Do you have an unstable chewing system?
People lose their teeth to 3 primary processes: gum disease, dental decay and an unstable chewing system. That chewing system is supported by your jaw joints, the supportive muscles and the teeth. You probably have noticed that your back teeth have points (cusps) and valleys (fossae). In an ideal bite relationship, the cusps of your back teeth fit snugly into the fossae of the opposing teeth while the two jaw joints (TMJ’s) seat completely in their sockets. We know that this is the least stressful and least destructive relationship for your teeth, supportive bone and gums, TMJ’s and jaw muscles.
The front teeth are also very important in guiding the functional process. Like guardrails on a highway, the overlap of the upper front teeth over the lower front teeth guide our lateral chewing motion and protect the back teeth by limiting excessive stress during chewing. When these front teeth are not in proper alignment or are worn down, they lose this protective function and the destructive risks accelerate for the teeth, bone, gums, jaw joints and muscles.
In my experience, an unstable chewing system is often overlooked or dismissed as part of the “natural aging process.” Analogous to a set of auto tires that aren’t aligned properly and are wearing down and losing their peak performance at an accelerated rate, an unbalanced bite leads to abnormally accelerated tooth wear, loose or cracked teeth, sensitive teeth, jaw joint dysfunction, gum recession, bone loss and early tooth loss.
What are the signs and symptoms?
- Worn tooth structure (lost outer enamel)
- Chipped or cracked teeth
- Teeth sensitivity to cold/hot/biting pressure
- A history of root canal treatments
- A tendency to clench or grind your teeth
- Wedge-shaped notches at the gumline
- Bone loss, gum recession and loosening teeth
- Jaw joint clicking and/or pain
- Headaches and facial muscle tension
- Dental work that fractures prematurely
In my experience, many people have unstable chewing systems and aren’t even aware that this is the reason for their dental problems. They often aren’t aware that the long-term risks associated with an unstable chewing system can be reversed.
How is an unstable chewing system treated?
If you have experienced any of the above signs and symptoms, we would encourage you to consider a more detailed evaluation of your bite. This involves taking impressions (molds) of your teeth, mounting them on a jaw simulator, and taking detailed records of your current condition. In many cases, patients with unstable chewing systems can undergo a predictable, reversible process utilizing splint therapy that allows your jaw joints to ideally seat in their sockets and relax overworked chewing muscles. A “splint” is an appliance that looks much like a nightguard, but unlike a conventional nightguard that’s simply designed to protect your teeth from frictional wear damage, the splint is designed to create a temporary idealized bite and allows the joints to return to their healthy position without interference from the teeth. While protecting your teeth from the harmful effects of clenching and grinding much like a nightguard, it also allows your jaw joints to realign to a comfortable, stable position, and your muscles to relax and release tension.
Additionally, splint therapy serves as a predictable, diagnostic tool for determining what’s causing the instability in the chewing system so that more definitive treatment can be offered. In essence, the restorative goals are to eliminate the discrepancies between a patient’s current unstable system and the ideal system created with the splint. Those restorative options are different for each patient and cannot be predicted in advance of splint therapy. Some patients can have their unstable chewing systems corrected quite conservatively with minimally invasive bonding techniques. Others might require more extensive restorative processes to reestablish healthy cusp/fossa relationships on the back teeth and guidance patterns on the front teeth. Some patients might benefit from orthodontics or even jaw surgery.