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Malocclusion associated with poorer postural and balance control

The impact of oral health on general health is a topic of current prominence. The latest research has found a connection between malocclusion and posture and balance problems. (Photograph: NorGal/Shutterstock)

2016-9-20 | News Europe

Malocclusion associated with poorer postural and balance control

by Dental Tribune International

BARCELONA, Spain/INNSBRUCK, Austria: In recent years, there has been increasing medical interest in correcting teeth that are not perfectly aligned in order to resolve diastemas and crowding and to prevent problems such as jaw pain. Two studies, carried out by Spanish and Austrian researchers, have now provided evidence that dental occlusion is associated with the control of posture and balance.


The studies, a collaboration between the Department of Cell Biology, Physiology and Immunology at the University of Barcelona and the Department of Sport Science at the University of Innsbruck, found a relationship between malocclusion and postural control. Both studies provide conclusive data that shows that postural control is improved—both in static and dynamic equilibrium—when various malocclusions are corrected by positioning the jaw in a neutral position. 

The first study took into account the type of dental occlusion and whether there had been previous orthodontic treatment. The results showed that alterations in alignment of the teeth were related to poorer control of static balance.

The second study assessed the type of dental occlusion, control of posture and physical fatigue in order to analyse a possible relationship between these factors. It demonstrated that balance improved when malocclusions were corrected, and that the latter had a greater impact on postural control when subjects were fatigued than when they were rested.

“When the subjects were tired, their balance was worse under both stable and unstable conditions. Under static conditions, the factor that had the greatest impact on imbalance was fatigue. In contrast, a significant relationship between exhaustion and dental occlusion was observed under conditions of maximum instability,” said lead author Dr Sonia Julià-Sánchez, a researcher at the Department of Cell Biology, Physiology and Immunology at the University of Barcelona’s Faculty of Biology. 

“When there is a malocclusion, it is classified according to scientifically established criteria. What is relevant in the study is that malocclusions have also been associated with different motor and physiological alterations,” Julià-Sánchez explained. This relationship is not as obvious in everyday static conditions, although there may be conditions associated with pathologies, such as obesity, that worsen the body’s instability, thus decreasing postural control and increasing the risk of falls.

In athletes, this relationship can play a crucial role in how well they ultimately perform, as well as in the prevention of injuries such as sprains, strains and fractures caused by unexpected instability as fatigue increases and motor control capacity decreases. “Therefore, it would be helpful for both the general population and athletes to consider correcting dental occlusions to improve postural control and thus prevent possible falls and instability due to a lack of motor system response,” added Julià-Sánchez.

“Postural control is the result of a complex system that includes different sensory and motor elements arising from visual, somatosensory and vestibular information,” explained the expert.

In recent years, there has been increasing scientific interest in the relationship between the stomatognathic system—the set of organs and tissues that allow us to eat, talk, chew, swallow and smile—and postural control. The link may have a neurophysiological explanation. There is a reciprocal influence between the trigeminal nerve and the vestibular nucleus, which are responsible for masticatory function and balance control, respectively, as well as between the muscles of mastication and of the neck. This influence would explain why dental malocclusions negatively affect postural control. Up until now, however, there was no conclusive research.

“The main problem stems from the fact that the majority of these studies had statically assessed balance under conditions of total stability, which in practice has little actual application in the control of posture while in action,” Julià-Sánchez pointed out.

The first study, titled “Dental occlusion influences the standing balance on an unstable platform”, was published in the October 2015 issue of the Motor Control journal. The second study, titled “The influence of dental occlusion on the body balance in unstable platform increases after high intensity exercise”, was published in Volume 617 of Neuroscience Letters.

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