Okay, say it with me: “or-thog-NATH-ic.”

Quite a tongue-twister, yes, and this complicated name is fitting for what it is. Orthognathic surgery digs a little bit more into the nitty-gritty of occlusal correction, because it is full-on surgery of the jaw or teeth. Orthognathic surgery moves the jaw or teeth into their proper positions in cases where braces or smaller-scale solutions will not be effective. If bones need cutting, screwing, or reinforcing, this is what should be done.

Dr. Sperbeck, West Los Angeles

A malocclusion is a “bad bite.” Easy enough, right?

If a good occlusion is defined as a bite where all components of the chewing system work together harmoniously, then a bad occlusion — a malocclusion — means that the teeth do not match up and fit together when you bite down. One or more of the components involved in the chewing system may not be functioning properly, and is most likely what is causing the teeth to come down abnormally.

The funny thing is that most of us don’t realize that we have a malocclusion until we go in for an occlusal analysis. After a while, we unconsciously train our muscles to chew in a certain way, to move in a certain direction repeatedly, so that it does seem like our teeth fit together fine. But you can’t really tell the difference between what’s “normal” and what’s “really normal” until you’ve had adjustments made because you’ve been doing it a certain way for so long.

Having a malocclusion almost guarantees wear and tear on your teeth, facial muscle fatigue, and long-term damage and/or disease throughout your whole mouth and jaw area. Having your malocclusion corrected is absolutely necessary for your mouth’s health and ultimately your whole body.

Dr. Sperbeck, West Los Angeles

An occlusion is basically the noun form of the word “occlusal”, which we already know is a term describing your bite. An occlusion is the way your bite is uniquely designed, how your teeth come down on each other and fit into specific grooves to properly chew. However, an occlusion does not merely describe how the teeth fit together because — what have we learned? — the chewing system involves the TMJ (temporo-mandibular joints… your jaw joints), jaw bones, muscles, ligaments, and all other soft tissues in your mouth. With the ideal occlusion, every one of these elements works with the others to create comfort, harmony, and efficiency in your chewing. If any of these elements is not functioning to its best potential, however, even the smallest hindrance can cause pain, injury, disease, and other problems. This is called a malocclusion and will be covered in tomorrow’s post.

Dr. Sperbeck, West Los Angeles

How is an occlusal analysis performed, exactly, and what is involved in the process?

Well, first, a mold of your teeth is taken so an accurate plaster or stone model of your bite can be examined. Using what’s called a facebow transfer, the dentist will find the center of your jaw joint’s rotation, and then take measurements to see how it relates to your upper jaw.

Imprints of your teeth are then taken for a bite registration. A bite registration shows the dentist how your teeth come together when you are biting down completely. Also, the pattern of your jaw’s movement when chewing is unique to every individual. This pattern is also recorded.

There is a device called an articulator that a dentist uses to view your exact bite without having to use your head (which translates into countless hours in a dentist’s chair for you, the patient). It looks like this. The models previously made of your teeth are installed into the articulator, along with all the measurements of your jaw’s exact movements and how your teeth come together when you bite down.

After some examination (and long after your appointment is finished and you’ve driven home in time for dinner, don’t worry), the dentist will do some analyzing and will determine what is causing problems with your bite. Is it a TMJ disorder? Are crowns that were formed years ago getting in the way of proper chewing? What needs to be done in order to make the next procedure(s) successful?

Your dentist will be able to tinker with the articulator and find the ideal form of chewing system for you. A wax model will be made, and your dentist will move towards making these changes before moving on to the aforesaid procedure(s).

And, voila! Not only will you have some super treatment coming your way, but you’ll be comfortable knowing that your entire chewing system will be working the way it is supposed to.

Dr. Sperbeck, West Los Angeles

Apexowhat?! Yes, this is definitely quite a new word to wrap our heads around. What can I say? It’s a two-for-one deal: learning a little bit about dentistry while simultaneously sharpening your vocabulary skills. How convenient, right?

Anyway, in the previous post, I introduced the concepts of apexogenesis and apexification. Apexogenesis will be briefly discussed in this post.

Apexogenesis is a procedure performed after an injury that helps a young adult tooth root to continue growing and the the pulp to heal correctly. Medication is used on the surrounding soft tissues to prevent infection and ensure proper recovery. If the procedure is successful, the apex (remember, the root’s tip which has a slight opening) continues to close as the tooth grows, and the root canal walls thicken. A successful operation also relieves the patient of any further endodontic treatment, provided the pulp heals completely and the tooth’s life is fully preserved.

If, however, the apexogenesis therapy did not prove to be successful, apexification may be required. Details coming!

Dr. Sperbeck, West Los Angeles