“Occlusion 101 is how I teach the New Mexico residents. Each year, ten new dentists just one month out of dental school, have taught me to relax about the lack of occlusion in dental school curriculums. These young professionals are bright, hungry for knowledge, excited to be a real dentist, confident and are examples of a bright future for dentistry. Digital technology is everyday life for the new generation of dentists. The future of dental education will be exciting as clinical digital technology continues to integrate into the schools.”
Occlusion is a cranial based problem; two TMJ’s and one occlusion. Cranial anatomy is not a strong asset in dentistry today. Digital imaging will improve our ability to learn cranial:
- Growth and Development
- Condyle Anatomy and Function
- How the Mandible Engages the Maxilla
Pictures help teach because a dentists mind is trained to be visual dominate.
The mandible is a mirror image 3-D position of the cranium. The mandible is a fulcrum to the base of the skull. When the mandible does not sit center to the maxilla, it will pull the cranium off center to the spine. The most common muscle trigger in the human body according to Dr. Janet Travell is the trapizius attachment to the occipital bone. Why? Because it affects all of our posture patterns. How we eat, sleep, drive, and work will dictate how the head relates to the spine at C-1 (atlas) and below.
Any change in the mandible has to force the muscles behind the T.M. hinge to counter the torque force. The key for dentists to learn and teach occlusion to patients is through the T.M. joints. Remember, two T.M. joints, one occlusion. The best analogy is a door and its frame.
Patients understand this analogy but somehow 90% of dentists think that the position of the T.M. joints doesn’t matter. Out of sight, out of mind! Most jaw joints grow at a healthy rate. A healthy condyle/T.M. joint is in an orthopedically braced position. That is the definition of “centric”. No question, digital imaging teaches an infinite number of shapes, sizes, positions and adaptations of the condyle/disc/fossa relationship. In digital occlusion, no two bites, T.M. joints and envelope of function are the same. Every individual has a unique signature of occlusion. How perfect is that? Now, measure it. A digital force scan that is generally center when the condyles are healthy and seated is the goal for dentistry.
Is that possible for every patient? The answer is “no”. Remember, every human adapts. If a center of digital force pattern is not possible for a patient, then the dentist must THINK!! What options do I have? We get to choose from:
- Do nothing
- Send to alternative therapy (massage, chiropractor, physical therapy, etc.)
- Make a splint
- Equilibrate
- Restore
- Orthodontics
- Orthognathic
- A combination of any of the above.
The question is always, “what combinations are the correct combinations to unlock the mystery for your unique patient? Figure it out!! You are smart and care about your patient. Your care, skill, and judgment is invaluable and that’s what you get paid for. So, how do you figure it out?
- Radiographs
- Digital photographs
- Facebow analysis and centric bite records.
- Digital force scan in two positions (see Habitual Force Distribution Patterns)
- Sitting in an eating position (habitual)
- Supine with shoulders stretched back (cranium support)
Figure out the most conservative way to bring the two patterns to a center position and maintain or (retain) that position.