One way dental diseases contribute to TMJ disorders is by destabilizing bites.  A bite which is stable over time is fundamental to long term TMJ health.  Dental health affects bite stability, and bite stability affects the course of the TMJ disorder.

 

A stable bite is needed for the jaw muscles to get healthy exercise.  The contours of the bite table determine the exercise template that the jaw muscles work out against, so a stable bite is needed for the jaw muscles to stay healthy.  To provide a good exercise platform, the bite must be even and unstrained.

 

A stable bite is also needed to maintain healthy TMJs.  The bite determines the bracing position, the “home base” for the jawbone.  Any shifting of teeth shifts the bracing position for the jawbone and thereby also the pressures exerted at the TMJs.  Joints all over the body are designed to acquire a perfect fit between the bones when they are in their bracing positions by remodeling to fit the pressures exerted there.  If the bracing position of the jawbone frequently shifts even slightly, the TMJs will not have a fixed target for their remodeling activity, and they may never acquire sufficient goodness of fit to maintain joint health.

 

Another way dental diseases contribute to TMJ disorders is by increasing jaw muscle tension.  Dental diseases automatically increase jaw muscle tension just as inflammation of a TMJ or almost any other source of pain or cell damage in the face.  All these sources of noxious impulses to the nervous system cause the muscles in the area (primarily the jaw muscles) to automatically go on “guarding” behavior.  They hold themselves tight at rest, and they fire carefully and weakly during function.  Because the massive jaw closing muscles are almost all arranged vertically, increased resting jaw muscle tension causes increased resting compressive forces in the TMJs.  These increased resting compressive forces can produce cellular damage in a TMJ which has no cushion because its disk is displaced.

 

Improving dental health requires cleaning your teeth, massaging your gums, and getting good routine dental care.  The goal is not to sterilize your mouth or even kill the microbes which live there.  The goal is to grow a stable crop of healthy microflora which protect your tissues from pathogens much like healthy growing plants in a garden prevent the growth of weeds.  Your microflora is affected not just by how often you brush and floss, but also by what you eat, how much stimulation your gums receive, and your overall state of health. 

 

Generally preventing cavities is important in adolescents and teenagers, and preventing periodontal disease is important in adults.  Cavities occur anywhere food gets trapped between the teeth or in the valleys on the tops of the teeth.  Bacteria digesting the food produce acid which eats a hole in the enamel.  This problem is common in youth when teeth have deep valleys that trap food, lots of sugar is consumed, and mouths are more acidic.  In adulthood most peoples’ mouths get more alkaline (less acidic) and start depositing minerals in the form of calculus at the gumline rather than dissolving minerals on the tops and sides of the teeth.  At the same time, the gums receed leaving large spaces where food can get trapped around the roots of the teeth.

 

Preventing periodontal disease requires removing plaque from the gumlines on a regular basis.  Plaque is the white paste made primarily from flour and water which pick up minerals and harden, forming a tough layer of material which surrounds the necks of the teeth and acts like a microbial incubator at the gumlines.  Once it hardens, it becomes almost impossible to remove without a professional teeth cleaning by your dentist.  While it is still soft, it can be removed by various teeth cleaning tools like little bristles brushes pushed in between the teeth and a rubber tip rubbed along the outer and inner surfaces. 

 

In addition to removing plaque from the areas where they meet the teeth, massaging the gums is often required to keep them healthy.  Our gums evolved while chewing produced an almost constant source of physical stimulation from chewing.  Chewing continued for hours every day, and it always took place close to the gums because the teeth never got long from gum recession.  Chewing compressed and released the gum tissues thousands of times a day.  Each compression pumped out the old blood, and each release replenished the gums with new blood.  In most adults today, the combination of soft food and gums which have receeded far from the chewing surfaces leaves the gums without sufficient natural massage.  To keep the gums healthy, we need to recreate that massage.

 

Gum massage can be provided by toothbrushes, little bristle brushes, and tooth picks, but the best tool for providing healthy massage is the rubber tip.  Rubber tips were included on the end of every toothbrush for 50 years, because we know they are effective.  The reason it’s been removed in the last decade is primarily because it lasts for many years, so it’s a marketing disaster.  The dental companies have been instead moving toward disposeable materials.  The rubber tip should be rubbed along the gumline from one tooth to the next and pushed in between the teeth.  With each rub, the gums turn white and then pink again.  They turn white when they lose the old blood, and they turn pink again when new blood flows back in.

 

Gum massage becomes even more important if you are wearing a daytime appliance, such as a disk recapturing appliance.  These appliances further limit the natural massage generated by chewing, because the plastic covering the teeth sheds the food during chewing even farther away from the gums.