What kind of problems might I have?
If your teeth don't fit together properly, you can have problems not only in your teeth themselves, but
also in the gums, the temporo-mandibular joint or the muscles that move your jaw. These problems are called 'occlusal'
problems. Dental occlusion is another name for the way your teeth meet when your jaws bite together.
- 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 an incorrect bite.
- TMJ-The letters TMJ are
short for '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.
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.
- 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.
How can I tell if I have a problem?
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 from:
flattened, worn teeth
broken teeth, fillings and crowns
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.
You may find that you clench or grind your teeth, although most people who do aren't aware of it. Sometimes
this can be caused by anxiety, but generally most people clench their teeth when they are concentrating on a
task - housework, gardening, car mechanics, using a keyboard 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'.
How are these problems treated?
See your dentist. They may be able to help you or may refer you to a specialist who deals with occlusal
Depending on the symptoms 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.
- Relaxation-Counseling and
relaxation therapy may help in some cases. These techniques help the patient to become more aware of stressful
situations and to control tension.
- 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 applying heat. Physiotherapy exercises can often help, and your dental team may be able to show some of these to you.
- Dental Guard-There are
ready to wear devices available which are designed to protect the teeth and help prevent the TMJ from clenching and
- 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.
If your dentist suspects that
your symptoms are due to an incorrect bite, they may help to improve the problem by giving you a 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. Relief in some patients is instant: in others it can take a long
- 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 a bridge.
Your dentist will not usually replace missing teeth
until they are certain you have occlusal problems.
Certain drugs can help in some cases, but this is usually only temporary. Hormone replacement therapy may also
help some women.
How many people suffer from these problems?
Up to 1 in 4 people may have some symptoms. Both men and women are equally affected, although women tend to
ask for treatment more often than men. The symptoms can often start with the menopause or other hormonal changes.