Many people experience headaches (migraines), jaw pain, and sore teeth, and this could be directly related to the way their teeth come together. If the jaw joint (or TMJ) is not in its most comfortable (or orthopedically correct) position when one bites down, joint pain (clicking and popping, limited range of motion, etc), muscle soreness (sore jaw and neck muscles), and over-functioning of teeth (fractures, worn teeth, advancing gum problems, mobile teeth, etc) may develop.
An unbalanced bite may place teeth at a higher risk for poor performance and can cause unsightly changes to one’s smile. Recognizing bite problems in the early stages increases the probability that teeth will remain esthetic, healthy, and function properly as one ages.
The treatment sequence:
When a patient presents with jaw pain or muscle soreness, the first step is to fabricate a splint (Lucia Jig) that covers the front teeth and puts the jaw in its most stable position. The Lucia Jig aids in drastically decreasing muscle activity during nocturnal grinding and clenching by allowing contact only on the front teeth. If clenching and grinding was the cause of the patients pain, most people find relief within a few days. If the issue is related to the joint, the Lucia Jig provides invaluable information toward a diagnosis. It allows the joint to function in its most stable position, irrespective of tooth position. The Lucia Jig is usually worn at night for 2 weeks.
Once a stable joint position is obtained, an occlusal splint (or nightguard) is fabricated to cover all of the upper or lower teeth. The bite in the nightguard is idealized to fit where the jaw joints are most comfortable. This becomes the temporary perfect bite, and may require several adjustments. When the splint is properly adjusted and worn as prescribed, many of the signs and symptoms of bite problems often disappear. Properly adjusted bite splints can then be used as a guide to idealize the bite.
There are several options when looking to idealize your bite. These options will be determined once the patient is stable with the occlusal splint.
Occlusal analysis: The doctor will mount models of your teeth on a mechanical jaw that can mimic all of your jaw movements. He or she will then determine what kind of adjustments/dental work will be needed to perfect the bite.
Equilibration: A focused reshaping of the teeth so that they bite together simultaneously with even pressure. The doctor reshapes the areas that are interfering and most likely causing you to clench and/or grind. This is accomplished in 1 to 3 appointments and is usually painless (no anesthetic required) during and after the procedure.
Equilibration combined with restorations: Equilibration as above, with the combination of some teeth that need fillings, crowns, veneers, etc.
Orthodontics: If the teeth are severely malpositioned, orthodontics may be recommended to improve their position. With improved position, the bite can then be idealized with equilibration, possibly combined with restorations.
Surgery: For the most severe alignment issues, the bite may need to be re-set with a surgical procedure. If this is indicated, you will be referred for an evaluation by an Oral and Maxillofacial Surgeon.