We see this all too often in dentistry: a collapse of the bite.
Of course there are varying degrees of it, depending on the extent of the attrition of the teeth, as well as the number of back teeth that are missing. The following are some of the effects that may be seen as a result of a bite collapse:
1. Damage to the Temporomandibular Joints. This may result in arthritis of the T.M.J’s as well as pain/dysfunction of the joints.
2. Increased muscle contraction (shortening of the muscles) of the jaw. This may cause further destruction of the joints (mentioned above) as well as muscle tension headaches.
3. Cracked or chipped teeth and tooth loss; due to uneven forces applied to the teeth.
4. Sagging of the corners of the face (inverted smile); due to the bite collapse.
5. As a result of the inverted smile (number four above), the corners of the mouth become cracked…this is called Angular Cheilitis.
6. Problems chewing…If there is a lack of the proper number of teeth in the back of the individual’s mouth, there will most likely be gaps in between the teeth. This will make it difficult to chew.
7. Aggravation of existing gum (periodontal) disease. If a tooth is not on the best foundation to start with and deleterious forces are applied to it, the existing ‘gum’ problem may worsen.
Explanation of Number Seven Above
If a patient has periodontal disease (mobile teeth due to an unstable foundation) then it is possible to have a bite collapse as a result of a loss of teeth or the teeth tipping forward.
Let’s Go Back
We have already seen that a loss of vertical dimension can arise because of tooth wear (attrition), but the above situation (periodontal disease) differs because the loss of vertical dimension is not from attrition…rather, it is due to the fact that the teeth are poorly supported in the bone. It is either the tipping of the teeth or the actual falling out of the teeth that is causing the decreased vertical dimension.
Note: When periodontal disease is present one can have a bite collapse with normal (not overly excessive) forces i.e. since the roots of the teeth are on a poor foundation, normal forces can cause them to become mobile and fall out.
Treatment of a Bite Collapse:
a) If the cause of the bite collapse is attrition – Crowns can be placed on the back teeth to deal with the collapse.
b) If the cause of the bite collapse is a lack of a proper number of back teeth i.e. number seven above, then partial dentures can restore the vertical dimension.
Note: In some instances when the teeth wear slowly, they may continue to erupt…this can prevent a vertical bite collapse.
However, this may be a problem because if the teeth are worn, and continue to wear then there will be no room to place any crowns.
This may be a good time to review the blog “Option to replace a Missing Tooth” posted on October 2, 2011.
Have I ever mentioned that Implants are a great solution to replace a missing tooth 😉
Yours in excellent dental health,
Dr. F. Keshavarz Dentistry
