Jaw and Bite Problems FAQs

How do I know if my head and neck pains are being caused by jaw and bit problems?

Have a look at the questions below. If you answer ‘yes’ to several of them, 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?

What kind of problems might I have?

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 or jaw joint [TMJ] or the muscles that move your jaw.

These problems are called occlusal problems and may include:

• 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
• Gum disease, loose teeth or receding gums can all be made worse by a faulty bite.
• Clicking, grinding or pain in your jaw joints (known as TMJ), 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.
• 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?

You may find that you clench or grind your teeth. However, most people grind their teeth whilst asleep or when concentrating on a task which 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 Temporo Mandibular Dysfunction [TMD].

How many people suffer from these problems?

Up to 1 in 4 people may have some symptoms.  Men and women are equally affected, 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 from:

• Flattened, worn teeth
• Broken teeth, fillings and crowns
• Loose teeth
• Continual sensitivity of your teeth to temperature change
• Tooth ache with no apparent cause.

If you think you have any of these problems, please do contact us and we will be happy to help.

How are occlusal problems treated?

The 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. We have considerable experience and have helped many patients alleviate these problems.

First, 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 our dentist suspects that your problems are due to an incorrect bite, they may help to diagnose the problem by supplying a plastic appliance that fits over your upper or lower teeth.  This appliance (also known as a splint) needs to be measured and fitted very accurately so that, when you bite together, all your teeth meet at exactly the same time in a position where your muscles are relaxed.  Splints are usually worn at night although they sometimes need to be also worn during the day.  If the appliance relieves your symptoms then your bite may need to be adjusted permanently.

Will straightening my teeth help?

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.

What treatments are used?

The most frequently used treatments are:

• Occlusal Examination
  This involves a full investigation of any occlusally related problems you may have including examination of the way the jaw moves, the way the teeth contact, and a check for tenderness or abnormalities in the muscles that move the jaw. This gives us the information we need to treat your problems and monitor the progress of treatment.
   
• The Lucia Jig
  This is a very small splint, constructed in the surgery. It clips onto the front teeth and prevents the back teeth touching, allowing the jaw joints to close in a comfortable resting position. It is designed to be used for a few weeks only. It can be used to treat acute jaw problems and is very useful in helping to diagnose whether there is a dental component to your headaches.
   
• Full Occlusal Splint
  This is a hard plastic splint which covers either the upper or lower teeth. It is carefully constructed to allow the teeth to contact in an ideal bite position when the jaw closes. This can be used to give long term relief from bite related symptoms and also helps with diagnosis of occlusal problems.
   
• Equilibration
  If a splint has relieved the symptoms, it may be possible to produce a permanent ‘cure’ by carefully trimming minute areas of the teeth to allow them to close together evenly and correctly without having to wear a splint.
   
• Orthodontics
  Large errors in tooth position can be corrected by an orthodontist. This should enable a better relationship between the teeth and a more comfortable bite
   
• Reconstructive Dentistry
  Sometimes the best way to correct the bite involves restoring the teeth with carefully constructed restorations (fillings, crowns, bridges etc) designed to improve way the teeth fit and close together.
  
  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 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.

What else might help?

The most frequently used treatments are:

• Medication - pain relief can help in certain cases, but this is usually only a temporary treatment.
• 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 external heat.  Physiotherapy exercises can often help, and your dentist will be able to show some of these to you. 
• Relaxation - counselling and relaxation therapy may also help in some cases.  These techniques help you to become more aware of stressful situations and to control tension.