Q. What
is dental occlusion?
A. Dental occlusion is another name for the way your
teeth meet when your jaws bite together.
Q. What is TMJ?
A. The letters TMJ are short for “ temporo-mandibular joint”,which
is the joint connecting your lower jaw and your skull. The movement in this
joint lets you open and close your mouth and chew from side to side.
Q. What kind of problems might I have?
A. If your teeth don’t fit together properly, you can have problems not
only in your teeth themselves, but also the gums, the tempo-mandibular joint
or the muscles that move the jaw. These problems are called ‘occlusal’ problems,
for example:
TEETH
Teeth that are out of line, heavily or constantly breaking, fillings that fracture
or crowns that work loose may all be signs of occlusal problems. Your teeth
may also be tender to bite on or may ache constantly.
GUMS
Loose teeth or receding gums can be made worse by a faulty bite.
TMJ
Clicking, grinding or pain in your jaw joints, ringing or buzzing in your ears
and difficulty in opening or closing your mouth could all be due to your
teeth not meeting each other properly.
MUSCLES
If your jaw is in the wrong position, the muscles that move the jaw have to
work a lot harder and can get tired. This leads to muscle spasm. The main
symptoms are continual headaches or migraine, especially first thing in the
morning, pain behind your eyes, sinus pain and pain in your neck and shoulders.
Sometimes even back muscles are involved.
Q. How can I tell if I have a problem?
A. You may find that you clench or grind your teeth, although most people who
do aren’t aware of it. Sometimes this can be caused by anxiety, but
generally most people clench their teeth when they are concentrating on a
task- housework, gardening, car mechanics, typing and so on.
You may wake up in the morning with a stiff jaw or
tenderness when you bite together. This could be due
to clenching or grinding your teeth in your sleep.
Most people who grind their teeth do it while they
are asleep and may not know they are doing it.
If you suffer from severe headaches, or neck and shoulder
pain, you may not have linked this with possible jaw
problems. Or you keep having pain or discomfort on
the side of your face around your ears or jaw joint
or difficulty in moving your jaw. These are all symptoms
of TMJ problems.
If you are missing some teeth at the back of your
mouth, this may lead to an unbalanced bite, which can
cause uneven pressure on your teeth.
Together, all these symptoms are called “TMJ syndrome”.
Q. How are occlusal problems treated?
A. We may be able to help you! Depending on the problems you are having, it
can be possible to spot the signs of an occlusal problem.
Various muscles may be sore when tested, or the broken and worn areas of your
teeth will show you are grinding your teeth- a common sign of an incorrect
bite.
If we suspect that your problems are due to an incorrect
bite, it may help to diagnose the problem by supplying
a temporary soft nightguard or hard plastic appliance
that fits over your upper or lower teeth. This appliance
needs to be measured and fitted very accurately so
that when you bite on it, all your teeth meet at exactly
the same time in a position where your muscles are
relaxed. You may have to wear this all the time or
just at night. If the appliance relieves your symptoms
then your bite may need to be corrected permanently.
TOOTH ADJUSTMENT (equilibration)
Your teeth may need to be carefully adjusted to meet evenly. Changing the direction
and position of the slopes that guide your teeth together can often help
to reposition the jaw.
REPLACEMENT OF TEETH
The temporo-mandibular joint needs equal support from both sides of both jaws.
The chewing action is designed to work properly only when all your teeth
are present and in the correct position. Missing teeth may need to be replaced
either with a partial denture or bridgework.
Replacement is not usually done until a diagnosis has been confirmed by using
an appliance and this has fully relieved the symptoms. Relief in some patients
is instant: in others it can take a long time.
MEDICATION
Some drugs can help in certain cases, but this is usually only temporary. Hormone
replacement therapy may also help some women.
DIET AND EXERCISE
As with any joint pain, it can help to put less stress on the joint. So a soft
diet can be helpful, as can corrective exercises and internal heat. Physiotherapy
exercises can often help, and your dentist may be able to show some of these
to you.
RELAXATION
Counselling and relaxation therapy may help in some cases. These techniques
help the patient to become more aware of stressful situations and to control
tension.
Q.Will straightening my teeth help?
A. If your teeth are far out of line or in a totally incorrect bite position,
it may be necessary to fit an orthodontic appliance to move them into a better
position.
Q.How many people suffer from these problems?
A. Up to 1 in 4 people may have some symptoms. Both men and women are affected
equally, although women tend to seek treatment more than men. The symptoms
can often start with the menopause or other hormonal changes.
Many people have imperfect occlusion and missing teeth,
yet never have symptoms because they adjust to their
problems. Occasionally, in the times of increased stress
and tension, the symptoms may appear and then go away
immediately. Or, your teeth and gums may be affected
straight away and instead of headaches, you may suffer:
1. Flattened, worn teeth
2. Broken teeth, fillings and crowns
3. Loose teeth
4. Continual sensitivity of your teeth to temperature change
5. Toothache with no apparent cause
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