Occlusal adjustments are procedures used to realign the jaw to help alleviate pain or tension that may be the cause of TMJ disorders.
Why Occlusal Adjustments?
When the joint between the lower jaw and the base of the skull is not working well it can lead to abnormal jaw movement or locking,noises, clicking or grating, muscle spasms, tenderness or pain. These are often the symptoms of Tempromandibular Joint Disorder, which is a common issue among people, and might be caused by occlusion (the way the teeth bite), trauma or stress. Treatments include occlusal adjustments, splints, physiotherapy and surgery.
Occlusal Adjustments – Procedure
Occlusal adjustments involve reshaping the enamel (outer layer of the tooth) located on the biting surface of tooth. Adjustments involve the process of grinding the opposing teeth surfaces down to a point where the contact, or occlusion, is properly in line. An occlusal examination should be performed before any type of invasive treatment is conducted because this procedure is irreversible and involves the removal of tooth structure. The capabilities of a bite adjustment have limitations, so a proper indications must exist before it is considered.
The goal of occlusal adjustments are to improve the contact pettern of each tooth against the lower or upper counter part. The occlusal adjustments procedure is also known as selective grinding, which involves the successive removal of all less than ideal occlusal contacts. The contacts on each tooth determine how an opposite tooth will interact during the bite. A slide occurs during the bite based on the incline on the tooth, and the opposing tooth moves to seek a more stable position. Majority of people contain some sort of slide during a bite, which are identified as a antero-superior, lateral, or horizontal slide. The extent of the slide can be detrimental, and the major cause of a multitude of oral problems or discomfort. The difference is the extent of what is called a malocclusion, which also determines the necessary treatments needed to adjust for each issue. During the examination the periodontists will assess the patient’s mouth, and identify which treatment is best based on the severity of the misalignment. The procedure is relatively simple and does not require anesthesia – the specialist will only be removing microscopic layers from the teeth, staying far away from any nerve endings.
There are two major guidelines that determine the best treatment plan. A slide with a large vertical component can be more easily eliminated than a slide with a large horizontal component. While the other is that an anterior slide of 2mm or less can usually be eliminated with occlusal adjustment alone.
Occlusal Adjustments – Appliances
Occlusal adjustments often require an a appliance, which is a noninvasive, removable, device that fits on the incisal and occlusal surfaces of the teeth. The appliance may be referred to as a night-guard, bite guard, splint, or other similar term. Splints may be considered for use as part of various treatments ranging from TMJ disorders to minimizing unfavorable forces on newly fabricated dental prostheses. Since occlusal appliances are removable, it indicates that the success of the treatment depends upon patient compliance. A patient who does not wear the appliance will not benefit from the treatment. Patient compliance is largely related to comfort. The more comfortable the appliance, the greater the compliance with and success of the treatment.