Occlusion is a word most laymen are not familiar with. To keep it simple, your occlusion is your bite; how your teeth fit together. More specifically, the study of occlusion is the science of how your teeth work as they come into contact with each other. The precise placement and timing of where and when each tooth comes into contact with another is absolutely critical to how your jaw, temporomandibular joint, and all the muscles that control the movements of these structures work when it comes to biting, chewing and even speaking.
Your occlusion is intimately and inextricably interrelated to your TMJ. The position your jaw (mandible) assumes in the TMJ during any movement, especially maximum closure, is dictated by the teeth. The teeth will not allow the jaw to close in a position that will damage the teeth. Therefore the jaw may be forced to deviate from its natural or ideal rest position, or arc of movement by the alignment of the teeth (occlusion). This excess movement by the jaw to keep the teeth from colliding with each other often places additional stress on the muscles that move the jaw. One of these muscles is actually attached to the articular disc in the TMJ and is activated by occlusal prematurities. (That is: the teeth that are interfering with the jaw's normal movement.) As such, a malocclusion (improperly aligned teeth) will contribute to, and can actually cause, a TMJ problem.
More commonly, however, the opposite is true. Dr. Nichols is a proponent of a treatment philosophy known as Joint Based Occlusion. This philosophy is based on an assumption that all malocclusions are caused by derangement of the TMJ, until proven otherwise. The reality is that the overwhelming percentage of defective or pathological bites (malocclusions) are reactions to injuries or developmental disfigurements in the TMJ that alter both the vertical and horizontal position of the jaw in the TMJ. As that joint space is altered, and the jaw moves in response to the alteration, the occlusion will be immediately altered as well. As such, a good rule of thumb is that changes in the TMJ due to degenerative disease processes precede changes in the occlusion. Therefore the occlusion is primarily reactive in nature. That is - the bite changes in order to respond to changes in the TMJ.
The occlusion is assessed in two steps. The first is a detailed examination during the initial exam. The second is far more detailed, and is completed by utilizing diagnostic casts. These are models of your teeth mounted on an artificial jaw, called an articulator. Using a device to measure the TMJ and its arc of rotation combined with a bite registration, we can see where your teeth are when the jaw is in its normal, natural, orthopedically correct rest position. This allows us to see, on a tooth-by-tooth basis, exactly what is causing the bite problem, and more importantly what options are available to correct these problems. An MRI of the TMJ's is necessary to get the complete picture of precisely what is going on with the bite, as well as understanding why it's going on. Options to correct malocclusions include orthodontics, equilibration (comprehensive adjusting of the contact surfaces of the teeth), additive reshaping (by using crowns or veneers to establish or enhance contact where it is inadequate between teeth), or splint therapy. All these therapies have the goal of reducing or eliminating the hyperactive (thus, sore, achy or tender, tired) muscles that are caused by malocclusions. This reduces the physiologic stresses on both the teeth and the TMJ.
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