Bite Equilibration

WHAT IS AN EQUILIBRATION AND WHY MIGHT I NEED ONE?

When we talk about equilibrating your bite, it means adjusting the way your teeth mesh such that when your jaw muscles are relaxed and your jaw joint (the temporo-mandibular joint, or TMJ) is in a neutral position, your teeth are touching evenly with equal contacts between the upper and lower teeth. Other terms used to describe an equilibration are having your bite adjusted or an occlusal adjustment.

An easy way to think about equilibration is to think of having your tires balanced and wheels aligned. If you do not have this done, you can still drive your car. Your tires will wear unevenly, however, and your car will handle poorly. In severe cases, it may even be dangerous to drive at high speeds. Similarly, if your bite is poorly balanced and aligned, you will have poor performance! Your teeth will wear excessively, chip or crack, and you may move your jaw about in an attempt to locate a comfortable position where your teeth fit together. Your jaw muscles may become fatigued or painful by continuously trying to achieve a position of balanced force distribution on the teeth. You may grind your teeth in an attempt to “mill” them into a position; this usually occurs while you are asleep and is called bruxing. Your jaw joints themselves may suffer from the stress of this over-use and develop noises or pain.

The most common reason I recommend equilibration is to ensure that you have a balanced jaw position before undergoing dental rehabilitation. This is to ensure that your new restorations are not built in a poor bite position. Building your new restorations in the wrong position can result in them failing prematurely, and/or jaw joint pain and dysfunction and facial muscle pain.

I may recommend equilibration of your teeth if heavy bite forces are placing abnormally high pressure on just a few teeth, and the problem can be corrected comfortably without orthodontic treatment, dental rehabilitation, or jaw surgery.

If you have localized areas of gum recession, it may be due to excess bite forces on the teeth that have the recession. Recession can be stopped or often reversed by gum grafting, but a bite equilibration may be necessary to stop the grafted tissue from receding as well.

The first step of an equilibration is to take impressions for diagnostic models. Depending upon the complexity of your bite, I may recommend having additional bite records taken so that I can do a trial equilibration on the models. After studying and working on models of your teeth I may recommend alternatives to an equilibration, or preliminary appliance therapy. Appliances that I may suggest include a removable acrylic night guard or a daytime removable ‘deprogrammer’ similar to an orthodontic retainer.

When we proceed to the actual equilibration, I will selectively shape your teeth with a polishing bur in order to eliminate the interferences. This procedure takes at least an hour because of the required meticulous attention to detail, and is totally painless. After the equilibration you will likely notice that your teeth fit together more comfortably, but I will caution you to not “play” with your new and improved bite. Over-use of your jaws, even with a well-balanced bite, will lead to pain and problems! I will bring you back for an appointment to check your bite one week after the equilibration. Additional adjustments – “fine tuning”- are often required at the one week appointment.

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