Occlusal disease is the condition where your bite — the way your teeth come down onto each other — is uneven, crooked, or misaligned. You may not be able to bite down all the way or chew thoroughly, and your jaw muscles must work harder for these simple tasks.
Because of the unevenness, some teeth are worn down faster than others, and further wearing, breaking, or chipping of teeth and dental work may occur. The muscles of the head and neck have to twist, turn, torque, and strain to maintain the lower jaw in a position that helps the majority of teeth stay in contact even if that means the TM joints have to be strained or dislocated. The extra work on the jaw muscles can cause pain all around the jaw, mouth, head, and neck. This includes migraines, cluster headaches, tinnitus (ringing in the ears), and other symptoms. “Aging,” worn teeth are not aging at all — the wear and tear is because of a bite problem long left untreated.
Occlusal disease is often hard to spot. Unlike cavities or gum disease, it’s not always visually apparent. What may appear to be a randomly broken tooth could be a more severe underlying problem… and fixing just that one tooth is not going to help if the whole jaw is misaligned.
Much research goes into fixing the problem; casts and models of your teeth are made so the dentist can see where the problem lies and how it can be adjusted (bite analysis). Occlusal disease also ties directly into bioesthetic dentistry and treating TMJ disorders. A simple, non-surgical tweaking of the muscles uses a MAGO (maxillary anterior guided orthotic), or nightguard-looking splint that helps untrain the muscles and allow them to realign in the correct physiologic positions. It can take 2-6 months of treatment to stabilize the TM joints. You basically have to wear the MAGO 20 out of 24 hours a day to get the maximum benefit and move the treatment along quickly and to achieve the best results. If the pain has not resolved in that time then a dental cause can be ruled out and other medical evaluations may be needed.
In addition, supplementary care may include various physical therapy modalities (at the office or by a physical therapist), trigger point injections, exercises, and various medications. Adjunctive care by other practitioners may be indicated. Since stress is commonly a contributing factor, stress management may also be indicated.
If you feel you or a loved one has a TMJD issue please call for an appointment for Dr. Coates to evaluate the situation and review all the pros and cons of all treatment options.