The Chewing system
The chewing system is composed of intricately related parts (teeth, muscles, jaw joint, etc). All of these parts must work together in a harmonious manner for proper function and maintainable health. When one or more of the parts malfunctions, problems develop.
A very common problem we see in our office is disharmony in the chewing system. In a healthy chewing system we find harmony and no pain. The muscles are relaxed. The joint is stable and the teeth work in a protected environment. When teeth bite together in the “normal” bite, all of the teeth should contact, all precisely at the same time along the long axis of the tooth. Our goal at Reuss Dental is to promote health and prevent disease in all of our patients.
DO YOU HAVE ANY OF THESE SYMPTOMS?
Some of the symptoms (problems people experience) related to Bad Bite are…
- mild tooth pain
- severe tooth pain and tooth nerve death leading to root canal treatments
- tooth loss
- loose teeth
- sensitive teeth to cold and air
- “melting” (abfraction) of tooth surface
- contact wear on tooth enamel (teeth look worn down)
- chipped, cracked, and fractured teeth
- crowding, tipping, and misalignment of teeth
- general headache
- migraine type headache pain
- muscle spasm
- trigger points (radiating pain to other muscles, teeth, eyes, ears, neck). The whole upper body can be involved in severe cases.
- sore, easily fatigued muscles (jaw always feels tired)
WARNING…CAUTION…Severe pain cases should be evaluated by a qualified team of doctors. General dentists, dental specialists, physicians, physician specialists, physical therapists, and chiropractors can all have a role in diagnosis and treatment.
- recession of gum tissue around teeth
- loss of supporting bone around teeth
- horizontal bone loss around front and back teeth
- jaw joint pain in front of the ears one or both sides (occasionally radiating deep into ear. It feels like an ear ache)
- popping, clicking, grinding, and locking of the jaw joints
- melt down of joint surfaces
- deterioration of protective disc
- loss of precision dental sensory perception
- radiating pains through out teeth, head, neck, and upper shoulders. (Warning…radiating pain to the left jaw and left arm may be a sign of heart attack)
FUNCTIONAL AND COSMETIC PROBLEMS:
- collapsed bite (teeth disappear behind lips)
- collapsed lower face (deepening of wrinkles)
- drooping smile (sore, wet spots on corners of mouth)
- loss of lip support (lips become thin and lack fullness)
- inability to chew effectively
- swallowing problems
WHAT DO YOU DO IF YOU HAVE SOME OF THESE PROBLEMS?
Because Bad Bite problems can be quite complex, a diagnosis is necessary before dental treatment is started. A diagnosis of the dental problem will uncover the CAUSE of the problem so a proper treatment plan can be created. Almost all dental treatments have Bad Bite as a component to consider in the treatment plan. So, a diagnosis of the dental problem is necessary to understand the CAUSE of the problem and creation of a proper treatment plan.
Another very good reason for a diagnosis is to sort out dental problems from medical problems. Medical problems must be referred to appropriate medical health care providers for evaluation and care.
Too often dental treatment is started before a diagnosis is made and disappointing consequences follow. So before good dental treatment can begin a thorough diagnosis (a discovery of the cause of the problems) must be made.
THE BIOLOGIC DENTAL MODEL…the ultimate in dental health
How is a Bad Bite related to jaw problems, muscle pain, and headache? First let us look at a Good Bite. We call a Good Bite the perfect ideal…it follows THE BIOLOGIC DENTAL MODEL.
The teeth dominate and control the biting position. A Good Bite is a full set of beautiful teeth in perfect relationship to each other and their opposing biting partners (other teeth). Since there is a Good Bite the teeth function properly and cause no strain (pain) on the jaw joints and muscles. There is no dysfunction in the system. This is an ideal system. Tooth wear, gum recession, and bone loss around teeth is non-existent. Everything is working in harmony. This is very hard to find in the general population but they are out there. We call this the BIOLOGIC DENTAL MODEL. It is based on health, not disease. This is the model we use in our office to base all reconstructive dentistry. It is not a man made model. The Biological Dental Model is a natural model found in those few individuals blessed by the Creator with beautiful, self-sustaining perfect dental function.
