed a wearing of the - for want of a better word - jaw hinge. As the pig ages, the "hinge" wears down resulting in the mouth being slightly open. The teeth don't grind properly anymore.
Having seen the progression over a month, he planed the back teeth to compensate for the worn jaw hinge. This time, he ground the teeth much more drastically. Willie's mouth now closes perfectly. He probably won't need another trim for 6 weeks. Due to his worn "hinge" he will need maintenance trims for the rest of his life. Caught early, the vet thinks he'll do fine.
Fri, 21 Jan 2000
Hi, Willie is still not putting the weight back on and I'm thinking more and more that a "face lift" is the answer. The question is: Could he end up worse than he is now? Or at the worst, would he just end up in the same shape? He's probably due for a teeth trim at the end of January. In other words: is it a case of "it couldn't hurt?"
Thu, 27 Jan 2000
Willie's weight last May was 2 lb. 13 oz. He's now down to 2 lb. 4 oz. He was 2 lb. 7 oz. at the time of his first teeth trim. We occasionally forcefeed to keep him at the 4 - 5 oz. mark. He doesn't seem able to gain back his weight after filing. I'm thinking that his jaw is getting slacker all the time. He seems to need trimming every 4 weeks, rather than 6 to 8.
Is there any way you can measure the slackness of the jaw to see if it is dropping continually? Is there is a drug therapy that will tighten up the jaw ligaments? Want to make one up?
Sat, 29 Jan 2000 from Dr. Legendre
"Is there any way you can measure the slackness of the jaw to see if it is dropping continually?" Not that I am aware of. "Is there is a drug therapy that will tighten up the jaw ligaments?" Not drugs but in humans they use TENS machine which stimulate the muscles fibers. I wander if we could get a physiotherapist interested. There a physio at the Animal Critical Care Group, her name is Cindy. I wander if we could "try" something. "Want to make one up?" Working on it! Loïc >>+
Feb. 9th and 16th we visit the physical therapist and the Chin-sling is designed.
Mon, 21 Feb 2000
Well, this is interesting. Willie is happier and eats better when he's wearing his sling!??!!? He can only wear it for 12 hours at a time or his ears swell. I have to finetune the design to keep the pressure off his ear base. I'm beginning to think his jaw is uncomfortable without support.
Mon, 21 Feb 2000 - from Dr. Legendre
People with TMJ problem also feel better when they have their bite guard on. The appliance or sling in this case removes the pressure on the muscles trying to shift the mandible. This is good news. Take some pictures with the sling on, this may be an important step forward in the treatment of GP with malocclusion.
Wed, 23 Feb 2000 21:11:01 -0800
It is working. Willie has shown vast improvement in just one week. The therapist feels he wasn't eating properly before, because his jaw muscles were aching all the time. When he did eat - the chewing action was probably giving him a headache and taking away his appetite. The sling supports his jaw and takes the strain off the weakened muscle, as you surmised. Cynthia has prescribed twice-daily electric toothbrush massages and 3 or 4 times daily holding-his-mouth-closed-while-he-chews sessions. He is also to wear his sling 8 hours on, 1 hour off for 1 week - 6 hours on, 2 hours off for 1 week and 4 hours on, and 4 hours off for 1 week and then we have another appointment. She has suggested that I trademark (patent?) the chinsling.
So far, we have only treated him for 2 weeks (starting Feb. 20) - so the results are extremely preliminary - but within 1 day of wearing his chin-sling the difference in personality was remarkable - it really was like a headache had lifted. He is now acting like a 1-year-old instead of a 4-year-old. And yes, he is eating much better.
4 times a day we are also to gently hold his mouth closed while he eats for 2 minute sessions to retrain him to chew properly.
Mon, 13 Mar
Willie has lost a little weight - but it might be because he is so active now. He is going a mile a minute all day chasing the other boars and making a nuisance of himself with the sows. It's like he's making up for lost time. Ordinarily, he would have been due for a planing at the beginning of March.
Come Wed. he will have had his muscle treatment for 3 weeks. He may still need a grinding done. I don't know if he would be able to grind them himself with just the chewing action or whether he's only capable of maintaining the molars when they are at the proper length.
Willie saw his physical therapist today - and briefly, Loïc. The treatment has been declared a success. His teeth are 3 weeks overdue for a planing - but don't need it. His mouth is now closed and he has proper muscle action when he chews. A difference of night and day in 3 weeks. April 28 he'll get sedated for a full dental exam, pictures, xrays.
He is now down to 2 hours of chin-sling on - 6 hours off. It is conceivable that he might have to wear it at night while in the cage (much like humans with mouth guards) as a longterm therapy. But this is preferable to filing his teeth once a month. The therapist was amazed at the difference in him - attitude and nonstop chowing down on grass. She says as he continues proper chewing action - his muscles will get stronger and stronger.
We all think that this might be the tip of the iceberg and that a huge percentage of malocclusion in senior pigs may be treatable with simple, noninvasive jaw muscle therapy.
