11: Occlusion: Your Bite, Temporomandibular Joints, Temporomandibular Dysfunction

CHAPTER 11 Occlusion

Your Bite, Temporomandibular Joints, Temporomandibular Dysfunction

Until recent years the area of occlusion in dentistry has not been emphasized. Therefore, many dentists have not been involved with treatment of people with occlusion problems. As a rule, the specialty most involved with movement of teeth to provide acceptable occlusion is orthodontics. Other areas of dentistry, including prosthodontics, periodontics, oral surgery, and general dentistry, are more involved with the condition commonly called temporomandibular dysfunction (TMD) or temporomandibular joints (TMJ) in the lay literature.

Currently, TMD is used most often to describe the syndrome (or disease), while TMJ is used to describe the anatomy of the specific location. This chapter is primarily concerned with TMD, whereas moving of teeth into proper function and appearance is included in the chapter on orthodontics (p. 99).

Your skeletal size is partially formed before your teeth erupt. As the primary (baby) teeth or permanent teeth erupt into the mouth one by one, the upper and lower teeth occlude (come together) in a haphazard way in direct relation to tooth size, size of the upper and lower jaws, relation of the jaw joints in the head, relation of jaws to one another, health of the patient, any oral habits, and numerous other factors. If all the factors are related in the manner that nature intended, the teeth will occlude (come together) correctly. If one or more of the factors is incorrect, malocclusion (incorrect bite) may be present, teeth may appear crooked and irregular, and the bite will be abnormal.

Other factors may cause a poor bite, including mixed genetics of various races; improper development of the jawbones; accidental trauma to the mouth; dental fillings, bridges and dentures; diseases such as arthritis; and other conditions.

Does a poor bite automatically stimulate a jaw dysfunction, pain, and jaw joint degeneration? No. However, one of the conditions that has been associated with TMD is a malaligned bite. This subject deserves an entire chapter because it has caused significant distress among patients, continual discussion by the lay press, and, most importantly, confusion among patients and all categories of health practitioners. Because some dentists do not treat occlusion, you may want to initiate the discussion of your specific problems with your general dentist. Referrals may be made to another general dentist; a prosthodontist; a periodontist; an oral surgeon; an ear, nose, and throat specialist; a chiropractor; or a physical therapist.

This chapter discusses clinical conditions that you can observe, as well as the treatment that your health practitioner can provide.


Conditions, Signs or Symptoms Related to Occlusion, or Temporomandibular Dysfunction

5. Teeth Visibly Worn From Bruxism or Clenching

At least one fourth to one third of the world population grinds their teeth excessively, thereby wearing tooth structure beyond normal expectations (Fig. 11.1). This activity is called bruxism or clenching. During the first years of life this wear usually goes undetected, but soon it is evident, and concern is expressed. In the later stages of this problem, pain or even tooth death is caused by the wear. If you brux or clench your teeth excessively, you have the following potential treatment options, directly related to the severity of the condition as observed by your dentist:

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Jan 3, 2015 | Posted by in General Dentistry | Comments Off on 11: Occlusion: Your Bite, Temporomandibular Joints, Temporomandibular Dysfunction
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