Treatment of occlusion disorders, an innovative branch of dentistry, deals with diseases resulting from abnormal distribution of forces acting on the teeth and temporomandibular joints. This is particularly important because the human jaws act with a force of as much as 900 Newtons (corresponding to the pressure of 90 kg), and movement of clenching teeth repeated several times during the day can lead to the destruction of not only teeth, but also to disorders of the temporomandibular joints (TMD) or muscles controlling the position of the skull. Malfunction or disorders of occlusion are called occlusive disease. Overload of the teeth, for any reason, is the result of harmony disturbance between temporomandibular joints, muscles around the face, and teeth.
Are occlusion disorders a serious problem?
Early detection by a dentist or the patient symptoms of this disease is very important. The onset is often unnoticed by the patient, and often also for the doctor. In the initial stage, patients do not feel any pain, but the disease progresses leading to the destruction of teeth.
Initial phase of occlusion disorders
The discovery that the patient develops occlusive disease may be based on number of factors such as:
Some of these symptoms include popular recently in the media and everyday life term bruxism, or pathological teeth grinding during sleep. This phenomenon is particularly worrying because it can be unnoticed for a long time and leads to loosening of the teeth, gingivitis and periodontitis, destruction of enamel (and consequently - to cavities), the formation of wedge-shaped cavities (uncovering the necks of teeth) and degeneration in the temporomandibular joints. Most often it is a disorder caused by chronic stress, which affects people in everyday life (family problems), at work (eg. stressful job, working after hours) or during leisure time (often during exercise).
Progression of the disorders
Occlusive disease progresses in time, which means that by the contractions of masseter muscle (which is moving the jaw) the teeth are hitting each other in a wrong way, and thus the osteoarticular elements of the masticatory system are becoming strain. If you notice any of these symptoms should immediately contact a dentist. Patients with advanced occlusive disease often complain of masseter muscles (located on the sides of the face) pain on palpation or with no reason, spontaneous or palpation-triggered pain around the temporomandibular joints, frequent migraines, ringing in the ears, dizziness, ocular symptoms, pain in the area innervated by the trigeminal nerve, pins-and-needles sensation on the face, ears or arms, sleep disorders. In addition, they often present with symptoms distant from the affected muscle – in the head, neck, shoulder girdle, upper limb and chest. It is important to report of these symptoms to your dentist, because early treatment can prevent further destruction of the tooth and emerging psychological problems (sleep problems lead to chronic fatigue, decrease in concentration, nervous tension).
TreatmentThe treatment in the early stage of the disease mainly involves protection of teeth from further destruction process using relaxation overlays. Apart from this the occlusion should be corrected, abraded teeth restored together with inclusion of the orthodontic treatment, which is aimed on positioning of the teeth in such a way that they will stay in harmonious contact with each other and the forces were spread evenly.
In the advanced stage of the disease, treatment is long-term and multidisciplinary, and the chances of resolving the lesions made by the ongoing long destructive process are sometimes uncertain. Therefore, prevention of disease is to detect it at an early stage.
Diagnostic and therapeutic procedures
The diagnosis of occlusive disease is based on the examination of the patient, with taking into account the medical history and radiological examinations. It usually includes an ultrasound examination of the temporomandibular joints and masseter muscles with use of the Doppler effect. The goal of the treatment (in a number of stages) is to restore normal occlusal relationship, ie one in which there is no injury to the teeth and abnormalities of the temporomandibular joint. Treatment of occlusion disorders involves many procedures and analysis conducted and provided by an experienced practitioner – Ewa Fitak, MD, PhD in collaboration with suitably equipped laboratory. The scope of the analysis includes functional examination, ultrasound examination of the temporomandibular joints, diagnostic impressions and analysis of diagnostic models. After the analysis, the doctor provides the patient with a treatment plan and trial work in the form of a wax-up. In the next stage, if necessary, procedures resulting from the treatment plan are performed that often take into account the restoration of the lost hard tissue of the teeth in the form of conservative fillings or restorations and creation of proper occlusion planes (equilibration).
Basic conditions that have to be fulfilled while undertaking the decision of begining the treatment of occlusion disorders are:
In Impressio-Med Dental Clinic responsible for occlusion treatment is Ewa Fitak, MD, PhD.
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