TMJ Information

Many people today are aware of Jaw & Bite pain problems, caused by the Temporomandibular Joints. Your TMJ are actually two sets of muscles, one on each side of the skull behind the ears, that connect the lower jaw to the skull.
When your teeth, muscles and jaws work together correctly, the teeth do not wear out and your facial muscles and jaw joint are comfortable. Patient comfort is our main concern. Dr. A.J. Boyajian is dedicated to repairing teeth with a focus on maintaining Jaw and Bite health.
For more information on Jaw and Bite health and other services provided in our office, please call and schedule an appointment with Dr. Boyajian in Westchester, CA.

There has been a lot of dental surgery going on around here. The information I collected at the AAID seminar has been put to good use!

If you are new to the entire dental implant procedure, the next few posts will be helpful for you to read. Every implant surgery is unique to the individual receiving it; every case is different. Dental implants require more than drilling a hole in your mouth and sticking an artificial tooth in that hole. (Ugh, that sounds like cruel torture stated so bluntly!) That is basically what dental implantation is; however, because we are not cavemen and have all kinds of brilliant technology and intelligent doctors* handling your oral ailments, you can be assured that such a surgery will be done with the utmost care and precision with long-term sustainability in mind.

Let’s say, in a “simple” case, a tooth has been extracted, lost, or missing for years. There is no tooth — or no healthy tooth — and the doctor determines that an implant is needed. After several careful measurements; x-rays; sizes; ways, shapes, and forms are recorded, the drilling begins. Don’t worry; you’d be under anesthesia. The place for the tooth in your jawbone or facial bones, depending on where the tooth is going, is drilled into and prepared for the implant base that will be twisted, screwed in, and anchored.

Side note: I have mentioned one-piece implants here before, but I will not bring that up just yet. Just imagine for a second that we’re using typical, two-piece implants.

After the base is screwed in nice and tight, the second piece is anchored onto it. This second piece is what the crown of the artificial tooth will fit onto. When the below-the-surface hardware has healed and integrated into the surrounding bone with no complications, the crown is installed. The crown, by now, has been formulated by the doctor after more measurements and math. In my holistic practice, it would be important for me to be sure this new tooth isn’t just some standard tooth that looks good alongside the others. This tooth must fit into the body’s naturally designed chewing system so that it does not interfere in any way with other teeth or the whole jaw. If it were to interfere, it could break, cause other teeth to wear down or break, or change how you chew in a way that might be detrimental to your jaw joints. I’ll go on about this later.

So finally, that crown is inserted and anchored into the implant site, allowed to heal, and there you have it: a brand-new tooth.

This is a problem-free version. Questions patients might have include:

What about if there is not enough bone to drill into?

What if multiple teeth in a row need to be adjusted?

How long does the entire process take?

Does it even look good afterwards?

I’m terrified of this procedure, but if I let my condition worsen, I will be infected and in pain the rest of my life. Which poison do I choose?

Oh, we’ll go over it all. Thanks for reading!

Dr. Sperbeck, West Los Angeles

I figured I’d end the series on correcting malocclusions with “pretty” thoughts… thoughts about the visible benefits of occlusal correction.

What makes your smile natural also makes it beautiful. A correct bite will show in a smile that looks exactly how it was designed to look, not only displayed by straight teeth, but by the rest of your face as well. Your jaw moves in a way that is no longer detrimental to the surrounding muscles and joints in your face; your teeth no longer inhibit that movement or acquire further wear-and-tear; and you’ll be feeling better overall, because unusual tightness or tiredness in your mouth area will be gone. Add to all of that the confidence of a pretty smile!

A different kind of analysis, called a functional and aesthetic analysis, may be performed during the therapy in order to ensure the longterm health and beauty of your teeth.

Dr. Sperbeck, West Los Angeles

This type of therapy for occlusal correction is temporary, but does a lot of good things over a period of time to protect your bite and its bad effects on your whole chewing system — even your whole head, down to your shoulders.

I’ve mentioned the MAGO way back when, and how I use it to treat TMJ cases. This is just about identical. It is basically a hard plastic mouthguard designed to fit your mouth in such a way that provides a stable bite and prevents further clenching and/or grinding of your teeth. The splint also relieves jaw and muscle pain caused by malocclusion problems. The kind of treatment you’ll need after using an occlusal splint will determine how long you wear it, and may even change the course of negative effects again caused by your malocclusion.

