How well are your teeth actually working for you? Are things wearing down more rapidly than you might expect, pieces breaking off, maybe even some facial pain developing? All of this falls under the next assessment we do for our patients:
Functional Risk Assessment (How Well are my Teeth Working?)
Do you have problems with your jaw joint (pain, sounds, limited opening, locking, popping)? Your jaws are meant to open and close smoothly, just like all of your other joints. Except for chronic medical issues like arthritis, jaw joint issues mentioned here indicate a problem with how the system is working. Not evaluating this can lead to further and more significant problems
Do you feel like your lower jaw is being pushed back when you try to bite your back teeth together? At rest, you will “hold” your lower jaw where it feels most comfortable. If your jaw has to be pushed back to chew your food, you may have an inbalance between the size of your top and bottom jaw, or misalignment of your teeth. This constant “shoving back” of the jaw can injure the joint and muscles.
Do you avoid or have difficulty chewing gum, carrots, nuts, bagels, baguettes, protein bars, or other hard, dry foods? Your teeth and jaw are designed to eat a variety of foods with a variety of textures. Pain in the jaws, muscles, or teeth when eating those foods indicates malfunction.
In the past five years, have your teeth changed (become shorter, thinner, or worn) or has your bite changed? Normal tooth wear is measured in microns, and we are expected to have 1mm of tooth wear every 100 years. Unless you are miraculously 300 years old, your teeth should look the same in length in teen years and adulthood. Worn teeth signify poor chewing function, abrasion from habits, or erosion from acids; all of these require evaluation ASAP.
Are your teeth becoming more crooked, crowded, or overlapped? If your bite is stable and you breathe through your nose most of the time without speech impediment or tongue tie, your teeth should stay in relatively the same position over the years. Essentially, proper tongue position at rest and during speaking and eating while nose breathing continuosly will allow for your body to naturally retain the teeth in their proper position.
Are your teeth developing spaces or becoming more loose? The same prinicples for the above question also apply to this question. Too much tongue pressure and open-mouth breathing contribute to spacing of teeth; as well, loosening of teeth can be a result of teeth clenching and grinding as the bone softens from excess pressure on your teeth.
Do you have trouble finding your bite, or need to squeeze, tap your teeth together, or shift your jaw to make your teeth fit together? Just like walking down the street should not involve conscious effort to make your legs work properly, your bite should always be effortless, and anything less tells us you have bite dysfunction.
Do you place your tongue between your teeth or close against your tongue? Patients who have discomfort when their teeth touch, either due to weakened teeth or imbalanced bite/sore muscles, will often subconsciously use the tongue to brace or cushion the bite in a more comfortable way.
Do you chew ice, bite your nails, use your teeth to hold objects, or have any other oral habits? Any of these actions are not the normal role of teeth or your mouth, and every effort should be made to discontinue these habits to avoid problems down the road.
Do you clench or grind your teeth together in the daytime or make them sore? Clenching indicates a postural imbalance. The brain tells the jaw to clench, which stabilizes the head position on your neck. Often clenchers have postural issues like back/hip pain, and can best be evaluated by a health practitioner to correct this (chiropractor, osteopath, physical therapist).
Do you have any problems with sleep (i.e. restlessness or teeth grinding), wake up with a headache or an awareness of your teeth? We could write many blogs pieces just on sleep, as it is that vital to overall health. A recommendation we always make to our patients who respond “yes” to this question is a sleep study to diagnose the cause of poor sleep. Inadequate/inefficient sleep is linked to many serious diseases, and dental disease is on this list.
Do you wear or have you ever worn a bite appliance? We have many patients of our practice who come to us with a history of wearing a “night guard” as a means of prevention of wear. The newer research in dentistry tells us that patients very rarely ONLY have dysfunction in the jaws during sleep, and when they do a sleep study is mandatory before any type of dental appliance for sleep should be worn. For the majority of patients who exhibit jaw problems due to daytime dysfunction, a night time appliance alone actually does quite little to improve stability of the bite over time.
Most patients we meet with severe breakdown of teeth and gums wish we had been able to diagnose their bad bite earlier, when we could have prevented future destruction of a beautiful smile. We can improve all of these issues, but please ask your dentist (or us!) to assess your functional risk sooner rather than later!
Dr. Andrea Stevens is a cosmetic and family dentist in practice in Kanata, Ontario. If you have dental questions, you can call her at 613-271-7091 or visit her at drandreastevens.com Please also feel free to leave comments or questions below, and Dr. Stevens will be happy to answer.