The truth is…most of us have bites that function and appear less than the dental ideal. Thankfully, even though most of us have less than ideal bites (crooked teeth, open bites, misaligned teeth, over-bites, under-bites, and so on) we get by without too much disruption in our normal lives. This is a testament to how well our bodies (chewing system) can adapt to adverse circumstances. However, some of us suffer from damage caused by Bad Bites. Thankfully, there is good treatment available to help those suffering from consequences of Bad Bites.
Dental Treatments for Bad Bite…
Proper treatment for Bad Bite begins with a diagnosis. The cause of the problem must be discovered so that a proper plan can be developed. Diagnosis begins with records to gather information and a systematic approach to organize the information to see and discover where problems exist.
The DIAGNOSTIC PROCESS…
Almost every person has some kind of dental need. The most recognized dental problems are tooth decay (cavities) and gum disease or periodontal problems (gingivitis, periodontitis, pyorrhea). Another very common dental problem, and frequently overlooked is a Bad Bite. Bad Bites cause unnatural, destructive forces on the jaw joints, teeth, muscles and jawbones. Many times Bad Bites can cause more pain, suffering, and destruction than the more commonly recognized problems of tooth decay and gum disease. Comprehensive dentistry is a process of discovering the cause of dental problems and then creating a treatment plan that deals with the causes of dental disease and correcting the damage caused by the disease.
STEPS IN THE DIAGNOSTIC PROCESS…
Phase 1A: Jaw Joint Stabilization
This is the first step in understanding the problems involved with a bad bite. Bad Bites cause the jaw joints (TMJ’s) to become unstable. Jaw Joint Stabilization is a process to protect the jaw joints from injury and deterioration caused by Bad Bites. Stabilization of the jaw also protects the teeth from destructive wear of the enamel. and bone loss from unnatural movement.
A Bad Bite forces the jaw joints into unnatural, strained resting positions. Misaligned teeth that function improperly are the main culprits in a Bad Bite. On closure of the jaws the teeth come together and force the jaw joints to misalign in the sockets placing a constant strain on the joints when the teeth are touching. Over time this micro trauma (unnoticed cycles of strain) can injure the jaw joints. The most common symptoms of strained jaw joints (TMJ’s) is clicking, popping, locking, and pain (local spot pain and/or headache pain). In certain cases there are no painful symptoms and the jaw joints may be functioning with no apparent problems. However, in these cases the most common unnoticed symptom is wear on the protective tooth enamel. Over time tooth wear increases and teeth begin to crack, chip and melt away.
To stabilize the jaw joint a custom made, removable Jaw Stabilizing Splint (JSS) is made to fit over the upper teeth. The JSS is made of clear plastic material similar to an orthodontic retainer. It is made as small as possible for comfort and social acceptability. The splint must be worn for the benefit of protecting the jaw joints and the teeth. The splint must be precisely adjusted to allow the jaws to stabilize in an unstrained natural position. The JSS does not make any permanent changes to the teeth or bite. The splint is removable, so when the splint is out of the mouth, the teeth will quickly reposition the jaw to the harmful, strained biting position dictated by the Bad Bite.
The goals of joint stabilization are:
- stabilize the joints in a natural, comfortable, unstrained rest position
- reduce jaw, muscle, and headache pain
- reduce unnatural stress on the joints and teeth
- reduce strain of the supporting tissues (bone and gums) of the teeth
- allow the neuromuscular system to “reprogram” to a natural, comfortable resting position
- allow the dental muscles to relax
- provides the clinician with a reproducible point where your jaw hinges in its most comfortable position
This process usually takes one to three months of splint wear. Note: the splint is not intended to be a long term, definitive treatment. When the goals of joint stabilization are achieved Phase 1B can begin.
