Why fixing misaligned or broken teeth should start with the question, ‘why’…
What is occlusion? Dental specialists use the term occlusion to describe your bite or the way teeth contact occurs. In particular, it is assessing the relationship between the upper (maxillary) and lower (mandibular) teeth and how the jaws meet when chewing or at rest.
Malocclusion or misalignment means that the ‘bite’ is out of alignment and causing pain or injury to the individual and/or the teeth.
Occlusion in dentistry is an important feature of prosthodontics and reconstructive dentistry because it requires an in-depth understanding of the way the oral structures function together. While proper occlusal harmony looks different for each individual, it is extremely important, and often overlooked, in the assessment for oral and overall health.
This is why a prosthodontist is a specialist at restorative treatment, because they ask why a tooth has broken, when teeth are out of alignment, or if you are experiencing pain and use that information in resolving issues rather than just ‘fixing’ a tooth.
Have you ever had a filling or crown placed and then experienced headaches, jaw discomfort, sinus issues, or just felt “off”? Most dentists have the ability to create aesthetic and functioning crown, however a prosthodontist creates a functioning crown in alignment with your other teeth so that you don’t experience these issues.
What is malocclusion?
Malocclusion is a term that describes the misalignment of teeth. Other terms frequently used to describe the types of malocclusion, are crowded teeth, overbite, crossbite, underbite, and open bite. In addition, you may have heard dentists describing the three main categories of occlusions:
- Class 1: Ideal bite
- Class 2: Overbite
- Class 3: Underbite
Malocclusion symptoms include:
- Broken teeth or continually breaking dental restorations (i.e., dental fillings, crowns, etc.)
- Teeth on either the upper or lower jaw misaligning with teeth in opposition
- Facial appearance issues or changes
- Frequently biting your inner cheek, lip, or tongue
- Discomfort when biting and/or chewing
- Breathing more through the mouth than the nose
- Interference with proper chewing of food
- Temporomandibular joint (TMJ) pain
- Speech changes, such as a lisp
- Stress and wear on teeth
- Neck or back pain
- Sinus issues
- Sleeping issues
Dental Implants and Your Bite
Prosthodontists provide a unique, full-centered approach as they design highly durable, functional, and aesthetic dental restorations.
You will absolutely find a great dentist who can aesthetically repair or replace your crown, veneer, etc. However, if you find yourself continually having issues with pain, breakage, or recementing, begin to ask why.
A prosthodontist looks at placing a dental implant differently than an oral surgeon or periodontist, who primarily look at your periodontal, or gum, health to discern the best placement for an implant. A prosthodontist is looking at the final aesthetic results and will examine occlusion along with surrounding periodontal structure, determining the best placement for a dental implant and how that placement will ultimately work with the restoration (crown, bridge, or fixed denture), the surrounding teeth, and your final bite.
Here is an analogy: When building a house, the “oral surgeon or periodontist” looks at the landscape to see where the best land is for a foundation and they will build the ideal foundation to support the house. The “prosthodontist” looks at the entire landscape to see where the house looks best, and designs the house of your dreams: where the sun hits the house, where the plumbing is best placed, etc. In taking the time for further evaluation and using advanced training and technology in planning, you will find the best long-term outcome for your dental work.
How does fixing occlusion treat these issues?
To assess your occlusion, we begin with a full set of “records” that include a CBCT scan, traditional x-rays, photos, 3D iTero digital impression of your teeth, jaw and bite, and a complete exam with Dr. Spitz, a prosthodontist.
Prosthodontists, with two or more years of advanced training, are well suited to assess and re-align your bite when necessary. They use their knowledge of the overall masticatory system (which includes the periodontium, TMJ, cranial skeletal components, and the neuromuscular structure), to establish your correct occlusion, or bite.
Possible treatments for malocclusion include:
- Braces (Invisalign, LightForce or traditional braces in conjunction with an orthodontist)
- Restorative work such as dental implants, crowns, bridges, dentures, etc.
- Surgical intervention
- Bone grafting to prepare for dental implants
- Bite guards, dental splints, or occlusal splints
- Night guards