Dr Clayton A. Chan…How did you start studying occlusion?

It is a long story, but the short and brief version is that as a trained lab technician I soon recognized occlusion matters.

At the Start…
In dental school when I delivered by first 3/4 gold crown on my patient she came back telling me that her new crown that I cemented on was now causing molar tooth sensitivity. Intuitively I realized that something was hitting high and so I adjusted the high spots and shortly thereafter my patient said her toothache went away.

That real live clinical experience, as simple as it was, indicated to me that small high spots in one’s bite can trigger irritating symptoms like teeth sensitivities, mobile teeth and boneless, to muscle tensions, headaches, neck aches, pain in the jaw, facial pain, tingling down the hands and fingers, ear congestion feelings, clicking popping in the jaw joints, etc. to name a few related TMD symptoms. Now we realize that a single tooth, or a group of teeth, or it can even be a complete arch of teeth after ortho or extensive restorative dentistry when out of alignment can trigger all kinds of seemingly unrelated symptoms called TMD.

That is my first clinical experience of what started me on this journey to study occlusion. From this point forward I realize I needed to learn more about occlusion, so I started to pay attention and realized there is so much to occlusion that often goes unnoticed or the issues are swept under the rug and the patient is told that the filling or crown or splint is new in their mouth and they will need to get use to it…. But now I know for certain that that is not right!

After Practicing….
After practicing general dentistry in San Diego, CA for a number of years I realized masticatory muscular pain was associated to the bite and how things come together. So I decided to study Centric Relation concepts. Why? Because that is what I was influenced by from my dental school days having been around dental articulators and mounting models. So naturally I thought that centric relation was the starting point to understanding dental occlusion – the hinge axis theory, face bow/ ear bow mountings I learned as well as “organic occlusion” – a sophisticated gnathologic way of doing equilibrations on models records before actually performing the procedures in a patients mouth. These meticulous steps I took to record a so called “reproducible” hinge axis to mount my patients models prior to equilibrating their occlusion in a cusp to fossa relationship was intriguing and interesting to learn.

But after a number of years doing this on my patients who I felt needed this type of treatment, I realized it was not always reliable. A small percentage of these patients mandibles I noticed were coming forward even after my occlusal equilibrations. That is when I stopped and felt a total re-evaluation of what centric relation theory was about needed to be analyzed on another level….

So I began to search for another better way and a better answer.

Thank you for asking!