When Trauma Comes Back To Bite You!
Question:
Dear Dr. Crapo: I’m a 26 year old woman working in a high stress, high profile work environment. The atmosphere is quick paced, competitive and tense. The rewards are extraordinary for success in our work and painful for failure. I go home every night with tension headaches, at least that’s what I think they are. I see a chiropractor and physiotherapist on a weekly basis to relieve aches and pains that come from tension. I know I clench and grind my teeth to the point that my shoulders and neck muscles feel tired every morning. The reason I’m writing is because recently I’ve noticed my bite change. I think my front teeth are no longer touching and I can’t bite things off with my two front teeth as I could only two months ago. I’m also having pain in my joints especially when I bite down. I saw two specialists in orthodontics (braces) and one said he didn’t handle those kinds of problems so he referred me to another orthodontist. This specialist said my teeth had over erupted (grown longer) and I need surgery to compensate for this growth so that my front teeth would come together. This came as a real shock and with my tiredness and change in my bite I’m really concerned and worn out. It can’t be overgrowth of teeth in two months can it? Please shed some light if you can.
Answer:
It would be very unusual for your teeth and the bone which supports them, to suddenly grow vertically in the molar region resulting in an open anterior bite (front teeth that can’t come together). Your symptoms suggest a displacement of the disc that cushions and separates the ball from the socket of your TMJ (temporomandibular joint). Excessive clenching and grinding are contributing factors to a joint disc displacement but almost always there’s a trauma that is responsible, even if and sometimes especially if, the trauma occurred during childhood. Women tend to suffer more than men; in fact, I have four individuals in mind, whose bite opened up as you’ve described, whose ages range from seventeen to sixty-five. All had a less than ideal bite, were clenchers and grinders, and all had traumatic accidents from extremely rough sports to motor vehicle rear-enders. An MRI is the gold standard for diagnosing disc displacement. When the disc slips out, your ball and socket squeeze the disc attachment tissue, which is akin to catching your “hiney” between loose boards in a two hole outhouse. Yes I understand your pain! You need to be seen by someone who understands your problem, can confirm it and get you the treatment you need.
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