Q What is dental occlusion?
A Dental occlusion is another name for
the way your teeth meet when your jaws bite
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 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.
Loose teeth or receding gums can be made worse
by a faulty bite.
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.
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 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
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
Q How are occlusal problems
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.
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
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
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
- toothache with no apparent cause.
If you think you have any of these problems,
ask your dentist.