Functional Dental Disease


Functional Dental Disease can lead to teeth chipping, cracking, wearing down, pain, tooth loss, as well as jaw joint (TMJ - Temporomandibular joint) and neuromuscular dysfunction (where nerves and muscles do not behave in a healthy manner).  Figuring out the cause of functional disease and providing the most conservative and effective treatment options can be challenging.  Accurate diagnosis can help in determining the appropriate treatment plan that will help reduce the patients level of risk and improve the prognosis in the most conservative way.  A faulty diagnosis, or incomplete diagnosis, misdiagnosis may lead to a lack of treatment, wrong or inadequate treatment or overtreatment. 

There are some terms used in a Diagnostic system:

Disease: The cause of Damage to the biologic system.  How and Why the damage occurred

Disease Indicators: Sign and Symptoms of how a disease expresses itself.  These are subjective and objective observations. 

Risk Factors: Variables that increase the probability of acquiring the disease.  For example: Eating a lot of candy increases sugar intake

Risk: The probability that further damage will occur to the biologic system due tot he disease severity and risk factors that are present

Prognosis: The prediction of what will happen to the biologic system based on the risk level, patient's age, and patients expectations.  

Taking all factors into consideration a Functional Disease Differential Diagnosis can be assessed.  They are as follows:

Acceptable function: Absence of a current functional disease.  Harmony in the way the teeth meet, proper TMJ and neuromuscular function. 

Frictional Chewing pattern: When teeth meet there are interferences and that causes them to rub against each other and cause wear over time.  

Constricted chewing pattern:  The position of the mandible gets deflected when the teeth meet during closing.

Occlusal dysfunction: Inefficient use of the masticatory muscles, back teeth do not meet well and that causes avoidance patterns, may also result from TMJ disorders

Parafunction: Destructive Overuse of the chewing system with no functional purpose

Neurologic Disorders: Medical Conditions such as Parkinson's or tardive dyskinesia, or use of medications

The correct collection of data can help in determining an accurate diagnosis.  As a result,  a conservative treatment plan can be implemented to reduce a patients long term functional risk and improve biomechanical, functional and dentofacial prognosis. For a patient that is equivalent to saying the bite is healthy, comfortable and stable for long term.  

Article by
New York Dentist