Our teeth are exquisitely sensitive. Think about how a strand of hair feels between your fingers. Now think about how that same hair feels between your teeth.
We can have up to 32 of them touching together, each with several points of contact, yet rarely does our brain allow us to clash them together by accident. Amazing isn’t it?
Occlusion is the act of the teeth coming together – the relationship between the upper and lower teeth and how they approach and slide over each other.
Our teeth are part of a larger system, which includes our jaw joints and the muscles of the head and neck that hold the system in place. The position of our teeth in relation to our jaw joints and the way they work on each other needs to be in harmony. When these positions are not coincidental, the disharmony, for some people, in certain situations, can cause harm to the weakest part of that system.
This harm may present as sensitive teeth, fractured teeth, worn teeth, non-vital teeth, gum recession and gum disease, clicky jaw joints or joint pain – and headaches due to muscle cramps that can feel as bad as migraines, and go undiagnosed for years.
As members of the British Society of Occlusal Studies, your dentist at Market House is trained to keep a good eye out for this insidious but pervasive problem and will advise and educate you accordingly. On occasion we may suggest treatment that can help mitigate future problems.
Understanding Occlusion and Problems with Occlusion
Many of us have small errors in our bite, which cause us to put our teeth in a position that is most comfortable for our teeth, but not where our jaw joints want to seat. This means that the muscles that hold the system together are in constant use and under strain trying to balance the two differences.
Many of us have small errors in the position of our teeth which means they cannot slide over each other harmoniously. If our tooth surfaces cannot slide over each other harmoniously, our brain is constantly having to keep our head and neck muscles active to avoid the surfaces which are causing the disharmony.
A bit like having a stone in a shoe, this won’t make you limp but it will make you strain different muscles.
We may clench and grind our teeth because of
a. Problems 1 and 2 above.
b. Stress or dissonance.
c. The Central Pattern Regulator in our brain tells us to grind
(and we cannot treat this!). We can, however, help you to mitigate its effects.
Life is bumpy! So when we go through more busy times, upsetting times, stressful times, or times of dissonance, we can clench or grind with more force. It is amazing how many people book appointments with cracked teeth, having been through a divorce the year before. Or people coming in with cracked or sensitive teeth, as they are about to go on holiday and have become uptight trying to get their affairs in order before they go, so life won’t be so stressful on return. A sick relative, a bereavement, hard times with the business, multiple decisions to make, moving house, children, changing job or career.
Dissonance & the stiff British upper lip
If the seating of our jaw joint is not coincident with the position of our teeth and if the movement of our teeth over each other is not ideal, during these bumpy times in life, we can do ourselves quite a bit of damage.
We dentists get it too!
Our jaw muscles can exert pressures that can destroy our teeth. The only reason they don’t, is because our brain’s protective centers prevent us from doing so. When we are asleep, these protective mechanisms are switched off and so we can exert far more force.
Think of it like this…
A car tyre is around 35psi and a bicycle tyre around 50psi
50psi: When eating some food, we can exert a pressure of up to 50psi
150psi: At your angriest during the day, you may exert up to 150psi when clenching
950psi: At night, you may exert up to 950psi – and for 5 hours or more!
So you can see how we may cause more damage in a night than we might otherwise do in a whole year!
Bruxism is the dentist’s term for this activity.
Remember, clenching (which makes no noise at all) can cause more trouble than grinding!
If you have a bite error, when you bite together, lots of the muscles that control the jaw are working in an uncoordinated way, all at the same time, which tires them very quickly. This can then lead to pain in your head or jaw – like a cramp pain…or headache.
Where there is no bite error (or if we have eliminated it for you with some minor bite adjustment treatment), the teeth can all meet together in harmony, and in harmony with the jaw joints too. This means the jaw muscles can all shut down and relax too.
An error in the bite can cause different symptoms to different people. Some of these include:
- Tooth clenching or grinding (Bruxism)
- Tooth sensitivity or pain
- Recurrent tooth fracture
- Headaches that can be as bad as migraines, which go undiagnosed for years
Diagnosing this as a cause of pain can be extremely complex. It can present with very similar features to other conditions. To help diagnose the cause of the pain, we may make you a small plastic jig that fits over the upper front teeth to wear for a couple of weeks. If this helps to relieve the symptoms, we may consider it appropriate between us, to move on to more definitive treatment options.
Cause of Bite Problems
There are a great variety of causes. However some of the more common ones are:
- We were born or destined to develop that way .
- They wore through wear and tear that way.
- Restorative dentistry (fillings, crowns, bridges and dentures) carried out over the years, without too much planning.
- Orthodontic Treatment. An orthodontist may put our teeth where they look nice, rather than where they need to be functionally. This can result in bite problems too.
Treatment of Bite Problems or a Clench and Grind Habit
Your dentist may choose to address your bite problem with one or all of the following:
- A bite guard to protect the teeth from future damage
- Minor additions to certain teeth to restore harmony
- Minor adjustments to certain teeth to restore harmony
For some people, for an unknown neurological reason, the Central Pattern Regulator in their brain just tells them to grind their teeth and nothing can stop them. For these people, we cannot do anything to stop the habit, but we can take steps to help mitigate the damage to the teeth and jaw joints.
A bite guard can be made from acrylic that creates a false platform between your teeth. This platform ensures that when your teeth close down upon it, your jaw joints are in their most comfortable, balanced position and when you move from that position, the contacts between the acrylic and the teeth have been made ideal. This allows the muscles of the head and neck to relax, as harmony is restored. As the muscles relax and the brain trusts the balanced contacts again, it suddenly releases all the muscle tension. It is a quite striking result, every time we see it. We call this neuromuscular release and we look for it at the end of our treatments, to ensure we have achieved harmony.
If a patient requires a lot of work on their teeth, it may be desirable to correct any of these bite errors, rather than copying them in to the new work. So as long as the jaw joints are healthy, a minor bite adjustment treatment can be carried out before replacement of any old fillings or crowns. This will ensure your new work is more durable and lasts longer.
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.