How do I know if my bite is off?

Unevenly worn teeth, cracks, a sore jaw on waking or restorations that keep breaking are the usual signs. Examining the contacts and the wear pattern confirms it.

Does correction take long?

It depends on the cause. A guard takes two appointments; adjusting the contacts is quick; orthodontic correction runs into months. The cause decides, not how much it bothers you.

Should the bite be corrected before crowns?

Where the bite is implicated in the fractures, yes: putting ceramics onto a bite that has already broken natural teeth exposes them to the same fate, without the reassurance the patient was hoping for.

Bite Correction

A full-arch implant rehabilitation fitted, front view

What the bite decides

How the teeth meet, thousands of times a day.

The bite is how the upper and lower teeth meet. When a few teeth take a load meant to be shared by all of them, they wear, crack, loosen or hurt in the cold — and restorations built on them break sooner than expected.

It is often the diagnosis being looked for when a crown comes off twice, or when a veneer fractures without being knocked.

The signs

Wear, cracks, waking with a clenched jaw.

Incisal edges going flat and translucent, vertical cracks on the canines, sensitivity at the neck of the tooth, a sore jaw muscle on waking, morning headaches, a click or a catch on opening.

None of those is specific on its own, and it is the combination that points somewhere. Many coexist with night-time grinding, which is both cause and consequence.

Learn more about bruxism

What gets corrected, and in what order

From reversible to irreversible, never the other way.

You start with what can be undone: a guard, which protects the teeth and shows what happens at night. A fine adjustment of the contacts follows, limited to a few tenths of a millimetre. Where the cause is the position of the teeth, orthodontics is the answer; where teeth are missing and the others have tipped, they have to be replaced first.

Grinding teeth down to "balance" a contact before understanding why it takes the load is the most common way of making the problem worse, because removed enamel does not come back.

Learn more about orthodontics

Bite — Frequently Asked Questions

How do I know if my bite is off?: Unevenly worn teeth, cracks, a sore jaw on waking or restorations that keep breaking are the usual signs. Examining the contacts and the wear pattern confirms it.
Does correction take long?: It depends on the cause. A guard takes two appointments; adjusting the contacts is quick; orthodontic correction runs into months. The cause decides, not how much it bothers you.
Should the bite be corrected before crowns?: Where the bite is implicated in the fractures, yes: putting ceramics onto a bite that has already broken natural teeth exposes them to the same fate, without the reassurance the patient was hoping for.