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Am I suitable for an occlusal bite adjustment if my top teeth do not touch my lower teeth?

Orthodontics Dental Cosmetic Dentistry

2 of my upper wisdom teeth are overgrown and sometimes hit my lower molar. My 2 lower wisdom teeth were extracted when I was much younger since they were both impacted.  Are there any solutions such as an occlusal (bite) adjustment to save the 2 upper teeth?

DOCTOR’S ANSWER (1)

A tooth that does not bite on another corresponding tooth is described as a non-functional tooth

Non-functional teeth may drift within the jawbone until resistance is encountered to provide an occlusal stop (a stable biting position) because your bite pattern is determined by muscular and nervous control. This resistance can be another tooth, the gum or an artificial tooth replacement (an implant, a bridge or a denture).

Migration of the tooth is irregular and may result in slanting, tilting or tipping of the tooth. This may result in poor contact with the adjacent tooth (causing a food trap and increased risk of decay and gum disease in the area) or abrasion of the cheek mucosa (should the tooth tip towards the buccal or cheek side) or abrasion of the opposing gum (should the tooth drift vertically). This tooth migration is more likely to occur in the upper jaw because of the lower density of bone.

Orthodontic treatment or occlusal equilibration (bite adjustment) to remove bite interferences can be considered, but relapse (tooth migration) WILL OCCUR unless an occlusal stop is present. This means a replacement tooth in the opposing jaw MUST be present at the end of treatment

Wisdom teeth are usually NOT replaced because of the lack of space in the jaw for these teeth to begin with. A clue to how much space is present is whether or not the opposing wisdom teeth could erupt normally. Impacted teeth usually occur when there is insufficient room for eruption.

The most elegant method for dealing with non-functional upper wisdom teeth, especially if these teeth are starting to cause occlusal interferences with functional shifts (the lower jaw is deflected from closing symmetrically) is to remove the non-functional teeth. 

In certain cases where orthodontic treatment may be desired (e.g. orthognathic surgery for class 3 skeletal cases or when the upper 2nd molars are missing or have a poor long term prognosis), the strategic importance of the upper wisdom teeth may need to be considered. In most cases, the upper wisdom teeth do not have a bearing on the overall orthodontic treatment plan.

176 views 23 Feb 2019
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