Providing TMJ Treatment in Brookline, MA

This is a term that very few dental patients have ever heard of before. That is surprising since the vast majority of people have this occlusal dental disease at least to some degree.

Occlusal pathology can cause destruction of some or all of the components of our masticatory (chewing) systems. These components are the teeth, the supporting bone, the gums, the TM joint, and the muscles. In many cases if left undetected and untreated, occlusal disease can become quite disfiguring to the teeth and debilitating to our masticatory systems.

Occlusal pathology is a very complex subject, but I will try to make it as simple as possible for a basic understanding. Occlusal disease of the teeth is characterized by excessive or abnormally accelerated tooth wear. It is caused by deflective interfering contacts on back teeth or in other words, back teeth hitting in a glancing manner. Back teeth have cusps and fossae. The cusp is the point, and the fossa is the valley. The cusp (or point) of one back tooth, therefore, will contact the fossa (or valley) of the opposing back tooth. The ideal human bite has all of the cusps of all back teeth resting perfectly in the opposing fossae while the two joints are fully seated in their sockets.

This is very rarely found naturally and most patients that have this ideal bite relationship have had it produced by a dentist. The process that achieves this nondestructive and comfortable bite relationship is called an equilibration. Those fortunate patients that have had an equilibration have virtually had the cause of occlusal pathology removed. This ideal relationship has the effect of directing the forces of chewing down the long axis of the tooth. These vertical forces are what the tooth, the connection ligament, and supporting bone are best able to bear.

If all the teeth are bearing an equal load down their long axis at the same time the two TM joints are fully seated and braced in their respective sockets, then the system has had all the forces of chewing and other functions equally and evenly dispersed throughout the masticatory system. This is the least stressful and least destructive bite relationship for your teeth, bone, joints, muscles, and yes, your new dental work.

You should be evaluated for occlusal disease before embarking on any extensive restorative dentistry.

The Five Signs of Occlusal Disease

1. Jaw pain, clicking, locking
2. Muscle-tension headaches
3. Severe wear and/or chipping of your natural teeth
4. Loose and/or shifting teeth
5. Gum recession and/or grooves on exposed root surfaces.

How to Treat Occlusal Disease

Tooth Equilibration / Balancing a Bite

Occlusal equilibration is a gentle procedure that allows your lower teeth to contact your upper teeth very evenly all the way around your mouth.

The goal of this treatment is to create a "Solid bite" that prevents stress on individual teeth and reduces stress on the jaw muscles and jaw joint…

What's involved? I do occlusal equilibration by selectively and precisely reshaping the tiny bumps and valleys of the biting surfaces of individual teeth. Typically, the treatment is done in three visits — 2 weeks apart. The first visit is 1 hour, the second visit is 45 minutes and the third visit is 30 minutes.

What are the risks of treatment? Some patients report that their bite feels different after the first visit. Occasionally, the jaw muscles become sore between the first and second visit. Occasionally, some teeth may be sensitive to cold between the first and second visit. We will discuss the need to replace any dental work "that is too big for your bite", before we begin the equilibration. The adjustments made to your teeth are generally too small to see any change in their appearance.

This procedure is being recommended to you because you have teeth that have shifted in your mouth over time for a variety of reasons.

One or more of the following signs of an active dental problem are present:

1. Temporomandibular joint pain
2. Muscle-tension headaches around the sides of your head or around the jaw joint
3. Severe wear of your natural teeth
4. Loose teeth
5. Chipping teeth
6. Gum recession and other associated problems.
7. Grooves and chips forming at the gum line exposing root surfaces