Your headaches and your teeth.

What is Occlusion ?

Your dental occlusion is the way your teeth meet together when you bite

What is the T.M.J. ?

The letters T.M.J. are an abbreviation of Temporo-Mandibular Joint, which is the joint between your lower jaw and your skull. Movement in this joint enables you to open and close your mouth and chew from side to side.
Position of T.M.J. with mouth closed.
Position of T.M.J. with mouth wide open.
   

What are occlusal problems ?

If your teeth don't fit together properly then you can get problems in any of the structures that are involved in your bite ; the teeth themselves, the gums, the Temporo-Mandibular Joint or the muscles that move the jaw
1. Teeth - Teeth that are misplaced, heavily worn or constantly breaking, fillings that fracture or crowns that work loose may all be signs of occlusal problems. The teeth may be tender whilst chewing or may ache.
2. Gums - Loosening of teeth or gum recession can be aggrevated by a faulty bite.
3. T.M.J. - Clicking, grinding or pain in your jaw joints, ringing or buzzing in your ears, difficulty in opening or closing your mouth could all be due to your teeth not meeting each other properly.
4. Muscles - If your jaw is in the wrong position, the muscles that move your jaw will have to work a lot harder and can get tired and go into spasm. The main symptoms are chronic headaches or migraine, especially first thing in the morning, pain behind your eyes, sinus and pain in your neck and shoulders. Sometimes even back muscles are involved.
Location of jaw muscles in relation to neck muscles
   
How can I tell if I have an occlusal problem ?
1. Are you aware of clenching or grinding your teeth ? (most people who do, are not aware that they do). This may be related to anxiety, but generally, most people clench when they are concentrating while doing something with their hands, i.e household work, gardening, car mechanics, typing etc.
2. Do you wake up in the morning with an awareness about your teeth or jaw as if you had been clenching or had been grinding them in your sleep ? Most people who grind their teeth do so when asleep and may be unaware of it.
3. Do you have chronic headaches, or chronic head, neck and shoulder pain ?
4. Do you have recurring pain or discomfort on the side of your face around your ears or jaw joints ?
5. Have you ever had clicking or popping in your jaw joints or difficulty moving your jaw ?
6. Have you lost some teeth at the back of your mouth? This may have lead to your bite becoming unbalanced.
The symptoms are sometimes collectively referred to as the T.M.J. Syndrome

Cycle of symptoms involved in occlusal problems
   
How do i get the occlusal problem treated ?

See your dentist. He or she may be able to help you or refer you to a specialist in occlusal problems.

Depending on the problems you are having, it is possible to detect evidence of an occlusal problem. Various muscles may be sore when tested, or the broken or worn areas of your teeth will show you are grinding your teeth, a common sign of an incorrect bite.

Dentist testing for occlusal problems.
If your dentist suspects that your problems are due to an incorrect bite, he or she may help to diagnose the problem by supplying a hard plastic appliance ( see below ). This appliance needs to be measured and fitted very accurately so that when you bite on it, all your teeth meet at exactly the same time in a position where your muscles are relaxed. You may have to wear this all the time or just at night. In simple cases you may not need to wear an appliance.

Plastic appliance (Bite Block) for correcting bite.
If the appliance relieves your symptoms then your bite will need to be corrected permanently. This can be done by :
1. Tooth Adjustment ( Equilibration ) - Your teeth may need to be carefully adjusted to meet evenly. changing the direction and position of the slopes that guide your teeth together can often help to reposition the jaw.
2. Orthodontics - If your teeth are too far out of line, or in a totally incorrect bite it may be neccessary to fit a brace to move them into a better position.

Normal chewing forces

Abnormal chewing forces
3. Replacement of Teeth - The joint needs equal support from both sides of both jaws. The chewing action is designed to work properly only when all the teeth are present and in the correct position. Missing teeth may need to be replaced either with a partial denture or bridgework.
4. Medication - Some drugs can help in certain cases but usually only on a temporary basis. Hormone replacement therapy may also be helpful for some women.
5. Diet & Exercise - As with any joint pain, reduced stress, i.e a soft diet, corrective exercises and external heat can be useful in certain cases.
6. Relaxation - Counselling and relaxation therapy may help in some cases. These techniques help the patient become aware of stressful situations and to control tension.
   
Why Me ?  

Up to 1 in 4 people may have some symptoms and both men and women are affected equally, although women tend to seek treatment more often than men. The onset of symptoms can be particularly associated with the menopause or other hormonal changes.

Many people have imperfect occlusion and missing teeth and never have symptoms because they adjust to their problems. Occasionally, in times of increased stress and tension, the symptoms may occur and then go away immediately. Alternatively, another link in the chain breaks down and instead of headaches occuring you may suffer from:-
1. Flattened, worn teeth.
2. Broken teeth, fillings and crowns.
3. Loose teeth.
4. Continual sensitivity of your teeth to temperature change.
5. Toothache with no apparent cause.
   
If you think you have any of these problems, ask your dentist.