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 of ‘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 temporo-mandibular
joint or the muscles that move your jaw. These problems are called ‘occlusal’ problems.
Teeth
Teeth that are out of line, heavily worn 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, 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 pains 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 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 may keep having pain or discomfort on the side of
your face around your ears or jaw joints 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 See
your dentist. He or she may be able to help you or may refer you
to a specialist who deals with occlusal problems.
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 your dentist suspects that your
problems are due to an incorrect bite, he or she 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 external
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 too 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 often 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 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:
- flattened, worn teeth
- broken teeth, fillings and crowns
- loose teeth
- continual sensitivity of your teeth to temperature
change
- toothache with no apparent cause.
If you think you have any of these
problems, ask your dentist.
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