The Importance of the Bite:

Does it matter how the teeth function together?  The answer of course is yes.  However, it is important to understand that teeth do not function independent of the jaws, jaw joints, or chewing musculature.  If the jaw joint is not healthy, it will affect the muscles and the teeth.


There are warning signs that problems exist.  The presence of tooth wear, tooth mobility, sore teeth, or painful teeth are signs that there is a disharmony between tooth position and jaw joint position.  Other times, teeth may feel fine, but deteriorating jaw joints pop or click.  While other patients with unhealthy joints notice that they are clenching or grinding their teeth, muscles in their head and neck are sore and cause headaches, or their jaw locks open or closed.

A healthy mouth not only consists of healthy teeth and gums, but also healthy joints and muscles, creating an entire healthy chewing system.  This system functions harmoniously and protects against tooth breakage.  It allows for efficient chewing of food with back teeth, and front teeth are shaped and positioned so that they protect the back teeth and give the patient an attractive smile.  Muscles and joints in a healthy chewing system should function without pain.  If patients want to keep their teeth their entire life, it is important to consider the role a healthy bite plays.

TMJ:


What does TMJ stand for?  TMJ stands for temporomandibular joint or more simply the jaw joint.  TMJ is often used incorrectly to describe temporomandibular joint disorder or TMD.  Everyone has two TMJs as part of their normal anatomy. 

Fortunately, not everyone suffers from TMD.  The most common form of TMD is occluso-mucsle and refers to pain in muscles caused from a disharmony between the jaw joints and the teeth.  When this disharmony occurs, the muscles work to bring the teeth together in the best way possible for chewing.  For some patients, the jaw joint itself becomes sore from popping out of place to accommodate the functioning teeth.  For other patients, the muscles become fatigued or sore.  If the muscles are constantly working to position the teeth in a strained jaw position they will eventually hurt.  Still, for other patients, symptoms may present as sore, mobile, or worn teeth.

The second type of TMD is an intra-capsular disorder.  This type of TMD is less common and more difficult to treat.  Usually intra-capsular disorders are the result of current or past trauma.  Intra-capsular disorders describe an internal derangement of the joint itself.  Individuals with this type of TMD may be helped with straightforward non-surgical therapies or they may require surgery.

Treatment of any type of TMD almost always begins with an appliance that will give relief to the jaw joints, help stretch and relieve muscles, and provide protection and stability to teeth.  Appliance therapy begins with accurate diagnostic records.  With these records Dr. Miller can study the patient’s bite outside of the mouth and fabricate a bite appliance.  After the appliance is delivered to the patient, the patient will be seen for subsequent follow-up visits to adjust the appliance until the jaw joints and muscles return to a healthy state.  Once joints are stable, Dr. Miller will work with the patient to determine if further treatment is necessary.  For many patients, simply wearing an appliance at night as a preventative measure is all the treatment that is needed.  However, for more complex cases Dr. Miller may need to customize a treatment plan that best fits the patient’s needs.

TMJ and Bite Treatments

NICHOLAS MILLER, DMD

Family Dentistry