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Occlusion Dentistry

What is occlusion?

Occlusion in dentistry is the field which aims to treat malocclusion which affects masticatory muscles and temporomandibular joint. Most common problem found is Bruxism.

Bruxism is the excessive grinding of teeth when sleep. Patients may experience jaw pain, joint or cheek muscle fatigue in the morning. People who share same bedroom might hear the grinding sound at night. However, patients might not aware of his own condition.
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Biting force when sleep is stronger than when awake. Several symptoms could be found in oral cavity of bruxists, such as attrition, tooth fracture,sensitive teeth. This parafunction might lead to problem of masticatory muscle and the joint.

Abnormality of masticatory muscle and temporomandibular joint

Temporomandibular joints are located next to ears. They are synovial joints articulating between condyles, which are part of mandibular, and temporal bone of the skull. Articulate discs at the joints helping smooth the movement. There are also ligaments and muscle attached to the joints for border movements. These organs are the main components of what so called “Temporomandibular joint (TMJ)”.

Disorders of these joints are called “Temporomandibular Joint Disorder (TMD)”.
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Symptoms of TMD:

  • Pain of the joints (next to the ears) and/or pain of the jaw, cheek and temporal
  • Limitation of mouth opening, pain when opening the mouth
  • History of jaw lock
  • Clicking sound when opening and closing the mouth
  • Deviation of jaw when opening, pain when chewing
  • Some patients experience pain in the ear cavity, headache or migraines

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Causation of TMD:

The causation is unclear. However, TMD might be cause from multiple factors

  • Malocclusion
  • Disharmonization of occlusion. For instance, removal of molar which cause tooth tipping to the space and lead to malocclusion.
  • ccident to the joint
  • Unbalanced function of the muscles due to chewing on one side
  • Chewing hard sticky food or chewing bubble gum frequently
  • Bruxism
  • Stress

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In normal joint movement, condyles normally move with articulate discs. However, in disorder condition, articulate disc displaces to the front while condyle displaces backward. In mouth opening, condyle slips over the disc making “click” sound. When mouth closing, condyle get back to former position making another “click”. Without proper treatment, this condition might get worse.

If those symptoms occurred, patients should seek professional advice. The treatment mainly uses occlusal splint or night-guard.
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Patient self-care before seeing the doctor:

  1. Refrain from eating hard, sticky or crunchy food. Avoid chewing gum. Take soft diet. Limit mouth opening. Do not bite on big chunk food.
  2. If waking up with muscle pain causing limit mouth opening (1-2 fingers width),use three fingers( index, middle and ring fingers) to massage and press down on the muscle for 15-30 minutes. After, apply hot compress with towel soak in lukewarm water for another 15-20 minutes. These treatments will release pain and increase mouth opening.

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