Introduction

It is not generally known that various head and neck pains can originate from the tired muscles that open and close the jaw.  It has been shown that over 50% of regularly recurring headaches are caused in this way.  These problems can be magnified by various other factors:-

Dental occlusion is another name for the way your teeth meet when your jaws bite together.

If you have several positive replies to the questions below, you may have a problem we can help with.

Do you clench or grind the teeth during the day?
Are you aware of clenching or grinding the teeth at night?
Do your jaws feel tired when you wake up?
Do you suffer from chronic headaches of any kind?
Do you experience chronic neck or shoulder pain?
Do you get pain around the jaw joints or the ear?
Do your jaw joints ever click or pop when you open your mouth?
Do you have problems opening your mouth wide?
Do you tend to chew on 1 side of your mouth?

Do you have problems biting?

Q          What kind of problems might I have?
A          If your teeth don't fit together properly, you can have problems not only in your teeth themselves, but also the gums, the temporo-mandibular joint [TMJ] or the muscles that move your jaw.  These problems are called occlusal problems.

Teeth
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
Gum disease, loose teeth or receding gums can all be made worse by a faulty bite.

TMJ

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.

Q  How can I tell if I have a problem?
A  You may find that you clench or grind your teeth. However, most people grind their teeth whilst asleep or when concentrating on a task.  This can be further amplified by stress and anxiety.

You may wake up in the morning with a stiff jaw or tenderness when you bite together.
If you suffer from severe headaches ,neck or shoulder pain, you may not have linked this with possible jaw problems. You may experience recurrent pain or discomfort on the side of your face, around your ears or jaw joints or have difficulty in moving your jaw. These are all problems associated with your jaw.

If you are missing some teeth at the back of your mouth, this may lead to an unbalanced bite, which can cause uneven pressure on your teeth.

Together, all these symptoms are called Tempero Mandibular Dysfunction [TMD].

Q  How are occlusal problems treated?
A  Visit a dentist who has been trained to treat occlusal problems. Dentists at Clarence House  have a special interest in occlusion and have spent years studying the subject. We are members of the British Society for the Study of Occlusion (www.BSOS.org.uk). We have considerable experience in helping many patients with these problems. We carry out a specific Occlusal Examination to assess the signs and symptoms of an occlusal problem.  Various muscles may be sore when tested, or the broken and worn areas of your teeth will show you are grinding your teeth - a common sign of an incorrect bite.  Once the problem has been identified we are able to recommend appropriate treatment.

If your dentist suspects that your problems are due to an incorrect bite, he or she may help to diagnose the problem by supplying a 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.

Q  Will straightening my teeth help?
A  If your teeth are too far out of line or in a totally incorrect bite position, it may be necessary to fit an orthodontic appliance to move them into a better position.

Q  How many people suffer from these problems?
A  Up to 1 in 4 people may have some symptoms.  Both men and women are affected equally, although women tend to seek treatment more often than men.  The symptoms can often start with the menopause or other hormonal changes.

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 disappear almost  immediately.  Sometimes, however, your teeth and gums may be affected straight away and instead of headaches, you may suffer:

The temporo-mandibular joint needs equal support from both sides of both upper and lower 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 eg. with a partial denture, bridgework or implants.

Replacement is not usually done until a diagnosis has been confirmed by using an appliance and this has fully relieved the symptoms.  Relief in some patients is instant: in others it can take a long time.

• Medication

• Diet and Exercise

• Relaxation