Phase 1B: The Diagnosis
This is the phase when the causes of Bad Bites can be discovered. Once the jaws are stable a clinical procedure called Axis Tracing is done. The procedure involves making accurate impressions of the upper and lower teeth, taking a series of bites to record the jaw relationships, placing recording instruments on the lower jaw to trace the arc of closure and record the axis point. This procedure takes about ninety minutes and allows Dr. Reuss to very precisely analyze how the teeth align, where the teeth contact and/or do not contact and how the teeth function. Dental photographs, X-rays, and a 3D scan is also used to evaluate and discover areas of strength and weakness in the existing oral conditions. The final and very important piece of diagnostic evidence that is developed by the doctor and highly trained skilled technicians is a full mouth wax up. This is done in the dental laboratory on accurate casts of your teeth. All of this information gives a basis for an accurate diagnosis and foundation for feasible options. All of this information is used to develop a blueprint for comprehensive lifetime dental care. When the diagnostic data is completely analyzed a consultation will be scheduled so all findings and options can be reviewed and questions answered.
Phase 2: Dental Treatment
All treatment options and consequences are discussed and questions answered at the diagnostic consultation. This consultation is extremely important for mutual understanding of the treatment process. It is recommended that all interested parties (spouses, trusted friends…who may be involved in the support process) be present at the consultation. Often more than one treatment plan can be considered. Generally treatment can consist of a combination of the following procedures:
- Reductive Coronoplasty: This is a process used to reshape the biting surfaces of the teeth to improve the bite. It consists of very carefully reshaping the teeth where improper biting contacts occur. This is done with very specific goals in mind. There are limitations to this approach since the teeth have a limited thickness of enamel. It is preferable to preserve an adequate layer of enamel to protect the teeth.
- Additive Coronoplasty: Reductive coronoplasty is done first then additive coronoplasty can be done to add biting contacts where necessary so that all the teeth bite properly with the corresponding opposing biting partner. Additive coronoplasty is usually done with tooth colored, bonded, composite. This material resembles natural tooth enamel in color and hardness. Generally it is less costly than laboratory fabricated porcelain crowns.
- Porcelain crowns: Various types of porcelain crowns can be constructed to rebuild badly worn or decayed teeth. Porcelain crowns can be used to fabricate multi-unit fixed (non-removable) bridges.
- Removable full dentures and partial dentures: Removable prostheses may be chosen to replace all of the teeth or many teeth in one or both arches.
- Orthodontic treatment: May be recommended to straighten the teeth and align them to improve the function of the teeth to insure longevity. Very frequently orthodontics may be recommended even after orthodontics had be previously done. Generally orthodontics is a cosmetic treatment, so if a Bad Bite develops orthodontics may be an appropriate treatment to improve the function of the teeth and support stable jaw joints.
- Orthognathic surgery: Some times after stabilizing the jaw joints it is discovered that the jaws are very much out of alignment. (This occurs when uneven growth patterns cause the jaws to be significantly miss-aligned.) This is one of the most rare recommendations but it may be the only way to correct very significant miss-alignment.
When an acceptable plan has been chosen treatment can be scheduled to begin reconstructing your dental health to a level comfort, function, security, and confidence for many years of future enjoyment.
On TIME and MONEY… WHAT WILL IT COST?
The process that we are describing above requires a significant commitment on your part to get the best results. Investing both your time and money allow you the best treatment possible. There are many options to decrease the amount of time and cost of treatment, but may not provide the best results. Our goal is to work with you to find what best suits your situation. We want to help you discover the most feasible treatment options to meet your expectations. Everyone is unique and so are you.
I’M READY WHAT’S THE NEXT STEP?
Call our office at 530-365-4581 to let us know that you have read this and are ready for the next step. The DISCOVERY APPOINTMENT is the next stepping-stone in getting you ready for a big change. Just say, “I’m ready for Health”.