An area often overlooked during a clinical examination is the patient’s occlusion or bite. Therefore, I’d like to discuss some important factors on the subject of occlusion.
What is occlusion or bite?
Occlusion is how your teeth come together when you close your jaw. Your occlusion is influenced by three primary components: (1) teeth, (2) nerves and muscles, and (3) bones. Another factor, which can affect the way your teeth come together, is your posture.
Take note of the fact that when you tilt your head back and bite, your teeth will hit differently than when you tilt your head forward. The same rule applies when you are lying down on your side. Your lower jaw will shift to one side. We now need to define ideal occlusion or bite. I’m going to attempt to explain this by describing some functional terms.
Occlusion Bite Boca Raton
Centric Occlusion is the term used to define the habitual position of closure. In other words, the position your teeth are in when you repeatedly bite. In an ideal centric occlusion all the teeth are in proper contact.
The teeth are not in cross bite, there is no under bite or over bite.
Now let’s try and explain how an individual with an ideal bite functions. Starting at centric occlusion and keeping the teeth in contact as much as possible, we slide the lower jaw to one side. In an ideal occlusion, when the lower jaw is shifted to one side, the posterior teeth should not touch.
What happens is that the lower canine or eye tooth is riding up on the upper canine. This is called Canine Guidance or canine protected occlusion.
Canine protected occlusion is an important concept, especially for people who have excessive wear on their teeth, erosion of their roots, gum recession, and suffer from TMJ (temporomandibular dysfunction).
Nature’s Biofeedback Mechanism
There is a biofeedback mechanism that comes into play. When the canines touch, nerves send a message back to the brain which in turn sends a message to those large muscles that close the jaw. That message says, “Hey – ease up on the force”, and the muscles relax.
Bruxism Boca Raton
When you take away that canine protection, the muscles stay active. That’s when you can get clenching, grinding of the teeth, joint pain, fracturing of teeth, excessive wear of the enamel on top of the tooth, erosion of the root surface (abfractions), and gum recession.
If teeth are properly aligned all the components that make up the occlusal system (teeth, nerves, muscles, and bones) should function in harmony.
Here’s an interesting note concerning the forces that you can put on your teeth. Normal chewing places about 68 lbs/sq inch of pressure on the back teeth.
If you intentionally clench your teeth you may increase that force to about 150 lbs/sq inch. However, an individual who clenches and grinds their teeth subconsciously at night can place up 1200 lbs/sq inch of force. That sounds like an industrial grinding machine!
Anterior Guidance Boca Raton In a normal bite the anterior (front) teeth guide the posterior (back) teeth into position or centric occlusion. When the front teeth are placed together on their biting edges the posterior teeth should not touch.
If the posterior teeth touch in that position, the symptoms described above can occur. There are some individuals whose front teeth do not touch at all. They have what we call an anterior open bite or have an overbite. This is due to bony (skeletal) discrepancy between their upper and lower jaw bones. Sometimes this can be corrected by a combination of orthodontics, surgery to reposition the bones and/or crowns (caps).
Vertical Dimension is another factor to consider. If you can picture a person without teeth, their face would be collapsed. This means that they have a loss of vertical dimension. You can have a decreased vertical dimension by loss of teeth or by excessive wear of the posterior teeth. Some individuals have a very steep overbite, which can be helped by opening the vertical dimension. Often, individuals with a decreased vertical dimension suffer from TMJ. Vertical dimension can be increased by building up the height of the posterior teeth.
Now let’s list some of the signs of possible occlusal/bite problems. If you think that you have these signs, contact your dentist to evaluate your occlusion.
- Heavy wear facets on the biting surface of the teeth.
- Receding gum tissue
- Erosion/notching of the root surfaces (abfractions)
- Cracked/fractured teeth
- Front teeth do not touch
- Pain in the joint and muscles
- Erosion of the biting surfaces of the back teeth, loss of enamel
- 8. Clenching or grinding of the teeth
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