Sometimes we have a patient who comes into our office complaining that their bite feels wrong. They don’t have any other symptoms, and measurements of the jaw system show that, contrary to the way the bite feels, it’s actually perfect. It’s rare, but it happens. We won’t adjust a bite that’s perfect, and we sometimes lose that patient over the disagreement.
Now we have a name to put to this condition: occlusal discomfort syndrome, which is finally becoming a recognized medical condition.
Defining Occlusal Discomfort Syndrome
The first definition for occlusal discomfort syndrome was just put forward by the Japanese Prosthodontic Society (JPS). In 2011, the JPS convened to attempt to address reports that dentists were encountering this problem with some regularity. There was no recognized condition that could help define research into the phenomenon or define clinical guidelines for how dentists are supposed to respond. Initially, the JPS considered the label occlusal dysesthesia, but after collecting reports from dentists about the actual nature of the disorder, it was decided that the simple and descriptive occlusal discomfort syndrome was the best label.
Is It All in Your Head?
Many patients are baffled if we can’t find an occlusal problem that matches their sense of discomfort. Sometimes, they think we are saying that it’s an imagined sensation, but that’s not the case at all. Although there are sometimes psychological dimensions to these types of disorders, there are also physical causes that may result in occlusal discomfort syndrome.
One potential explanation is sensitization. If you have developed a sensitization disorder, your body is amplifying normal sensations disproportionately. With sensitization, the normal occlusal contacts that help guide your bite might seem excessive, leading to a sense of discomfort. Sensitization disorders can occur peripherally–related to the nerves in your teeth or jaw–or they can occur centrally–related to the way your brain interprets signals from the nerves. If sensitization increases, it can make these occlusal contacts painful.
Another possibility is that you are experiencing referred sensations. Your brain is used to interpreting sensations from your teeth related to occlusion, so when there is an unusual displacement elsewhere in the jaw system, your brain might interpret it as occlusal signals.
Occlusal Discomfort Syndrome and TMJ
As we are coming to understand, temporomandibular joint disorder (TMJ) is a complex constellation of conditions that stem from both physical and psychological causes. Like occlusal discomfort syndrome, TMJ can be related to sensitization disorders, and sometimes the discomfort is better treated with a different approach than occlusal adjustment and other neuromuscular TMJ treatments.
We’ll Help You Find the Right Treatment
It’s our promise to you that we will never perform an unnecessary occlusal adjustment. If you come to us because your bite feels off, but our measurements show it’s perfect, we will tell you so. We won’t create a dysfunction that could have potentially serious consequences.
Instead, we will work with you to help identify the cause of your discomfort and get appropriate treatment to help relieve your symptoms.