The Gelb is a flat plane mandibular splint, with occlusal coverage over the posteriors, designed for treatment of closed-lock cases. A metal lingual bar is usually the major connector, which allows for plenty of tongue room. The patient needs to relax the disc before moving to a pull-forward splint, so this splint is usually made to a centric bite. Patients should be seen often during this stage of treatment. A 30-day interval is normal to check the range of motion.
According to inventor Harold Gelb, D.M.D. and co-author of Killing Pain Without Prescription, Gelb says: “As therapy continues and your muscles relax, the position of the jaw might change approximately every three weeks. The attending dentist should accommodate the shift in the jaw balance by grinding down or building up the appliance to adjust the bite. After several months, the position of the jaw and the bite should stabilize. At this point phase 2 options should be considered.”