Occlusion

Occlusion

OCCLUSAL EQUILIBRATION

(Modifying the chewing surfaces of teeth)

  1. Purpose: Often, teeth and jaws do not occlude (come together) in an acceptable position. The result is called malocclusion and has been related to muscle pain and other maladies. Some reasons for malocclusion are fillings or bridges that have been placed piecemeal over a period of years, orthodontics, developmental defects, oral surgery, trauma, natural occurring malocclusion, bruxism, and clenching.
  2. Occlusal Equilibration: Occlusal equilibration is the mechanical adjustment of your teeth, dentures, bridges, fillings, or other oral appliances to allow your lower jaw to function as a natural hinge in relation to your upper jaw without improper influence from teeth.
  3. Is Occlusal Equlibration Harmful? When malocclusion is present, teeth are equilibrated because some problem exists: pain, abnormal wear, breaking of restorations (crowns), or other conditions. The problem is usually present because the teeth and/or

restorations do not meet in harmony with your lower jaw at the proper position. The teeth and fillings have not worn in properly. Occlusal equilibration wears some areas mechanically and allows the teeth to meet harmoniously. It is not harmful.

4. The future: A simple occlusal equilibration can make the teeth and restorations meet harmoniously. However, slight changes in your occlusion (bite) occur over a period of a time, because of small movements of teeth in the jaw bones. More complex equilibrations may require several appointments, and the teeth may shift significantly between appointments. When your symptoms are gone, and your occlusion is relatively stable, your occlusal equilibration will be finished. Placement of any new fillings in your mouth will change the way the teeth contact. The dentist accomplishing this future treatment should be advised of your past occlusion problem.

5. How your teeth feel: After occlusal equilibration, your occlusion (bite) will feel different to you. This is to be expected. You will gradually accept this location as your new chewing position.

If you have questions, please call us.

OCCLUSAL SPLINTS FOR TEMPOROMANDIBULAR DISORDERS (TMD), BRUXISM, OR CLENCHING

  1. Purpose: The purpose of splint therapy is to allow your lower and upper jaw to come together without tooth contact, and to reduce muscle pain. Many situations cause the malfunction of your lower jaw. Examples are accidents, surgery, developmental defects, peculiar oral habits, many fillings placed over numerous years, naturally occurring malocclusion (poor bite), orthodontics, psychological stress, clenching or bruxing (grinding teeth), and other conditions.
  2. Rationale for Splint Use: You will receive a plastic bite splint (occlusal splint). This treatment has been used for many years to keep the teeth from contacting during chewing and to allow the lower jaw to return to a comfortable hinge position without interference and guidance from the teeth. When the splint has been worn for a few days the jaw functions freely.
  3. Wearing Splint:
    • Temporomandibular Disorders: If your condition is temporomandibular disorder, you should wear the splint at all times including while eating, unless directed otherwise. If you remove the splint to eat, your treatment will not be as effective. Many fillings placed in your mouth over the years or other conditions have caused your teeth to meet in a position your jaws cannot tolerate. The splint eliminates tooth-to-tooth contact. Your symptoms will gradually disappear while you are wearing the splint; and your natural teeth, bridges, and/or fillings will be adjusted to the new bite by us. This procedure is called occlusal equilibration. After equilibration, you will wear your splint only at night. After a period of time, you will not wear the splint at all. The described treatment usually requires a few weeks to several months.
    • Buxism and Clenching: If your condition is bruxism (grinding of teeth) or clenching, you should wear your splint at night when you cannot control your jaw movements or during time of psychological stress. During the daytime, make sure your splint is placed in water to avoid warping.
  4. Cleaning The Splint And Teeth: Food will accumulate around and under the splint. At least one time each day, brush and floss your teeth very thoroughly. Brush and rinse the inside and outside of the splint, and then return it to your mouth. Dental decay will initiate if you are not careful about cleanliness of your mouth and splint. If you have a high dental decay potential, fluoride-containing rinses or gels are useful when placed in your splint once per day.
  5. When The Splint Is Out Of The Mouth: If the splint is out of your mouth for any reason, your teeth may not meet in harmony. This situation is to be expected because of muscle and jaw relaxation while you were wearing the splint. Occlusal equilibration will eliminate this improper meeting of the teeth (malocclusion). If the splint is out of your mouth, place it in a container of water to prevent it from warping. You may desire to soak it occasionally in a commercially available denture cleanser. As an alternative, you may soak it in a solution made by adding a few drops of Clorox to a cup of water.

PHYSICAL THERAPY FOR TEMPOROMANDIBULAR DISORDERS (TMD)

  1. Temporomandibular dysfunction is a lack of normal function between the upper and lower jaws. It can be caused by accidents, surgery, developmental defects, peculiar oral habits, extensive dental restorations (fillings), naturally occurring malocclusion (poor bite), orthodontics, psychological stress, clenching or grinding of teeth, or other conditions.
  2. Physical therapy can help your jaw joints to function freely and without pain. If you follow the treatment below, you can relax your chewing muscles, reduce severe headaches, and prevent related discomfort. This therapy has approximately an 80 percent success rate for patients with TMD. If physical therapy is not successful, additional treatment is available.
  3. Selecting a time to accomplish the exercises. For best results, do these exercises once a day, unless directed otherwise. The exercises require 15 minutes. Choose a relaxed time of day, such as immediately before bedtime, when you will be able to do the exercises without interruption. You may want to use a timer to ensure that you are spending enough time with the exercises.
  4. Accomplishing the exercises:
    1. Heat: Hold a heating pad, hot washcloth, hot water bottle, or other heat source on the painful areas of your head or neck. Apply this heat for five minutes to relax your muscles for the exercises.
    2. Exercises: Do the following exercises for one minute each (a total of five minutes).
      • Open-Close: Place a closed fist under your chin to gently resist movement. Open and close your mouth 30 times (one second to open and one second to close).
      • Forward-Backward: Place a closed fist on the front of your chin to gently resist movement. Move your lower jaw forward and backward 30 times (one second forward and one second backward).
      • Right: Place a closed fist on the right side of your chin to gently resist movement. Move your jaw to the right, and then return your jaw to a relaxed position 30 times (one second right and one second to chewing position).
      • Left: Place a closed fist on the left side of your chin to gently resist movement. Move your jaw to the left, and then return your jaw to a relaxed position 30 times (one second left and one second to chewing position).
      • Head Turn (Stand Or Sit Very Straight Up):
        • Right: Turn your head all the way to the right, and place the palm of your hand on the left side of your jaw. Every two seconds, push your head slightly farther to the right to stretch the muscles, and then return your head to the original side position (15 times).
        • Left: Turn your head all the way to the left, and place the palm of your hand on the right side of your jaw. Every two seconds, push your head slightly farther to the left to stretch the muscles, and then return your head to the original side position (15 times).
    3. Heat: Apply heat for another five minutes as suggested in Step (4a) to relax the muscles.
  5. Additional Treatment - such as a plastic bite splint to assist in making you bite in the correct position, or slight trimming of teeth and fillings to make your teeth and jaws come together correctly (occlusal equilibration) may be needed to assist in your therapy.

If you have questions, please contact us.

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