882C Emerson Street
Palo Alto, CA 94301
Nidhi Pai D.D.S.
2290 Birch St Ste C
Palo Alto, CA, 94306-1559
(650) 323-4222
Berezina, Victoria D.D.S.
900 Welch Rd # 106
Palo Alto, CA, 94304-1802
Baldassari, Lynne A D.D.S.
500 Middlefield Rd
Palo Alto, CA, 94301-2123
Mack, Thomas P D.D.S.
703 Welch Rd # A3
Palo Alto, CA, 94304-1707
It is ironic that one of the most common dental disorders is also the most neglected, malocclusion, bad bite. The way the teeth fit together when the jaw closes and chews is of profound importance to the long-term health of your teeth.
If surfaces of the teeth interfere with how the jaw moves, the teeth can be worked loose or the enamel can be worn away this is know an malocclusion, bad bite. The muscles that move the jaw are very powerful and can do major damage to the teeth when the biting surfaces don't fit together properly.
The problem can be compounded if teeth interfere with functional muscle patterns, the jaw muscles will attempt to "erase" the part of the tooth that interferes by grinding against it all the more. This can lead to even more severe wear or it may crack off a cusp or split the tooth. Or it may loosen the tooth or cause it to move out of alignment. The excessive muscle activity often results in pain in the muscle itself. All of the jaw muscles can become sore including the temporal muscles that are the source of many so-called tension headaches.
Some excessive muscle activity may be caused by emotional stress. But with some special exceptions, damage done by stress induced grinding and clenching can be minimized to a manageable level by equalizing the biting surfaces that are in conflict with jaw movements.
The power of the jaw muscles may surprise you. Some people can exert over 900 pounds of compressive force with their jaw muscles so you can imagine how much damage such force can do when you close into a single tooth and then work it from side to side. The effect is very much like working a fence post loose as the bone around the root breaks down. If you can put your finger on any tooth in your mouth, and then squeezing your teeth together causes the tooth to move, you can be sure that it is just a matter of time before there will be a problem with that tooth.
Sometimes in malocclusion, bad bite the muscle forces that work the tooth sideways stimulates bone around the root to build up and become stronger. When that happens, the tooth actually bends in its socket and this creates a microscopic chipping away close to the gum line to form a deep groove in the tooth. This is called an abfraction. These deep grooves at the gum line are often mistaken for toothbrush abrasion, but scientists have shown us that the grooves are actually the results of bending of the tooth in its socket. These grooves can lead to much sensitivity in those teeth because the opening into the tooth exposes nerves that can be exquisitely sensitive. Correction of the bite to remove excessive lateral forces on the teeth in most instances either eliminates the sensitivity completely or reduces it to a much more acceptable level.
Patients should be aware that much confusion surrounds the importance of a harmonious bite, including many misconceptions that have been fostered by flawed research that has failed to properly relate the bite interferences to the position and condition of the temporomandibular joints. Knowledgeable clinicians, however, are very much aware of this relationship and can achieve excellent results in making both your teeth and your jaw muscles more comfortable by bringing your whole biting into harmony and avoiding malocclusion, bad bite.
By Peter E. Dawson, DDS
Problems with the way your teeth fit together occur in many different ways. Some bite problems cause discomfort or even pain, and that pain can masquerade as problems that you would not readily associate with your teeth. Some bite problems can cause major damage to your teeth without producing any obvious discomfort.
There are some pretty simple ways that anyone can detect TMJ when a problem with the bite is causing or at least contributing to pain or discomfort.
The clench test: With your mouth empty so there is nothing between your teeth to bite on, close your teeth together and squeeze hard. If clenching your teeth together causes any sign of discomfort in any tooth, you have a disharmony in your bite.
Teeth that are sensitive to cold often get that way from the extra pounding they take if any part of that tooth strikes before the rest of the teeth contact during closure. Use the clench test to see if the extra sensitivity is related to an uneven bite. Squeeze hard. If you can make any tooth hurt by empty mouth clenching, the bite is probably the main reason for the sensitivity. This is a good way to find out if a new filling or crown is "high." If it hurts when you clench, it is probably not in perfect harmony with a correct bite. You should be able to bite hard and grind your teeth together in all directions without feeling discomfort in any tooth if your bite is perfect. The exception to this is if you have advanced periodontal disease, you may have several teeth that can't accept firm biting, but even then, you should not normally feel pain in a single tooth when biting.
If biting hard causes pain or discomfort in the jaw joint, (you may feel it just in front of your ear), you can suspect a possible relationship between your bite and a temporomandibular joint (TMJ) problem. It may be associated with a structural disorder in your TMJ, but more often the pain is coming from certain muscles that move your jaw joints to accommodate a bite that is not in harmony with your TMJs. Your dentist should be able to diagnose the exact source of the pain.
Look for severe wear on your teeth, as this is another sign that your bite is not in harmony. If you have worn all the enamel off the biting edges of your teeth, you will see a darker colored surface. This is dentin and it will wear down seven times faster than the much harder enamel that you've already worn through. So ask your dentist to evaluate what is causing so much wear. This wear can be especially damaging when it is on your front teeth, so if you notice your lower front teeth have worn down to dentin, have your bite checked. Better yet, don't wait till all the enamel is gone. Schedule a visit to your dentist office. Correcting your bite may stop or at least slow down the wear process.
By Peter E. Dawson, DDS
