TMJ

What is dental occlusion?

Dental occlusion is the term used to describe how the teeth of the upper and lower arch 'bite together' during jaw function.

What is TMJ?

TMJ is the abbreviated dental term for 'temporomandibular joint', the jaw joint between the skull and lower jaw. The TMJ allows mouth movement, opening and closing of the dental arches, and side-to-side chewing ability.

What kind of problems might I have?

Occlusal problems involve bite irregularity, which may be due to improper functioning of the temporomandibular joint or jaw muscles. When the teeth bite together abnormally, gum and dental damage may occur, usually causing pain in the jaw and face. Bite or occlusion difficulties include malocclusion. The four main occlusion areas affected are:

  • Dentition - teeth may become damaged and break, tooth restorations may fracture and tooth pain may be present.
  • Gum tissue - bite irregularity may cause receding gums, resorption and loose teeth.
  • TMJ - the jaw joint may grind and click, causing pain that radiates from the mouth into the face, neck and back.
  • Jaw muscles - jaw and facial muscles may strain leading to migraine, facial and sinus pain. Pain may also be experienced in the neck, shoulders and back.

How can I tell if I have a problem?

Teeth clenching and grinding may be a sign of an occlusion irregularity. Some develop bruxism or teeth grinding from anxiety and usually perform the habit during sleep. Others may clench and grind their teeth when concentrating during daily activities. Bite tenderness and a stiff jaw on awakening may be an indicator of jaw joint problems. Other symptoms include:

  • Difficulty moving the jaw
  • A clicking jaw
  • An inability to chew properly
  • Jaw-facial-neck pains.

When occurring simultaneously these symptoms are referred to as TMJ syndrome.

How are these problems treated?

Before treating an occlusion problem, a dentist will need to examine oral condition to determine the source of the symptoms experienced. In some cases a referral to an occlusion or TMJ specialist may be necessary. Various diagnostic techniques will be used to find the source of the symptoms, such as:

  • X-ray imaging
  • Muscular and 'bite' tests.

A range of treatments are available for occlusion problems, including:

  1. Mouthguard
  2. Sometimes teeth grinding is evident without painful symptoms. A dentist may then prescribe a soft mouth guard to be worn at night during sleep. The mouthguard prevents tooth-on-tooth friction.

  3. Bruxism or occlusion appliance
  4. Other oral appliances may be fitted to the lower or upper teeth in a bid to prevent teeth grinding. These appliances are usually worn continuously to relax muscles and relieve painful symptoms.

  5. Tooth Adjustment (equilibration)
  6. An irregular bite may need mild adjustment or extensive correction to normalise function and reduce malocclusion symptoms. Sometimes the jaw may be repositioned through altering dental slope and bite guide.

  7. Replacement of teeth
  8. For healthy dental function, we require the correct amount of teeth on the upper and lower arches to function together for chewing and normal bite action. Without all teeth, strain may be placed on the temporomandibular joint and muscles.

    Our natural occlusion is what provides support to the jaws. When teeth are not in their correct position or are missing this causes problems for how the arches meet. Teeth straightening and missing teeth replacements, such as crowns, dentures and bridges, allow for healthier occlusion and bite function that may treat the underlying cause of symptoms.

    However, in some cases wearing an occlusion device helps to identify if abnormal temporomandibular joint function is a cause.

  9. Medication
  10. Medication may be prescribed by a dentist or doctor to relieve painful symptoms. Women may benefit from hormone replacement therapy to relieve TMJ disorder symptoms.

  11. Diet and Exercise
  12. Reducing pressure on the temporomandibular joint may relieve painful symptoms. This may be achieved through a diet of softer foods. Gently applying a heat pack may help relax facial and jaw muscles. Specialist physiotherapy exercises prescribed by the dentist can also ease any tension within the jaw.

  13. Relaxation
  14. Treatment options for TMJ or occlusion disorders include: relaxation therapy and counselling. By learning how to reduce tension and stress in the body through therapy, relief of symptoms may follow.

Will straightening my teeth help?

A dentist may recommend teeth straightening using an orthodontic system to improve dental position and bite function. Orthodontic treatments are aimed at straightening teeth so that occlusion problems do not develop.

How many people suffer from these problems?

Symptoms related to occlusion or TMJ problems may be experienced by one in four people, regardless of gender. Studies show that women tend to seek treatment for symptoms more often, particularly during hormonal changes such as menopause.

Having missing teeth or malocclusion is not uncommon, however not everyone experience symptoms until periods of high stress or hormonal changes. Some may not realize that headaches are a common symptom of TMJ disorder. Other symptoms requiring dental care include:

  • On-going toothache
  • Persistent tooth sensitivity
  • Worn or flattened teeth
  • Fractured or broken teeth
  • Damaged fillings or crowns
  • Receding gums and loose teeth.

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