Occlusal Wear

Parafunctional habits: bruxism (grinding), clenching, or object biting (ice, nails, pens). These can occur for a number of reasons, including:
- Stress
- Medications: levodopa, fluoxetine, lithium, citalopram, etc.
- Habits
Bite interference due to:
- Natural tooth position
- Restorations that are “high” or unpolished porcelain rubbing against natural tooth structure.
- Shifting tooth position from periodontal disease
Missing teeth – spaces in your dentition will put more pressure than normal on the remaining teeth. This is most noticeable with your molars and other posterior teeth.
Diet
- Nuts, ice
- Excessive gum chewing
Systemic/Neurological
- Sleep apnea
- Huntington’s disease, Parkinson’s disease
- Down syndrome
- Autism
Developmental dental defects –enamel is thin or weak

Flattening of chewing surfaces
Trismus (restricted mouth opening)
Tenderness in the muscles used for chewing
Headaches, usually near the temples
The clicking of the temporomandibular joint (TMJ) – where your jaw attaches to the rest of your skull
The bite doesn’t “feel right”
Loose teeth

Teeth: Tooth sensitivity, fracture of teeth, exposure of tooth nerve, poor esthetics, toothaches
Functional: Decreased chewing efficiency, pain on chewing
Temporomandibular joint disorders, or chronic headaches

Bite equilibration: A procedure done in the office where the dentist reduces the area causing the interference, allowing the teeth to come together more naturally
Occlusal guard to prevent grinding and clenching
Restorative procedures: Fillings or crowns to prevent further wear, decrease sensitivity, or improve aesthetics of worn dentition.
Orthodontic movement to fix issues with a misaligned bite
For severe cases, the only treatment is a “full mouth rehab” – necessitating crowns for nearly every tooth.