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.