TMJ Treatment Portland

When Good Bites Go Bad

One of the more perplexing problems in dentistry is finding the ideal jaw position, the one point where the muscles and the joints and the teeth all work harmoniously and comfortably. This is generally referred to as the “ideal bite,” and varies with each individual.

All sorts of things affect the bite position. The genetic blueprint of the jaw bone structure is one, and one that cannot generally be much altered without major surgery. The configuration of the TemproMandibular Joint (the “TMJ” that you hear so much about) and the shape of the projecting head of the lower jawbone that functions within the TMJ are also factors that cannot be non-surgically addressed. The muscles that work to position the lower jaw to enable it to move and chew and talk and yawn, are directed by the teeth to pull the jaw to the position where the greatest number of teeth hit together at the same time; these muscles are also not “trainable,” and their position, length, and strengths cannot really be affected, again, without resorting to surgeries.

And so that leaves, as the only component a General Dentist can effectively alter, the arrangement and shape of the teeth.

Your muscles guide your lower jaw to close so the greatest number of teeth hit at the same time, and when this happens, the bite should be able to be heard clearly as you tap your teeth together; a muffled sound means that the bite is tentative, or is being deflected by a tooth or teeth because the muscles do not want to fully impact only a single tooth. You can check this for yourself by not only listening, but by putting your fingers on the outside of your upper teeth, and tapping, and then chewing side to side. If you feel only one or two teeth hitting on a side, or if the tooth is pushed as you chew, then your bite is off, and you may want us to take a look at it.

The results of a bad bite are many. If there are teeth that are out of position even a bit, the jaw may be pushed off center, and the TMJ may become sore. The muscles, having to work unnaturally to position the jaw, will try to get back to their resting, happy position, and will try to remove any excess material that is blocking that pathway by grinding back and forth. This is the genesis of grinding, and clenching.

Teeth stressed by grinding can show a number of telltale signs. Flat planes, called “facets,” will eventually be formed on the biting surfaces, where the teeth have been ground by the opposite teeth. Sometimes the gum tissues pull away from the tooth, forming a little “V” at the neck of the tooth. On dental x-rays, the bone level may slant toward the offending area of the tooth. Eventually, the enamel will chip off the tooth near where the tooth enters the bone, and form an indentation in the tooth itself; this is called an “abfracture”.

And, of course, eventually, the overall integrity of the tooth may be damaged to the point of it not being savable, or to the point of becoming intensely painful.

It is our responsibility to work with you to both recognize this problem before it becomes a bigger problem, and, in conjunction with you, to correct the situation and the bite in as minimally invasive a manner as possible. Sometimes this is as minor as polishing the enamel or restorative material where it is a bit higher than it should be, removing the offending high spot on the tooth. Sometimes it involves replacing a restoration or two or repositioning the teeth through Invisalign® or braces.

We have developed a series of wonderfully simple and effective ways to analyze the bite problem, and we also incorporate highly sophisticated computer bite analyses to show us what the problem is, where it is, and how big it is. Most of the time, the correction is straightforward and very comfortable for the patient.

Feel free to give us a call, and we are happy to discuss your particular situation candidly. There are very few things quite as uncomfortable or intrusive as a bad bite, but together we can treat your teeth for a smile that is not only beautiful, but comfortable, and extremely long-lasting.
It is, after all, what we do.