This individual presented for a restorative evaluation and during the exam reported that his front teeth are sometimes sore. The two images below show some interesting findings. What do you see that might be the cause of his sore teeth? He also reported some muscle symptoms, especially his anterior temporalis bilaterally and posterior fibers of both masseters. What might be the cause of that? The answer is on the tops of the teeth.

Upper teeth showing the back side. Teeth are white and clean.

Upper teeth showing the back side. Teeth are blotchy with dark colors.


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Commenter's Profile Image Mike Weisbrod
March 16th, 2012
I see a deep overbite impinging the papilla, also some excursive interferences on the anteriors, and some uneven incisal edge loading. The combination of the deep overbite (long pathway for excursives) and the uneven occlusal pattern on the anteriors would definitely give me a headache and sore teeth.
Commenter's Profile Image John Bach
March 16th, 2012
Locked in. And/or no cuspid disclussion
Commenter's Profile Image Jeff Lineberry
March 20th, 2012
Steve, Great case to share. It looks like he has heavy interfences in working and non-working movements and this would also account for his muscle pain in the ant. temporalis as well. The anterior teeth are probably sore from no good anterior stops, a "wedging" effect of his lower teeth into the lingual while clenching and he may have some prematurity there as well.(His posterior fibers of the masseters(deep masseter) are probably sore from limited or no posterior stops-I can see heavy excursive contacts, but no centric stops on the first molars back). Thanks for sharing:-)