Easy on that Bite!

I practice comprehensive dentistry.  In my process, I have a three-pronged approach to address all things that could affect the oral health.  The first is health related - where we evaluate the health of the teeth, gums and oral tissues.  The second is functional - all things relating to the bite and jaw joints.  And finally, Esthetics. - anything related to the smile.  When all three are addressed, the dentistry becomes predictable.

About 70% of my patients have issues with their bite. Some knowingly, most are unaware.  Through a discovery process, my patients who were unaware, become aware of bite (occlusal) issues. This leads to discussions about how function can affect both the health and the esthetics of the teeth.

Here is an explanation that I give my patients as a take home read to further explain the goals and my process of bite therapy.  Note that the therapy is a process - it is not "here is a piece of plastic for you to chew on..."  It is a process that sometimes takes several months to properly address.  

Occlusal (Bite) Therapy

Occlusion is a dental term for how your top and bottom teeth come together—as when you bite.  Biting serves one purpose: to break up your food so it can more easily be digested. When you have a healthy bite all of your top and bottom teeth hit each other evenly with the jaw in it’s most comfortable (or orthopedically correct) position.  When the bite is idealized, you will potentially need very little dental work over the course of your life.

Occlusal (bite) therapy is usually indicated if you present with symptoms (If you find that your teeth look worn, or you are constantly touching, clenching or grinding your teeth together when you are not chewing food) or if the doctor sees signs of over-function (fractures, worn teeth or fillings, advancing gum problems, mobile teeth, etc.)  You may “over-functioning” on your teeth. This will cause problems that may need attention either now or down the road.

If your bite is not balanced, (or if you clench or grind your teeth, chew gum excessively, or bite your nails, etc.) your teeth are prone to poor performance. You can experience cracking, fracturing or excessive wear. Dental work may need to be replaced prematurely. You are more prone to gum recession or advancing gum disease, sensitive or loose teeth. Finally, your smile can be affected with ground down or chipped teeth, especially your front teeth.

An unbalanced bite can also affect the jaw joints (known as the TMJ) and associated muscles that open and close the jaw.  Depending on the problem(s), over-functioning can lead to sore jaw and neck muscles, headaches (even migraines), clicking and popping of the jaw joints during opening and closing, severe pain and limited range of motion of the jaw.

Recognizing bite problems as early as possible increases the probability that you will have good looking and functioning teeth at an elderly age. Much of the dental work in an adult’s mouth might have been avoided if the signs of occlusal (bite) disease had been recognized and addressed in the early stages.

Lucia Jig

The Lucia Jig is the usually the start of occlusal or bite therapy.  It is indicated for a number of reasons.  The first is to help you stop clenching and grinding of the teeth together.  If you are unaware of these habits, hopefully it will make you more aware.  The second indication is to relieve pain in the jaw/jaw muscles, and/or headaches. By stopping the clenching it will shut off the muscles are overworking, dis-coordinated or are in spasm. Most people find relief within a few days to a few weeks.  The more that the Lucia jig is worn, the quicker it will start to work.

This is not a permanent solution.  Once the muscles have been deprogrammed, the jaw joints (TMJ’s) slide into their orthopedically correct position.  It is to be used as indicated by the doctor.  Please if you have any questions, don’t hesitate to ask

Occlusal splint (nightguard, bite splint, etc.)

This hard acrylic appliance is custom-made to fit snugly over either your upper or lower teeth. It becomes a temporary perfect bite for you. It is a process of determining what a perfect bite is and may include several adjustments until it is idealized. The doctor will encourage feedback from you on how things are feeling when you are wearing the splint as well as when you are not wearing the splint. When it is properly adjusted and worn as prescribed, many of the signs and symptoms of bite problems often disappear as long as you wear the splint. 

The properly adjusted bite splint can then be used as a guide to idealize your bite.  In most cases if your bite is idealized, you won’t have to wear the splint anymore, and your teeth have the best chance of working for you over the course of your lifetime.

Idealizing your bite

There are several options when looking to idealize your bite.  These options will be determined once you are stable with the occlusal splint. 

Occlusal analysis: The doctor will mount models of your teeth on a mechanical jaw that can mimic all of your jaw movements.  He will then be able to determine what kind of adjustments/dental work will be needed to idealize your bite.

Options include:

Equilibration:  A focused reshaping of your teeth so that they bite together simultaneously with even pressure.  The doctor reshapes the areas that are interfering and most likely causing you to clench and/or grind your teeth.  This is usually accomplished in 1 to 3 appointments, is usually pain free during and after the procedure. 

Equilibration combined with restoration: Equilibration as above, with the combination of some teeth that need fillings, crowns, veneers, etc.

Orthodontics:  If the teeth are severely malpositioned, orthodontics may be recommended to improve their position so that the bite then be idealized with equilibration possibly combined with restorative.

           

Surgery:  For the most severe alignment issues, the bite may need to be re-set with a surgical procedure. If it is indicated we work hand in hand with some of the finest surgeons in Colorado. You will be referred for an evaluation by an Oral and Maxillofacial Surgeon.


Copyrighted material (2013) Brett H. Kessler, DDS.