Dr. Sperbeck, West Los Angeles

Okay, say it with me: “or-thog-NATH-ic.”

Quite a tongue-twister, yes, and this complicated name is fitting for what it is. Orthognathic surgery digs a little bit more into the nitty-gritty of occlusal correction, because it is full-on surgery of the jaw or teeth. Orthognathic surgery moves the jaw or teeth into their proper positions in cases where braces or smaller-scale solutions will not be effective. If bones need cutting, screwing, or reinforcing, this is what should be done.

Dr. Sperbeck, West Los Angeles

Correcting a malocclusion with orthodontic dentistry is similar to selective reshaping of teeth. The difference, however, is that selective reshaping is meant for moving one or a few individual teeth. Orthodontics moves broader groups of teeth using removable contraptions like braces or retainers. These methods also cause pleasing aesthetic results, straightening teeth and providing a pretty smile.

Careful comprehensive observance must be taken as the teeth are being corrected, in case moving so many teeth causes other negative changes in the chewing system. Just because your teeth are now straight doesn’t mean other problems are not present or waiting to appear. All cares and concerns should be voiced as early as possible, whether before, throughout, or after the process has been carried out.

Dr. Sperbeck, West Los Angeles

The focus here is on occlusal (bite) correction, but this is where my CEREC unit comes in handy: restorations! Completely decayed, damaged, or missing teeth might be one of the most obvious problems contributing to a malocclusion… we cannot chew properly without all our teeth.

Like selective reshaping of teeth, restorative dental work is focused on the teeth and, well, restoring them, as opposed to reshaping the jaw or working with the surrounding muscles and cartilage. Crowns, inlays, onlays, dentures, or implants can be formed to bring back a mouth full of fully functional teeth.

Dr. Sperbeck, West Los Angeles

This is probably the first solution one might think of when wondering how a malocclusion will be corrected. The teeth are grinding together, so just move them around so they don’t. Right?

Well, I think we’ve learned that it’s a little bit more complex than that; but in some cases, the solution is as “simple” as moving teeth around. If the jaw, surrounding muscles and tissues, and everything else seems to be functioning well, selective reshaping can take place, and your teeth will fit together correctly when you bite down. This will halt and prevent further wear-and-tear on teeth that are perhaps showing signs of cracking, wearing, chipping, or breaking.

Dr. Sperbeck, West Los Angeles

A malocclusion is a “bad bite.” Easy enough, right?

If a good occlusion is defined as a bite where all components of the chewing system work together harmoniously, then a bad occlusion — a malocclusion — means that the teeth do not match up and fit together when you bite down. One or more of the components involved in the chewing system may not be functioning properly, and is most likely what is causing the teeth to come down abnormally.

The funny thing is that most of us don’t realize that we have a malocclusion until we go in for an occlusal analysis. After a while, we unconsciously train our muscles to chew in a certain way, to move in a certain direction repeatedly, so that it does seem like our teeth fit together fine. But you can’t really tell the difference between what’s “normal” and what’s “really normal” until you’ve had adjustments made because you’ve been doing it a certain way for so long.

Having a malocclusion almost guarantees wear and tear on your teeth, facial muscle fatigue, and long-term damage and/or disease throughout your whole mouth and jaw area. Having your malocclusion corrected is absolutely necessary for your mouth’s health and ultimately your whole body.

Dr. Sperbeck, West Los Angeles

An occlusion is basically the noun form of the word “occlusal,” which we already know is a term describing your bite. An occlusion is the way your bite is uniquely designed, how your teeth come down on each other and fit into specific grooves to properly chew.

However, an occlusion does not merely describe how the teeth fit together because — what have we learned? — the chewing system involves the TMJ (temporo-mandibular joints… your jaw joints), jaw bones, muscles, ligaments, and all other soft tissues in your mouth. With the ideal occlusion, every one of these elements works with the others to create comfort, harmony, and efficiency in your chewing. If any of these elements is not functioning to its best potential, however, even the smallest hindrance can cause pain, injury, disease, and other problems. This is called a malocclusion and will be covered in tomorrow’s post.

Dr. Sperbeck, West Los Angeles