Tue, 28 Mar 2000
Hey! Is it possible to tighten the jaw muscle too much? Willie's top teeth look to be a little on the short side and his bottom teeth look to be a little long. He's eating fine. Just looks suspicious to me. Wondering if we should stop the jaw massages.
Update - he hasn't had to have his teeth filed since the end of January - he was getting them done every 4 weeks. He only wears his sling for about an hour a day. His jaw muscles appear to have strengthened. In a couple of weeks he's having a full dental exam to check - but at this moment, we more or less consider his malocclusion cured. We haven't done the electric toothbrush massage for about a week - don't know if we'll continue.
Xrays show perfect alignment after 3 months of chin-sling and massage. The last 3 weeks he's just wearing the sling at night - no jaw massage. His lower front teeth were a tad long - that was it. Previously he needed dental planing every 4 weeks. The chin-sling has cured or controlled his malocclusion.
I noticed Peony's front teeth were slightly diagonal and she'd lost a little weight. (April14) Threw on the chin sling for a couple of 8 hour shifts in a 24 hour period - did one jaw massage - you guessed it. Teeth are evening out. Diagonal is disappearing within one day.
Peony's teeth are now completely straight - the diagonal is gone. I'm going to leave the chin sling off for a while to see if the diagonal comes back.
The diagonal wasn't so bad that it was panic causing - but bad enough to say one side of her jaw was clearly not the same as the other and that she needed to get her teeth checked.
Mon, 17 Apr 2000 - from Dr. Legendre
We may be onto something big here and we need to document these treatments. So if you can, take pictures before and after. The negatives of Willie are at Westview in your file. See you there or at ACCG. Loïc
Sat, 22 Apr 2000
Peony's teeth went diagonal again. 36 hours of on and off sling treatment - they're just about straight again. Took pics of before - but I doubt they'll turn out because I couldn't get in very close.
If I stop treating with the chin-sling. They will probably revert in a week. Did you want to take a digital pic? Or shall I continue to try and permanently correct it without record of how it was before.
We are letting Peony's teeth go diagonal so she can be used as a "control" (wrong term?). Dr. Legendre will examine her mouth catching the TMJ thing and we will throw the sling back on and document the realignment.
Peony's teeth are slowly but surely adjusting with chin-sling and massage therapy since May 8 - maybe one more week- then full dental exam and hopefully chin-sling just at night.
The only side effect is hair loss from the sling - but it is temporary. Hair growth can also be stimulated with at home laser treatments (pen laser)
Fri, 23 Jun 2000
Didn't think it was possible - but her front tooth is now going diagonal in the other direction. We overcompensated massaging only one side. We are now massaging the other side to even the teeth up. It appears that the right and left jaw can be adjusted independently.
Willie became extremely ill June 18. Turned out he had a heart condition.
Sat, 24 Jun 2000
Willie appears to be slowly recovering.
He really needs his chin-sling. In the last week he hasn't really been wearing it and he hasn't been working his teeth enough - the teeth have overgrown. Diagonal things with the front teeth. Today, I gave him a massage on the weak side and fed him while he was wearing chin-sling - After a while, he started "chewing his cud". But the most interesting thing is that he flopped down. All week he's been sitting upright. At first I thought the sling was too heavy - but now I think it's made him feel good enough to relax. Must be exhausted.
He's going to wear it continuously (more or less) until Mon. Debbie is planning to file his teeth bit then. With luck, she won't have to.
Sun, 25 Jun 2000
I suspect his back teeth may need work. I think Debbie was just going to do the incisors. He is still losing weight. I think it might be chewing problems. His mouth was hanging slack again. So he's been chin-slinged for 24 hours and counting. He does chew better while slinged. I don't know if there's enough time for him to self correct - he's 1 lb. 13 1/2 oz. down from 2 lb. 4 oz. just before he got sick.
Mon, 26 Jun 2000
Debbie trimmed the front teeth - he now must be handfed - he's too weak to scoop pellets. There is 1/8" gap. He is too weak for sedation so we'll have to rely on the sling to adjust the back teeth. We have to feed often to keep the teeth grinding. The xray was inconclusive. He is definitely more comfortable when wearing the sling. He needs the support. Interestingly, his entire body lacks muscle tone. He can walk fine and hold his head up but when I pick him up he feels dead. No struggle. No tensing. Perhaps that is part of the virus - maybe his muscles were attacked.
Willie wore his sling for a solid week. His teeth were ground back naturally.
Update: Willie wears his sling 6 hours daily for maintenance. Peony no longer needs to wear her sling. Neither have required dental work since wearing their slings.
Other guinea pigs who have used the Chin-Sling:
- Leo: Sun, 07 May 2000 - 2 weeks of intensive Chin-Sling therapy solved his overgrown teeth problem. Unfortunately his dental problems were the result of not eating due to kidney problems rather than malocclusion. But the Sling did force him to grind his teeth into shape.
