The Dawson Academy Blog

Dental Articles on Occlusion, Centric Relation, Restorative Dentistry & More

John Cranham, DDS is the clinical director of The Dawson Academy, where he teaches many of the lectures and hands-on courses. Dr. Cranham owns and operates an esthetic-oriented practice in Chesapeake, Virginia. Dr. Cranham is an internationally recognized speaker with 25 years of experience.

Recent Posts

How to Increase Case Acceptance for Cases of Missing Teeth

In this edition of Increasing Case Acceptance, I want to talk about patients with missing teeth. We all have them. We all have patients in our practice that are missing a molar, and time goes by as the patients wonder whether they should do anything about it. And as you observe the patient over the years, the teeth start shifting in. The upper tooth or the lower tooth start shifting in the space and things start getting off.

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Quick Tip: How to Increase Acceptance for Elective Esthetic Dentistry

In this edition of Increasing Case Acceptance, we want to focus on elective esthetic dentistry. There really isn't anything more fun than talking to patients about things that involve improving their smile. The mistake that we make as dentists is we focus too much on the procedure in the beginning of giving them options of what we're going to do to them, specifically to make them look better.

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How to Get Case Acceptance for Treating Periodontal Disease

When talking about periodontal disease and increasing case acceptance with that part of your practice, this really should be a very simple thing for us to do. Sadly, periodontal disease still goes grossly undertreated in this country and in many of our practices.

So again, what I want you to think about through the lens of optimum oral health, what are some of the terms that we can be talking with patients about to get them to understand?

  1. I would use words like the silent taker of teeth
  2. Talk about their breath
  3. Talk about the drain with the infection affecting their systemic health.
Here again, utilizing the trick of showing them some part of their mouth that's normal and some part of their mouth that is departing from normal really helps that.

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Dawson Quick Tip: Increasing Case Acceptance with Mindset Shift

The first step in increasing case acceptance is to think optimum oral health and to talk optimum oral health.

All too often in our practices, we start listening to patient's complaints and we get focused on a single, solitary, individual problem. And while that may be very important to the patient, we have to be mindful that there's a bigger picture going on; a system that involves the temporomandibular joints, the muscles, the teeth, and all the supporting structures.

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Dawson Quick Tips: Creating Stable, Equal-Intensity Centric Stops

Hey everybody. Welcome to Quick Tips. Today I want to talk to you about creating stable, equal intensity stops when we're looking at occlusion.

5 Requirements of Occlusal Stability

We talk about five requirements of occlusal stability, and number one is making sure that when we close our mouth that we have as many teeth as possible, hopefully 14 teeth, hitting 14 teeth simultaneously with equal intensity contact.

And so when we think about how a jaw closes, we want to make sure that we are aligning the cusp tip into the appropriate fossa or marginal ridge. So when we look at this stable bite, we are visualizing that cusp tip landing on a flat surface. If it's landing on an incline, it's going to cause the tooth to shift positions, get loose, move out of the way, or not be optimally stable.

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Dawson Quick Tips: Esthetic Restorations with Dental Implants

Welcome to Quick Tips. Today I want to give you some guidance when you are planning an esthetic restoration in the front of the mouth that's going to involve an implant.

What to look at first

When we look at these type of cases, the first thing we've got to be considering is the precision of that maxillary incisal edge. The second thing we have to think about is once we get that maxillary incisal edge figured out, where that gingival plane is going to be because that is going to be determining the optimum length of the tooth.

And then from there we have to think about how far that free gingival margin has to be from the head of the implant. Remember the incisal edge to free gingival margin really determines the length of the tooth.

Now we can plan the precise placement of the implant. We have our incisal edge position and we have our free gingival margin. We also know from the biology of implants that if the head of that implant can be about 3 millimeters from our free gingival margin, that gives us the room to be able to shape the tissue, support those papillas and have a great result.

So at the Dawson Academy, if you have an implant we still do everything the same way.

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Dawson Quick Tips: Customizing The Envelope of Function

Hello, everybody. Welcome to Quick Tips. In this edition, we're going to be talking about customizing your patient's envelope of function, which is a very important part of getting the anterior guidance right for your patients.

As you're looking at the lingual contour of provisional restorations, hopefully you are developing lines on your provisionals that provide evidence of posterior disclusion or anterior guidance.

Remember, if you don't get anterior guidance or posterior disclusion, then that is going to allow the back teeth to rub.

And if the back teeth rub, then we know that increases muscle activity and can create damage to the teeth, either by working them loose or by causing the teeth to wear. And make no mistake, a lot of the fractures we see are related to not having good anterior guidance or posterior disclusion.

But the question is, can we make the guidance too steep? 

When the patient starts chewing and speaking and the mandible starts moving outside-in, is it possible to get those lines too steep so it's actually in the way of the functional path that the lower incisors travel outside-in?

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