Small Changes… Big Difference

 Do you like to eat fresh berries?  I do.  As a kid we used to go out in the fields and pick cans full of what we called “dewberries”.  We would eat them right off the vine and my mom would bake up all the pies we could eat.  One thing about them that always bothered me though was the little seeds that would get in my teeth and change how my bite felt.  As a kid I would mess around with my tongue, a toothpick, my toothbrush and sometimes even my pocket knife (don’t try that one!) until they were all gone and I could bite my teeth together again  normally.  It just felt so good once they were all out.  I’ve noticed the same reaction in patients when I re-establish harmony between their jaw joints and their bite. 

Last week we discussed the importance of the temporomandibular joints in relation to overall oral health.  Today I would like to discuss another vital aspect of a comprehensive examination – the occlusion (your bite).  A stable bite is an important factor in long-term oral health.

Over time your bite goes through a series of small changes in the way teeth come together.  These changes are caused by many things including fillings, grinding, clenching, gum disease, habits, and injuries, to name a few.  These changes can create unequal or detrimental forces on your teeth.  You learn to “work around” these changes because the differences are very small and change very slowly (unlike the berry seeds that cause change quickly).  Because these changes occur over a span of years, the differences never feel abnormal to you.  Sometimes they only become evident when a tooth hurts, becomes loose, or breaks.  You’re surprised!  Everything was fine, why did this happen all of a sudden…on Sunday…or the day before we were leaving for vacation. 

Thoroughly evaluating your occlusion or bite involves looking for the earliest signs of these changes.  It studies the relationship between your teeth and the jaw joints and the functional relationship between the upper and lower teeth.  A patient may be completely unaware of overworked muscles, cracked teeth (they don’t hurt until the crack gets way inside) or a shift in your jaw as your teeth come together.  Patients train themselves to make the teeth hit where most of them touch each other even if this is an unstable position.  When a patient does become aware of a problem, the solution may be more involved and quite different from what would be appropriate had it been discovered earlier in a thorough examination. 

Berry seeds are quite small unless they are lodged on the chewing surface of a tooth.  They feel boulder-like at that point.  It is easy to see that changes in a patient’s bite must occur in very small increments (or it would feel like the seed).  The problem is that these small changes add up, and as they add up, they feel normal to you.  That’s why you are surprised when something breaks or fails.  What I’ve noticed is my patient’s amazement at how good their bite feels when these additive, dysfunctional changes have been corrected.  They have that “no more berry seeds on my teeth” look!  An even, properly functioning bite feels better than finally getting the last seed out of your teeth.  That good feeling is a sign that functionally harmony has been achieved – a feeling and fact that improves the likelihood of lifelong oral health.