Occlusion for patients
A lot of patients have small errors in their bite which make them put their teeth together in a position of comfort rather than the right position. This is a bit like having a stone in your shoe. This won't make you limp but will strain different muscles to those normally used as you try to walk normally. If we consider the teeth and jaws, instead of limping, patients jaw muscles are left to take up the strain of keeping their jaw in a comfortable position and it is usually in these muscles that the pain begins simply because the muscles can never relax.
When a patient clenches together on their back teeth, if there is a bite error, lots of the muscles that control the jaw are working in an uncoordinated way all at the same time, which tires them very quickly. It is this which can lead to pain in the head and jaw.
Where there is no bite error or when it has been eliminated by performing a minor bite adjustment treatment, the jaw muscles can all shut down and relax when the teeth are closed together.
This is also rather like picking up a heavy box. You can still pick up the box if you bend at the waste and strain all your back muscles but with the likely cause that you'll strain your back. Or, you can bend your knees, squat down and use the correct muscles and posture allowing you to pick up the box without doing yourself an injury! It's just the same for your jaw joint. It needs to be allowed to work how it was designed to work.
This error in the bite can cause different symptoms in different patients although in some patients there are no symptoms at all.
- tooth grinding or clenching
- tooth sensitivity and pain
- recurrent tooth fracture
- headache and migraine
To diagnose the cause of a patients pain, we will often make a small appliance which fits over the upper front teeth for the patient to wear for a few weeks. If this releives the headache we can move on to other more long term treatment options.
Bite problems and restorative dentistry
If a patient needs allot of work on their teeth, particularly their back teeth, it is desirable to remove any of these bite errors mentioned above, rather than copying a bite which already has the potential to cause problems. For this reason, as long as we can show that the jaw joint is healthy, a minor bite adjustment treatment can be carried out before replacing old fillings and crowns. This is done first of all as a trial on some models made of the patients teeth to check that this can be easily carried out.
After the bite has been corrected and is stable, the rest of the treatment can be carried out over as many months or years as necessary.
Tooth wear and tooth grinding and clenching (bruxism)
Up to 80% of the population grind their teeth at night at some time. 20% of people do this during the day as well. Most people are completely unaware that they do this at all.
There are two reasons why patients grind their teeth.
1-because of a bite error as mentioned above. You can subconsciously grind away at a tooth that in the way, potentially causing any of the above problems.
2-because of a neurological reason. In this case your brain just tells you to grind your teeth and it is very unlikely that anything can be done to stop this although the teeth can be protected.