Occlusion denotes the contact patterns between the upper and lower teeth. The word functional refers to the most healthy relationship that can exist between the teeth during their functioning. The most prominent role of occlusion is during the first phase of digestion. If performed optimally, mastication (the function of processing food orally i.e.; chewing) allows for the natural progression of the digestive system. If mastication is dysfunctional it alters the effectiveness of the entire digestive system. This has a dramatic effect on the entire body’s health from nutrient absorption to the body’s ability to handle environmental stress.
The keys to a Functional Occlusion are threefold:
A functional occlusion requires all three parts of the system to be in harmony with one another. In the presence of a discrepancy between optimal positioning of the teeth and optimal positioning of the jaw the teeth win and force a positional shift of the jaw, while demanding constant work from the ligaments, muscles and tendons of the jaw to keep the tooth to tooth position at all costs. This means fatigue and breakdown of the muscles and all the other supporting structures. When the keys to a functional occlusuion are missing we call it a Dysfunctional Occlusion.
In the presence of these signs and symptoms it wil be necessary for us to ask the questions: Do you have a dysfunctional occlusion? Is there a risk of making your symptoms worse by providing you with dental care? It is foolish for us, as holistic dental practitioners, to provide a service such as replacing your dental restorations with biologically compatible dental material that may perpetuate or worsen an existing dysfunctional occlusion.
As part of every comprehensive dental examination your occlusion will be evaluated and depending on the findings, further tests and analysis may be performed. First, with the help of one of our staff, a questionnaire will be completed. From your responses a clearer picture of your condition is established and additional testing may be performed in order to objectively measure the degree of your occlusal stress. Examples of testing would be:
An Occlusal Analysis – this is a comprehensive screening of your occlusion by evaluating very accurate impressions of your teeth in our laboratory following an exact recording of your jaw position and a measurement of the discrepancy between your optimal (healthy) jaw position and where your teeth fit best. The magnitude of this discrepancy is measured and possible correction scenarios are discussed at a separate office visit. In most cases biological dental procedures will be able to be performed with the use of a functional occlusal splint that will fit over the lower teeth to provide a stable jaw position while removal of harmful materials is completed.
A Forensic Orthodontic Assessment – may be performed especially if you have had previous orthodontic treatment. This helps us to understand where you ended after therapy and/or after growth had stopped. This allows us to select the best therapy to restore your functional occlusion. These tests will be in addition to your Occlusal Analysis and will require digital radiographs of your skull as well as computer analysis of jaw growth and relative tooth size proportions.
Once this is accomplished it may be necessary that a Comprehensive Occlusal Adjustment be performed in order to coordinate your occlusion with optimum jaw and soft tissue health. This is a procedure where minor amounts of tooth structure are reshaped and/or removed to achieve an optimum occlusal relationship that is in harmony with the jaw joints, muscles, ligaments and tendons that support the jaw. In other words, the process by which a functional, occlusion is achieved. If the discrepancy between optimum jaw position and occlusal position is too far apart, a preliminary orthodontic procedure via conventional orthodontics (braces) or invisible braces (Invisalign) may need to be perfomred prior to the final comprehensive occlusal adjustment procedure.
In extreme cases of a dysfunctional occlusion, TMJD may be present and would require diagnosis and therapy prior to any further dental work (See TMD/ TMJD/ TMJ).