Functional Dental Care


Some patients have problems with the way their chewing system works. These “functional” problems usually fall into two categories: those with abnormal wear on their teeth and those with ”comfort” issues related to the TMJ and related facial muscles and structures.

Abnormal Wear

In a healthy mouth where the chewing machine is working properly, very little wear on the front or back teeth should occur. Over an 80 year period, we should expect about 1mm of enamel loss from tooth surfaces. Where excessive wear is noted, we know the teeth and related structures are not functioning properly. There are several reasons why teeth wear at a faster rate than is normal and our goal is to determine where the wear is coming from and how we can reduce the risk of wear in the years ahead.

Often times patients with wear related issues have no pain, discomfort or other symptoms. Excessive wear on front teeth can have an impact on how we look, often times making us look older than we really are. Wear on the back teeth can cause increased tooth sensitivity or breakage. As our life expectancy increases, it makes sense that we need our teeth to work properly for a longer period of time.


Trouble with Your Jaw?

TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. Or, you may have a damaged jaw joint due to injury or disease. Whatever the cause, the results may include a misaligned bite, pain, clicking or grating noises when you open your mouth, or trouble opening your mouth wide.

Do You Have a TMJ disorder? Are you aware of grinding or clenching your teeth? Do you wake up with sore, stiff muscles around your jaws? Do you have frequent headaches or neck aches? Does the pain get worse when you clench your teeth? Does stress make your clenching and pain worse? Does your jaw click, pop, grate, catch, or lock when you open your mouth? Is it difficult or painful to open your mouth, eat or yawn? Do you have teeth that no longer touch when you bite? Do have more than one bite? Is it hard to use your front teeth to bite or tear food? Are your teeth sensitive, loose, broken or worn? Do you have abnormal wear on your front or back teeth?

The more times you answered “yes,” the more likely it is that you have a TMJ related disorder. Understanding TMJ disorders will also help you understand how they’re treated.

There are various treatment options we can utilize to improve the comfort, harmony and function of your jaw. Once an evaluation confirms a diagnosis of a TMJ disorder, we will determine the proper course of treatment.

Treatment for Temporomandibular Joint Disorders

TMJ (Temporomandibular Joint) disorders are a family of problems related to your complex jaw joint. If you have had symptoms like pain or a “clicking” sound, you’ll be relieved to know that these problems are more easily diagnosed and treated than they were in the past. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important. For patients having a functional-TMJ related problem, the objectives of treatment are to:

  • Reduce the pain.
  • Limit the recurrence of pain.
  • Restore comfortable function to the jaw.
  • Establish a more stable jaw relationship.

For some patients, stress plays a major role in TMJ-related functional problems. Tooth grinding, jaw clenching, or excessive jaw movements can be stress-induced. Often times, the simplest way to get relief is to become aware of the problem and take steps to stop or control the habit.

Should the habit persist, and muscles and joint related structures continue to be uncomfortable, other treatment techniques need to be evaluated. These may include physical therapy, jaw exercises or the use of a specially designed bite plate (orthotic). Bite plate therapy is often successful in relaxing the jaw muscles, reducing muscle spasm and allowing the jaw to close in a position that allows more muscle relaxation.

Sometimes a bite adjustment (occlusal equilibration) is indicated in order to get a longer lasting, more stable bite. In this procedure, tooth surfaces may be reshaped to reduce premature contacts, allowing the teeth and muscles to work together in a more harmonious fashion. Tooth structure that is in the way of harmonious jaw function is eliminated, resulting in improved muscle function. This allows all teeth to contact at the same time with equal force, reducing wear to the front and back teeth.