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WHICH TEETH TO KEEP AND WHICH ONE’S CAN GO: OCCLUSAL SUPPORT TO PREVENT TMD
by Dr Clayton A Chan DDS
From my experience I have found that patients who have at least 2 molars and 2 bicuspids per quadrant are easier to get stable.
Cases with 1 bicuspid and 2 molars per quadrant not as stable, but can be stabilized with clinical skills and understand of detailed GNM concepts.
Cases with 1 bicuspid with 3 molars per quadrant are easier to stabilize.
The general rule what I am trying to convey is that having a second molar tooth position (with a 2nd molar or 3rd molar/wisdom tooth is crucial for pitch, yaw and roll of mandible) in each quadrant is very important of jaw stability.
Now there are variations on the theme, but these are things dentist and lay persons should all consider, before just having teeth removed…
Nature designed teeth to help support posture. Nature placed teeth in particular positions for specific muscle and structural support reasons….more than for smiling and eating food.
Without them posture is compromised. Holding on to at least 28 units of teeth is the best…..when patient loose the support of the second molar region (occlusal support) it makes stabilizing the TMD jaw issues more challenging.
Typically the 3rd molars or wisdom teeth can be removed in most cases. The second molar is a key tooth that supports the posterior vertical dimension of the mandible, the jaw joints (condyle and disc) relationships and so much more. You can remove thirds since they often impacted, but you loose the seconds and the mandible starts collapsing in the back region….Yep front teeth are important, but the posteriors are even more important and significant to ones dental health. We need them all.
Consult your dentist as to what is best for your dental and masticatory health.
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