Reduction of tooth mobility may enhance the effect of periodontal therapy. There is no credible evidence to support the existence of abfraction or implicate it as a cause of gingival recession. Occlusal trauma does not initiate periodontitis, and there is weak evidence that it alters the progression of the disease. Does trauma from occlusion affect the Periodontium? By doing so the pressure on individual teeth is lessened, thereby making them less susceptible to becoming weak or contaminated. Traumatic occlusion is mostly treated by a procedure called occlusal equilibration in which the chewing and biting surfaces of teeth are grinded to achieve balance and proper alignment. Chronic trauma from occlusion is more common and has greater clinical significance. Which of the following types of occlusal trauma occurs unexpectedly as a result of biting on a hard object?Īcute trauma from occlusion occurs following an abrupt increase in occlusal load such as occurs as a result of biting unexpectedly on a hard object. The periodontium becomes more vulnerable to injury, and previously well-tolerated occlusal forces become traumatic. Secondary trauma from occlusion occurs when the adaptive capacity of the tissues to withstand occlusal forces is impaired by bone loss resulting from marginal inflammation. Secondary occlusal trauma typically occurs when there is a pre-existing periodontal condition. This contributes harm to a system which is already damaged. Secondary occlusal trauma occurs when normal or excessive occlusal forces are applied to the teeth with compromised periodontal attachment. Secondary occlusal trauma refers to when normal occlusal forces become excessive because of loss of attachment. Primary occlusal trauma refers to excessive force applied to a tooth or teeth with normal supporting structures. So, besides cavities, broken fillings and cracks in fillings, this is one of the first things I check when patients have pain on chewing or unusual temperature sensitivity, both of which can be caused by too much chewing pressure.What is primary and secondary occlusal trauma? This additional movement is more common in patients with bone loss due to periodontal disease. I have noticed that some patients need to be checked in a month or so to make sure that the teeth haven’t moved again. Within a few minutes the pain subsided and he should be fine. Although this patient has had no dental work since that period, that tooth had shifted enough to create a hyperocclusion (too much tooth contact upon chewing)which needed to be adjusted (this is known as equilibration in all of these examples). I took an x-ray of the area which looked totally normal, then I checked the bite. In this case, the patient had been coming for many years, and I had done a dental bridge approximately 8 years ago. Last month I had a patient come in for a similar kind of pain. That is how profound the discomfort can be. I checked the bite, found them to be high, and she couldn’t believe the relief she experienced in just a few minutes of adjustment. She had a complaint of pain on those teeth. I had a new patient who came in a few years ago who had crowns placed on 2 adjacent lower molars 2 years before that. This pain can also cause pain on the opposing tooth since chewing works in pairs. It is now in “ hyperocclusion” or too much tooth structure hitting the opposing tooth. There is no place for the inflammation fluids to go but between the root and the bone, and that lifts the tooth out of the socket a bit. With inflammation there is increased swelling around the root. This extra pressure causes an inflammation on the ends of the root. The immediate treatment is to adjust the crowns to get the bite more comfortable and so it doesn’t stand out. On both of these patients I noticed large areas of dark blue marks that indicated that the patient was putting extra pressure on these teeth when chewing, and that can hurt a lot. But after time, they were still feeling something when they chewed.īesides making sure that the teeth look OK on an x-ray, I have the patient bite on articulating paper (that’s the blue carbon paper that makes marks on the teeth to see if a patient is biting too hard on the tooth). They had crowns placed on the teeth, as is recommended for strength and protection of these teeth. This week I have had 2 patients who have had root canal therapy. One common condition is occlusal trauma, which means that the bite is too high someplace. I ask them what is going on, try to isolate where the pain is coming from, find out how long they have had the pain and how often. When an emergency patient comes into my dental office with some unwanted dental pain, it is important to listen carefully to the patient. Pain on Chewing: It Could Be Occlusal Trauma
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