What is occlusal disease?

added on: August 14, 2013

There are three reasons people lose their teeth:

Occlusion is the dental term for how your upper and lower teeth align when your jaws close together. Occlusal disease is a “bad bite” that, if undetected and untreated, can cause excessive tooth wear; cracked or loose teeth; sensitive teeth; jaw joint disorders and early tooth loss.

Occlusal disease is an often overlooked and sometimes “silent” oral disease that many people dismiss as “natural aging or wearing” of teeth. We can liken this to the way an improperly aligned set of tires will wear faster and not perform optimally, an unbalanced bite can lead to excessive or abnormally accelerated tooth wear.


On your back teeth, you will notice that there are points (cusps) and valleys (fossae). In an ideal bite, the cusps of your back teeth fit tightly into the fossae of your opposing teeth while the two jaw joints (TMJ’s) seat completely in their sockets. This is the least stressful and least destructive bite relationship for your teeth, bone, gums, TMJ’s, jaw muscles, and your existing dental work. The human bite is capable of generating forces measuring up to 900 pounds per square inch – so when your bite does not line up correctly, damage can and will occur.

Other important components of a healthy balanced bite include:

  • the contacts between your upper front and lower front teeth when the jaw slides forward (for example when biting into a sandwich)
  • canine contacts during lateral movements (for example when chewing, the canines guide the back teeth into their bite).

When your front teeth contact, they protect the back teeth by minimizing the amount of force that the back teeth can create when you chew and/or grind. When the front teeth are not aligned properly or worn, they are unable to provide this protective function, damaging both the front and back teeth, bone, gums, TMJ’s and jaw muscles.

A simple way to demonstrate this “protective” function is by placing your hand on the side of your jaw and clenching fully on your back teeth. Can you feel how forcefully your muscles contract?

Now, assuming that the upper and lower back teeth can separate from each other when your front teeth are edge-to-edge or canine-to-canine, try clenching with just your front teeth or canines. Can you feel how much less force is created by the muscles?

What are the signs and symptoms?

You may have occlusal disease or “bad bite” if you have one or more of the following signs and symptoms:

  • worn, chipped or cracked teeth
  • teeth that are sensitive to hot and/or cold
  • mobile or loosening teeth
  • muscle and/or TMJ pain
  • clenching/grinding your teeth
  • abfractions or wedge-shaped notches in the teeth at the gumline; when the teeth are stressed by an uneven bite or grinding, they flex causing a microscopic loss of tooth matter at the gumline
  • gum recession
  • severe localized bone loss around teeth
  • pain in the teeth and/or TMJ when you chew
  • headaches and facial muscle pain
  • teeth or dental work that fracture or break

How is it treated?

During your regular visits with us, we screen for the presence of occlusal disease by looking for the signs and symptoms described above. If your long-term goal is good dental health, you may choose to learn more about your “bite” problems. We will recommend a detailed evaluation of your bite, which includes mounted study models, digital photographs and detailed records of your current condition.

Many times a gentle and conservative procedure called coronoplasty (selectively and precisely adjusting teeth that are out of alignment) can create a bite that eliminates stress on individual teeth, TMJs and jaw muscles. In more complex cases, several teeth may need to be reshaped and/or restored in order to create the proper balance. In addition, bite splint therapy may be required to relax overworked chewing muscles and allow your jaw joint to properly seat in the jaw socket – years of a “bad bite” can create jaw joint and muscle imbalance or a TMJ disorder.

Dr. John has provided care for TMJ/Occlusal complex dental issues for many years with successful results.

Meet Jennifer V., she shares her experience partnering with Dr. John to relieve her severe headaches.

More information can be found on our Bite/TMJ page by clicking here.