Is it possible for my bite to change?

 

Although this is an unusual  event, it can happen. Interestingly, patients who experience changes in their bite either do not notice and even though patients don't complain, a change in their bites can be evidence of a deteriorating oral condition.There can be several possible causes.

Patients with TMJ problems can definately have an altered bite. This may be due to muscles of mastication that are inflammed and functioning in an imbalanced way or can be caused by skeletal remodeling of the mandibular condyle that cause the two ramuses to be different lengths. Musclar problems tend to cause different types of changes in the bite than skeletal. 

When the muscles are inflamed a patient may not be able to occlude in their usual comfortable bite but instead my be biting slightly more anteriorly. One way to deal with this sort of issue is to make the patient wear a deprogrammer  24/7 for a couple of weeks to see if the patients bite changes. These are removable niteguards that allow only a few anterior teeth to hit when the patient closes. Deprogrammers are designed to "shut down" certain muscles (masseter and pterygoids) and allow them to rest and recover.

Patients with skeletal changes of their jaws can experience a different sort of change  that may be evidenced by on entire side of the arch occluding properly, while the other remains open, even when they are full closed. This can be caused by a mismatch in the lengths of the condyles caused by arthritic deterioration or trauma. 

A more common cause is that a patients tooth has become loose as result of an infection and is protruding more than it used to and it doesn't allow the patients other teeth to meet properly. This is what happened to one of my patients who came in this week for his checkup and cleaning. I checked his bite to see how he was occluding and it seemed that he was biting differently than I remembered.  His bite is unusual anyway since he only occludes posteriorly on his first bicuspids because of the loss molar teeth. He also is a self admitted bruxer.

 It seemed that now when he closed only the right side occluded and only way he could make the L side meet was to move his jaw 2 mm to the left.  I scratched my head and wondered briefly if I was mis remembering the way his teeth occluded and I proceeded with his cleaning. When I got to cleaning around his maxillary right first bicuspid, I noticed it was very loose. I had my assistant Jennifer take a periapical radiograph. After viewing this, the mystery was solved , since this tooth was infected and needed to be removed. Probably it had  a vertical root fracture. Evidently this infection had caused a slight extrusion of his tooth and had shifted his bite to his right side. Mystery solved!