Malocclusion & Headaches

Do You Know Malocclusion & Wrong Contact Points Cause Headaches Or Neuralgias ? 🤔

I often see Patients with "missing teeth" or "ill fitting crown & bridge" or "improper Tooth Fillings"

More often than this, I see Crowns (Caps as generally referred by pts) fabricated with flat contacts, with no importance given to Morphology & contact points.😲

Let's discuss here briefly and in simple terms what Occlusion & contact points is all about & what happens if they are overlooked!

The Key to Occlusion has to do with how the Maxillary 1st Molar and the Mandibular 1st Molar come together

Do you know that a tooth will have so much in carvings🤔 ?.

The pic you see below is of one particular tooth & Each tooth is unique in its Anatomical Morphology & Carvings!

These Anatomical Carvings are often over looked majority of the times in fabrication of Crown or Bridge Prosthesis.

Do you know that every tooth will have certain unique contact points ? and never flat contacts as given by some for crowns & accepted by majority of the patients unknowingly that will cause more issues in future.

Occlusal contact points are on the functional cusps of the upper (Palatal) and lower

(Buccal) molars which can be clinically regarded as certain points, and these points slide on the inclining non-functional cusps of antagonistic teeth during lateral excursion. 

Now, what happens if teeth are missing, or worn out? 🤔

Simply Bite collapses! 😶‍🌫️ (also known as loss of vertical dimension of occlusion) OVD

This happens

1) When the patient grinds their teeth so aggressively, and reduces the biting surfaces so extensively that the upper and lower jaws rotate closer together than normal as shown in pic below.

2) This also occurs when enough teeth are lost that the remaining teeth and supporting (alveolar) bone are unable to withstand even normal biting forces, and begin to tip sideways, resulting in over-closure of the jaws (collapsed bite).

There is a serious link between occluding time, Occlusal Pressure & TMJ disorders.

The amount of relative force generated during each occlusal contact is imp to be noted.

This adjustment relieves most of the headaches of unknown etiology & also TMJ pains, discomfort during chewing & experience of tinnitus.

An equipment--"T scan III software" helps analyze the order of the occlusal contacts & also measuring the force percentages. Also occluding/disocclusion time.

So, With the help of T scan information, orofacial pain & occlusion related abnormal forces can be corrected.

Do you know Obstructive Sleep Apnea (OSA), increases with Tooth loss ? 😟

Yes ! The propensity of OSA increases by 2% with every tooth loss !

In simple terms what happens is when (OVD) Occlusal Vertical dimension is reduced the Mandible shifts back causing deep bite & reducing Pharyngeal Air Space (PAS) causing Snoring which may further lead to OSA.

This also shifts TMJ,.... altering Pressure which cause several associated issues from Headaches to Neuralgias !

It could be Frank damage to the jaw joints (TMJs), Severe pain or Dysfunction in the jaw joints (TMJ dysfunction)

TMJ Shift Causes TMJ Arthralgia, Headaches, & the pain may even radiate to C2 C3 Branches Of Spinal Cord, thus, one may even complain of Back Neck Pain in General.

Apart from TMJ issue one may also complain of Pain in Muscles of Mastication as shown in below pic, due to Excessive Force generated by Flat & Larger Contact areas Created Instead of Precise Contact Points.

Any of these or all of these muscles as shown in above pic may pain, even if your crowns are poorly fabricated manually Ignoring several Key Factors like FM (P) Angle (Pic below), apart from Contact Points.

Even the Selection of the Articulators Matters a Lot! See in below pic,

Difference Between Adjustable VS Conventional Articulators

Excessive muscle contraction forces the closing muscles of the jaw shorten

shortening of the lower face height (which can change one’s appearance, although it may not be obvious to a casual observer) as noticed in Below Pic

Leave alone the altered Smile-inverted smile (corners of the mouth sag)

Electromyography

EMG is a surface unit which helps evaluate muscles of mastication while at rest & in function. Surface tape electrodes are placed over target muscles & electrical energy generated by the muscles are effectively recorded which is measured in micro voltage.

T scan & EMG can also be linked for effective dental treatment & reverse analysis.

Overall Summary

1. Digital designed CAD-CAM precession crowns which are Bio compatible to oral tissues (Insist for Material Warranty) should always be elected.

2. The angulations of Maxilla with TMJ Frankfort plane should always be recorded with a Face Bow.

3. Anterior Guidance & Posterior Stop with accurate contact points should be accurately replicated

To Get your Occlusal Associated Headaches, Neuralgias, Facial Pains Evaluated & Corrected, Please book your slot at our website dentistLotusclinics.com

Issued in Public Interest

Disclaimer: Lotus Clinics claims no credit for certain images / Videos featured on our blog site taken from web, unless otherwise noted. This is written for Educational purposes and to bring awareness among public, with case Study pics of my Patients with their written /Audio/ Video Consent

However all visual content is copyrighted to its respectful owners. We try to link back to original sources whenever possible. If you own rights to any of the images taken from web, and do not wish them to appear on Lotus Clinics , please contact me and it will be promptly removed. I believe in providing proper attribution to the original author, artist or photographer. 🙏Knowledge is Virtue.