- Zag: One week after getting her teeth planed her front teeth developed a diagonal slant. After about 4 weeks of Chin-Sling therapy (Jan. 31 to March 5), her teeth were straight.
- Quinn:- owned by Linda in Washington:
- 10/8/00 - The teeth slant is almost gone. (Quinn started wearing the sling on Oct. 1)
- 10/9/00 - The teeth are almost perfectly straight.
- 10/14/00 - The sling is improving the slant on her front teeth, but she is still losing weight.
- 10/19/00 - Quinn had to be put to sleep today. She had a mouth tumor. On the good news side, if there is any, the chin sling was working beautifully on the right side. Her teeth were totally aligned. It would have worked great on the left side had it not been for the tumor, which was throwing her jaw out of whack. The vet said he was really impressed with how good her teeth looked, as he thought they would already be totally overgrown. She would have recovered fully had it not been for the tumor. The vet was astounded that her teeth were actually fine.
Dentist - Loïc Legendre, DMV, FAVD, Diplomate AVDC, EVDC
Physical therapist - Cynthia E. Webster
Toothbrush - Braun Oral-B Plaque Remover (D 6011) Use bristle end.
Chin-sling (U.S. Patent No. 6,553,945 -- Canada Patent No. 2323228 -- United Kingdom Patent No. GB2371231)
I used 1/8" thick neoprene and velcro. Neoprene is what wetsuits are made of. It's rigid, yet flexible and breathable. It's 7 1/2 inches in length and 1 inch at it's widest part. The little "wings" attach at the back of the neck to pull the ear holes wide to remove pressure from the back of the ears. If you don't do this - the ears will swell.
Side effects: If too tight the conjunctiva will swell. Swelling goes down upon removal or loosening of Chin-sling. There can be hair loss from constant wearing. Hair will grow back.
For veterinary and physical therapy consultation contacts, please have your vet or animal dentist email Pocket Pet Concepts Inc. at firstname.lastname@example.org
Dislocation of the Jaw
Pinta provided the following advice to a poster on the board regarding possible dislocation of the jaw (see: Forum Thread ):
"First of all you have to see if the jaw is stuck on a ridge. If you lightly massage the sides of the jaws with your fingers you should be able to move the jaw from side to side and up and down. If the jaw is stuck on a ridge, there is no movement. If both sides are rigid and there is no movement you will need an expert to manipulate the jaw into position. Once in position the Chin-Sling can help to keep there.
"I would think a vet would be able to diagnose a dislocated jaw without sedating the pig.
"If there is free movement on both sides of the jaw, chances are the problem is weak muscles. Does the mouth hang open when you look at the pig face on? That's another indication of weak jaw muscles.
PIf there is no movement at all on one side of the jaw, the jaw is stuck in a position that compromises chewing and will need manipulation from an expert to get it back in place. Often "dislocation" results from muscles being very weak on one side. The stronger muscles on the opposite side pull the jaw out of alignment, occasionally to the degree the jaw gets stuck on a ridge. Muscles usually get weak when the pig is favouring one side of the jaw while eating due to abscesses or anything else that causes pain.
"The Chin-Sling will not hurt a misaligned jaw as long as there are no unhealed fractures present and it isn't rigid. If the Chin-Sling is too painful for the pig to wear, this indicates there is a problem that needs to be resolved, such as elongated roots, ulceration on the inside of the mouth, abscesses, molars that have not been planed down far enough... Any condition that will be more painful under applied pressure will be more painful with a Chin-Sling on and pigs make it very clear when they can't tolerate wearing a Chin-Sling. Normally they should forget they have it on within 5 minutes(special treats help them to forget). If after 5 minutes they are bucking or flop down and refuse to hold their head up, they can't tolerate it.
"If the jaw is moveable on both sides, the Chin-Sling can hold it in position and the jaw muscles will redevelop through resistance (working against the pressure applied by the Chin-Sling).
"It's tricky positioning the jaw with the Chin-Sling but it is doable by putting the Chin-Sling on without tightening it fully and gently maneuvering the jaw until the front incisors are aligned with the lower incisors fitting neatly behind the upper incisors. Once the incisors are aligned the Chin-Sling should be tightened until it is fitting very snugly. It will then hold the jaw in position and force the molars into contact. As the pig grinds the upper molars against the lower ones, the jaw muscles will start getting proper usage again and begin to rebuild.
"Hand feeding while the pig is wearing the Chin-Sling is an excellent way to get those muscles working. When the Chin-Sling is off, massaging the sides of the jaw with the bristle end of an electric toothbrush(cover the bristles with plastic wrap) for a few minutes twice a day is very helpful muscle stimulation.
"I recommend taking the Chin-Sling to the vet appointment so the vet knows what you are using. Vets seem to understand the concept of the Chin-Sling once they see one and are very adept at putting it on pigs whereas owners tend to be a little nervous when trying to put it on at the beginning."
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