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OCCLUSION

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By Clayton A. Chan, D.D.S.

The Subject of OCCLUSION:

Dental occlusion is defined as: “The act of bringing the mandibular teeth into contact with the maxillary teeth.”   

“Occlusion \a-kloo΄shun\ n (1645): 1. the act or process of closure or of being closed or shut off; 2. the static relationship between the incising or masticating surfaces of the maxillary or mandibular teeth or tooth analogues;” [Glossary of Prosthodontic Terms GPT 9].

Acentric occlusion: “a condition in which the habitual voluntary closer pattern of the mandible does not coincide with centric relation, producing primary premature tooth contacts in the centric path of closure.” – Dorland’s Medical Dictionary, 26th Edition.

  • The act of closure.
  • The state of being closed.
  • An obstruction.
  • The relation of the maxillary and mandibular teeth when in functional contact during activity of the mandible…

I define it as:

  • Occlusion is the ACT of closing to a terminal contact. 
  • OCCLUSION is the “thinking process” before you do the irreversible deed.”

As dentists…

  • We all know how to examine and prep teeth. . .
  • We know how to fill and crown teeth. . .
  • We know how to bond teeth. . .
  • We know how to grind on and adjust teeth. . .
  • We know how to clean teeth. . .
  • We know how to do root canals. . .
  • We know how to image teeth. . . Identify decay, failing margins. . .
  • Extractions
  • We know how to take impressions. . .
  • Implant teeth. . . Etc.

Your patients occlusion is ACTing in one of the following ways:

  1. Supportive – It acts in a healthy way
  2. Destructive – It acts in an unhealthy way.
  3. OCCLUSION is the UNSEEN ACTOR.

YOU can control the kind of occlusion you provide your patients!

QUESTION TO ASK ONESELF:

How is one’s occlusion acting? It is either acting in a healthy comfortable manner….or is it acting in a manner that is unhealthy, uncomfortable, contributing to muscles strains, joint issues?. For some TMDer’s occlusion contributes to disability of their bodily functions – impairs normal healthy function and living quality of life. This is why occlusion matters!

Each groove, each fossa, each ridge height on the occlussal surface must function in very particular ways in order to allow muscles, joint/condyle disc and jaw positioning to occur whether positively or negatively. it all matters. If there are high spots the patient feels during the chewing cycle, the muscles will not calm down.

 . . . . So what else is there to know?

    

MOST DENTISTS HAVE NEVER TAKEN AN OCCLUSION COURSE or Really Learned It!

Any and all occlusion courses would be valuable to any clinically oriented dentist who is involved in complex TMD issues. It is good for dentist to learn both gnathologically based occlusion concepts as well as neuromuscularly based concepts. Secondly, any occlusion course that trains dentists on how to implement micro occlusal adjustments both intra orally and extra orally on removable anatomical appliances in a detailed manner (cusp fossa) relationships vs. gross removable of occlusal form would be hugely beneficial to understanding complex TMD patient cases.

Dentists don’t always have to agree on philosophies, but they will need to meet the needs of complicated TMD cases who present with masticatory dysfunctions, joint derangement and pain. Patient’s don’t worry about occlusal philosophies…they just are looking for a result to stop their suffering of pain and dysfunctions.

All dentists should learn how to find and identify the terminal contact position that is physiologic vs pathologic as well as occlusally manage all functional jaw relationships involving Class II division 2, anterior open bite, TMJ primary and cervical neck issues that effect the occlusal schemes.

Failures will continue when they don’t understand these fundamental occlusal issues that must be learned. It should not be considered optional, especially when dealing with the more complex TMD cases.

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