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Dentistry Ohio

'Living' Article August 2012- Occlusion


August 2012


oc-clude: verb- to close, shut, or stop up a passage, opening, etc.

In the dental world this verb is utilized when we discuss the ways in which the teeth meet when the mouth is fully closed or shut.  The study of the ways and places in which the teeth meet is called “Occlusion”. 

I can think of no other facet of dental health analysis that is as foggy as occlusion.  Depending on where any given dentist went to dental school or to which current occlusion guru he or she follows there is a myriad of ways in which occlusion is understood and how occlusal disease is diagnosed and treated. 

When my Dodge Durango started acting up I took it to the dealer, they hooked it to a computer, made a diagnosis, replaced a faulty part and it’s worked fine ever since.  I’ve learned at the dental office that people are not like Dodges.  Following dental treatment most people have no problems related to the way in which their teeth occlude even if we’ve restored most of the teeth within any given arch.  And then there are other times when we put a filling or crown on just one tooth and we work for weeks trying to get the occlusion of the teeth back to where it feels like home for that patient.  We make a bite guard appliance for one person with headaches and jaw pain, he/she responds beautifully and I look like a hero.  I make a similar appliance for another patient with like symptoms, he/she gets worse and I look like a villain!  Patient “A” has worn his/her teeth flat by age 23 while patient “B” has very little sign of wear at age 73!  What’s up with that?

In June I spent three days at the Scottsdale Center for Dentistry, home of the incredible Spear Education team.  The workshop I attended was entitled “Occlusion in Clinical Practice”.   In the course of those three days we reviewed the anatomy of the jaw joints and the muscles that allow the jaws to relate.  We looked at assorted abnormalities that lead the joints and muscles to misbehave.  We reviewed how the wear patterns on teeth have the potential to tell us exactly what any given patient is doing to create dental disease.  We tried to make sense of the vast assortment of mouth appliances that can be made to help diagnose and treat joint and muscle related problems.  We studied assorted real life occlusion cases and learned that some folks simply needed subtle reshaping of tooth anatomy to restore a balanced bite.  Other patients needed broken, worn or missing teeth to be restored with fillings, crowns and dental implants to create proper anatomy and balance.  Others required orthodontic and or surgical help to modify the ways in which the teeth mate when they come together. 

In the final analysis I’ve arrived back at home with newly opened eyes and greater insights to help my patients.  But I’ve also been reminded that no matter where I go and how much I study, people will never be Dodges.  People are always individuals.  Each deserves and demands special analysis and customized treatment.  Well, come to think of it, I guess that’s true both in and away from the dental office. 

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