Occlusion is a very complex area of dentistry that involves the multiple relationships between the upper and lower teeth and jaw bones during function or rest. .
First of all, we must understand that only the lower jaw moves. The upper jaw is permanently attached to the skull with no movement possible. There are skeletal/jaw bone and tooth position considerations when evaluating occlusion. There are 3 possible skeletal relationships (forget teeth) between the upper and lower jaws. Class 1 (the upper jaw is slightly anterior to the lower jaw, normal), Class 2 (the lower jaw is set too far back of the upper jaw, Andy Gump look), Class 3 (the lower jaw is set too far forward of the upper jaw, the picture of the marine on billboards with lower jaw protruding forward and stating “we need a few good men”).
Next we must consider the tooth relationships between the upper and lower teeth. It is important to note that in healthy occlusion, teeth do not just randomly contact each other. There are multiple contact points on each tooth and all of these contacts need to be in a precise location on the tooth for healthy occlusion.
There are six different positions between the upper and lower teeth and jawbones. The occlusal relationships between upper and lower teeth must be correct in all six of these positions In general, the anatomy of teeth, roots and surrounding ligament and jawbone are designed to resist occlusal forces in a vertical direction. Horizontal forces are very damaging to teeth and the surrounding soft tissue and bone. These harmful horizontal forces can result in abscesses, root fractures, restoration fractures, pain, TMJ dysfunction, mobility, tooth loss, headaches, limited range of motion, muscle spasms in face, neck and shoulders. Occlusion is further complicated when dental restorations (crowns, fillings, bridges, implants, partial or full dentures etc) are introduced into the picture. Additionally, complications occur when the patient has parafunctional habits such as bruxism (grinding teeth) or clenching, while awake and/or in sleep.
Correct occlusion is extremely important in implant dentistry. Unlike teeth, implants do not have a shock absorbing ligament that surrounds the roots of teeth. The surface of an implant is in direct contact with the surrounding bone (osseointegration) which leaves no margin for error in occlusal design.
There are multiple technologies to evaluate and correct occlusal problems. Many times the correction can be done with occlusal equilibration by a clinician who has specialized training and experience in this area. If the treatment is beyond equilibration, then more invasive techniques may need to be considered such as orthodontic movement of the teeth and/or upper and lower jaw bone surgery (orthognathic surgery).
At Britt Perio, we have the advanced training and skills to properly evaluate and treat occlusal problems with the least invasive methods possible.