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A Dental occlusion is another name
for the way your teeth meet when your jaws bite together.
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.
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.
TMJ
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.
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'.
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.
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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.
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.
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