Why is it important to have a balanced bite?
When the bite is uneven, patients tend to clench or brux more often. The bruxing and clenching wear down the teeth, resulting in a bite that is even more compromised and worn or fractured teeth. Some patients stop the habit entirely when the bite is balanced.
Chewing is impossible when only a few teeth touch during biting. As a patient squeezes harder to engage more teeth, her bite shifts. This initiates muscle spasms and may pull the disc out of position. The bite becomes further out of balance and a damaging cycle accelerates.
Finally, when the disc is permanently out of position (Disc Displacement without Reduction), the jaw joint functions by rubbing bone to bone. The consequence of the damage to the joint is a bite that is always changing as the bone wears down. A MRI of the joint will show the damage to the joint over time.
All healthy and damaged temperomandibular joints remain most healthy when all of the back teeth touch simultaneously when one closes lightly.
How can you get an even bite?
When a patient is in acute TMD distress, a nightguard or appliance is often used to quiet the muscles. When the muscles are not in spasm, qualified dentists can conduct an Occlusal Analysis.
The first step in balancing the bite is to find out the condition of the present bite at rest. Your dentist will take models of your teeth and a record of the way your upper and lower teeth relate to each other when at complete rest. These models will be mounted on a simulator, which will allow your dentist to look at your teeth during rest as well as during function. Look at the photo below. Each case is different, and your dentist might recommend one or a combination of the following procedures to align the bite:
- Bite equilibration or alignment by controlled reduction.
- Building up teeth with fillings or crowns.
- Replacing missing teeth with bridges or implants.
- Orthodontics or braces to move teeth to more favorable positions.
- Surgery to relate the upper teeth more favorably to the lower teeth.