1. Headaches & Treatment of ‘temporo mandibular joint’ disorder
TMD (temporomandibular joint disorder), neuromuscular dentistry, chirodontics, gnathology, TMJ (temporomandibular joint) therapy, malocclusion, occlusal disease, occlusal splint therapy, equilibration… these terms alone could give you a headache! So I will attempt to simplify the concept.
As someone who used to have headaches it was news to me that they might have been caused by the way my teeth met. My bite was ‘wonky’. As there are no straight lines in nature, neither are there any perfectly straight teeth. We all have to adapt to ‘wonkiness‚’ to some extent and indeed we are very good at it. We are designed to tolerate some degree of imperfection.
As our teeth meet together imperfectly our muscles move our jaw to compensate. One side of our bite will move a little more than the other. Our jaw joints will shift a little to compensate as we bite together. This is all normal and generally doesn’t cause a problem because we have flexible parts in our joints and our muscles are controlled in a coordinated way to make movements smooth and stop teeth clashing together.
So we have a very sophisticated system. The teeth are used frequently for chewing, speaking and smiling. The muscles are involved in coordinating all of these movements which hinge around the 2 joints on either side of our face (just in front of our ears).
There is a limit to how much we can adapt to our imperfect bites. This limit can be passed in a number of ways. We can over work our imperfect bites by chewing too much or grinding teeth together. Stress can make muscles more active. As our jaw muscles are highly active anyway, too much stress can lead to tooth grinding or clenching, often at night.
If we have imbalanced bites beyond a comfortable threshold then this alone can cause a problem. Imbalanced bites can be caused by poor dentistry, having teeth moved with braces, teeth movement after extractions, inheriting poor fitting teeth and trauma.
Throw poor fitting teeth and stress together and problems can develop. The muscles have to work too hard to coordinate movements and the joints get worn out. Sometimes the joint can dislocate and cause lock jaw. Joints get painful, muscles get painful and teeth get painful. The pain resulting from these areas can get quite confusing and often treated inappropriately.
Symptoms include; pain behind the eye, jaw ache, neck ache and stiffness, headache, hypersensitive teeth, clicking or grinding in the joints, stiffness or pain in the shoulders, ringing in the ears, ear ache and sinus congestion. The symptoms can manifest themselves in a pattern that specifically relates to the pattern of the patients bite imbalance and/or grinding habit.
The first approach to treatment is to assess whether the problem is temporary. If you are under some temporary stress then the symptoms may go with the stress. So stress management is one approach. If the problem is more to do with particularly ill fitting teeth then an appliance to balance the bite would be a good idea. A mouth guard can be made to balance the bite.
Some massage techniques and physiotherapy is also a good idea.
If a mouth guard is not tolerated then the bite can be corrected permanently by braces or by altering the biting surfaces of the teeth.
At Shelly Manor Dental we believe that a combined approach would be optimal because the problem itself is caused be several contributing factors.
2. Tooth contouring.
Tooth contouring is a very quick and easy, pain free procedure that can make a subtle improvement to your smile, assuming your teeth are suited to this procedure. It involves shaping the front teeth slightly, smoothing over jagged edges and rounding corners. Sometimes we add a small amount of white filling to an edge to help achieve a nice result. Great care is taken to match the shade exactly. We will not carry the procedure out if it involves removal of too much tooth tissue. Indeed in these cases contouring would not be suitable anyhow.
3. Fissure sealants.
Back teeth (molars) have pointy bits and also groovy parts called fissures. These fissures can trap food and this feeds the bacteria. The bacteria turn the food into acid which dissolves some tooth and this leads to cavities. A good way to prevent the food packing and so prevent cavities is to seal the fissure with a white filling material. This is a very quick, easy and painless procedure. Some people don’t have particularly groovy teeth so fissure sealants are not always necessary. An early sign that you might need sealants is if your grooves are getting stained.