Teeth that are out of line, heavily worn or constantly breaking, fillings that fracture or crowns that work loose may all be signs of occlusal problems. Your teeth may also be tender to bite on or may ache constantly.

Gums

Loose teeth or receding gums can be made worse by an incorrect bite.

TMJ

The letters TMJ are short for 'temporo-mandibular joint', which is the joint connecting your lower jaw and your skull. The movement in this joint lets you open and close your mouth and chew from side to side.

Clicking, grinding or pain in your jaw joints, ringing or buzzing in your ears and difficulty in opening or closing your mouth could all be due to your teeth not meeting each other properly.

Muscles

If your jaw is in the wrong position, the muscles that move the jaw have to work a lot harder and can get tired. This leads to muscle spasm. The main symptoms are continual headaches or migraine, especially first thing in the morning; pain behind your eyes; sinus pain and pains in your neck and shoulders. Sometimes even back muscles are involved.

How can I tell if I have a problem?

Many people have imperfect occlusion and missing teeth, yet never have symptoms because they adjust to their problems. Occasionally, in times of increased stress and tension, the symptoms may appear and then go away immediately. Or, your teeth and gums may be affected straight away and, instead of headaches, you may suffer from:

Counseling and relaxation therapy may help in some cases. These techniques help the patient to become more aware of stressful situations and to control tension.

Diet and exercise

As with any joint pain, it can help to put less stress on the joint. So a soft diet can be helpful, as can corrective exercises and applying heat. Physiotherapy exercises can often help, and your dental team may be able to show some of these to you. 

Dental guard

There are ready to wear devices available which are designed to protect the teeth and help prevent the TMJ from clenching and grinding.

Tooth adjustment (equilibration)

Your teeth may need to be carefully adjusted to meet evenly. Changing the direction and position of the slopes that guide your teeth together can often help to reposition the jaw.

If your dentist suspects that your symptoms are due to an incorrect bite, they may help to improve the problem by giving you a hard plastic appliance that fits over your upper or lower teeth. This appliance needs to be measured and fitted very accurately so that when you bite on it, all your teeth meet at exactly the same time in a position where your muscles are relaxed. You may have to wear this all the time or just at night. If the appliance relieves your symptoms then your bite may need to be corrected permanently. Relief in some patients is instant: in others it can take a long time.

Replacement of teeth

The temporo-mandibular joint needs equal support from both sides of both jaws. The chewing action is designed to work properly only when all your teeth are present and in the correct position. Missing teeth may need to be replaced either with a partial denture or a bridge.

Your dentist will not usually replace missing teeth until they are certain you have occlusal problems.

Medication

Certain drugs can help in some cases, but this is usually only temporary. Hormone replacement therapy may also help some women.

Will straightening my teeth help?

If your teeth are too far out of line or in a totally incorrect bite position, you may need to have an orthodontic appliance (brace) fitted to move them into a better position.

How many people suffer from these problems?

Up to 1 in 4 people may have some symptoms. Both men and women are equally affected, although women tend to ask for treatment more often than men. The symptoms can often start with the menopause or other hormonal changes.

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