When dentists speak of occlusion, they mean how the teeth meet and function together.
In normal occlusion, the teeth come together so they fit into a proper anatomical arrangement – much like puzzle pieces that all meet at the same time. In abnormal occlusion, some teeth may hit before others or some teeth may not hit at all. This can create pain in the teeth or the musculature of the mouth or both.
What do I examine when assessing a patient’s occlusion? At dental appointments, I assess a person’s bite, checking for abnormal wear on the teeth and for tenderness in the masticatory musculature (chewing muscles). My examination includes:
- Examine teeth to make sure that they mesh together without deflecting (or sliding).
- Check that all teeth meet evenly without undue pressure.
- Palpate (feel) the musculature and make sure that there is no tenderness.
- Look for abnormal wear areas- areas where the enamel itself has been worn or broken off.
- Look to see if the patient has worn or broken fillings or crowns.
- Discuss with the patient any pain that could be caused by occlusal disharmony.
TMJ – Pain in the Joint
Pain can occur at the joint just in front of the ears, called TMJ or temperomandibular joint problems. Sometimes I can feel or hear grinding within the joint. There are many reasons why grinding can occur, and I advise the patient when there is a possible problem within the joint complex. Therapy is not indicated where there are no obvious symptoms, but we warn these patients of the possible side effects that could occur in the future.
Treating Occlusal Problems
Occlusal therapy is indicated when either the teeth don’t meet together properly or when teeth abnormally grind, cause headaches, toothaches, or other types of wear or abnormalities.
What do we do when an occlusal problem exists? Sometimes orthodontics is necessary to straighten the teeth. Sometimes I need to adjust the bite of the patient to ensure the teeth meet more evenly. Sometimes we will create an occlusal guard – some are worn during the day and some at night to prevent people from grinding their teeth and causing TMJ symptoms. Occlusal guards also can allow us to realign the bite and take the stress of patient grinding out of the equation.
In this article I have provided an overview of the fundamentals of occlusion (how the teeth meet and function together.) I will be attending a seminar in December specific to occlusal therapy, and will provide additional articles related to occlusion.