Super-eruption?

by Jeremy
(Austin , TX)

I had suffered from a clicking and painful TMJ for years. A couple years ago, I began using an Anterior Repositioning Splint at night. With the APS in, my jaw is forward just a few millimeters, but it is enough to stop the click.

My jaw muscles stay trained throughout the next day after wearing the APS. I don't clench throughout the day, and my jaw stays relaxed. My headaches have virtually ceased, and as long as I use the APS at night, the clicking is gone. (Of course, if I don't use it for a few nights, the condyles of my jaw slide back to the old position, and I get all the same symptoms again).

Because of the anterior position of my jaw now, the occlusal surfaces of my molars rarely touch like they used to. I was told by a dentist that I could develop super-eruption in these teeth and develop problems from this. I wondered if you knew anything about that. It would be a shame to stop using the APS because it has helped so much. But I don't want to cause longer term problems because of the new (lack of) occlusion.

Any thoughts?

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Super-eruption?

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by: Dr. Spainhower

Hello Jeremy,

Yes, Super-eruption (SE) is something that needs to be addressed and to know about regarding using guards/splints. SE does occur in various situations. I'll give you a couple of quick examples...

If a person loses a tooth, and the opposing tooth does not touch a tooth when biting, the non-touching tooth will most often supererupt. That can cause problems with the bite and jaw disorders can result.

If I make a crown for a patient, and I over adjust the crown so that it does not touch/occlude the opposing teeth, it can supererupt to eventually touch the opposing teeth.

So, with mouth guards, the same principles apply "IF" you wear the guard 24 hours a day, and one or more teeth are not touching, the non-touching teeth can SE. The word "IF" is dependant on variables.

Typically, you shouldn't be concerned about SE if you are wearing your NIght Guard (ARS) only at night (8-10 hours worth). I don't know of any studies on this, but it's generally accepted by TMJ Dentists that you should be able to wear a guard...even an Anterior Repositioning Splint at night, and you should not have any SE problems. However...

If you wear the ARS at night only, and you wake up and go through your day and don't touch your back teeth together all day, then that is a problem. But, I don't see how that is possible.

See, we all swallow about 2000 times each day. When we swallow, our back teeth touch (normally). Also, when you eat, your back teeth should be getting sufficient "back teeth" contact to prevent SE. That last statement might be debated by TMJ Dentist purists but I believe eating is enough sensory contact to prevent SE.

So, if you swallow normally, and eat normally that allows your back teeth to touch throughout the day. Then you should not have problems with SE.

Now, if you don't feel your back teeth touch together, that can be a normal thing. About 95% of the population has an off bite. Generally we all fall into a category of having about a 1 mm difference from our Bad Bite occlusion compared to a perfect bite occlusion. Most of us live with that Bad Bite scenario with few problems. So, when you don't feel your back teeth touch, you could be experiencing a "normal" Bad bite situation, that is a result of wearing a guard at nigt. If that is the case...you should be fine.

If your teeth DON'T touch when swallowing throughout the day, and you eat with your front teeth only, then you need to change your night guard to a All tooth contact night guard. I'm assuming that your ARS has front teeth contact only.

Of course, I can't tell you that you "WILL" be fine without seeing you in person to evaluate your situation, but generally you should be just fine.

If you have any more questions, feel free to comment on this thread again.

Best regards,

Dr. Spainhower

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