Have you ever had a patient in your chair, you're doing a complete exam, you're evaluating the wear, and you notice that the wear on their anterior teeth is more than the posterior teeth? Are you wondering, "Why is this happening?" Well, let's talk about some possibilities that could be causing this.
Form follows function.
We've all heard the old adage everywhere, in all facets of life. And when it comes to anterior teeth we have to think of it as if we can get the function dialed in and honed in really well, the esthetics effortlessly fall into place.
If we have a symptomatic TMD patient and are trying to figure out, can we make this patient better or comfortable? How can we stabilize the joints?
So I want to take just a second and talk about the three basic requirements of occlusal therapy. And if we think about this, good occlusal therapy is going to be about force management and putting the appropriate forces on the teeth.
What is fremitus?
Fremitus is the vibration or movement of a tooth when teeth come into contact together. If you were to take your fingernail and put it on the front surface of a tooth and have the patient close together, and the tooth moved, that's fremitus.
Properly loading the joints tells you several things about the root cause of some patients' problems. This will also determine how functio nally stable the patients is. Let's start with the first item.
Why is the physiologically correct position in centric relation the most superior position in the joint space itself?
Now, if you're like me and you went through dental school earlier, maybe 20 years ago, you were probably taught that centric relation was actually a distalized position of the condyles.
It was a very frustrating experience not only for the dentist, but also for the patients because you're trying to put the mandible and the condyle into a very unnatural position.
We get asked a lot, what is a functional occlusion? And I think a lot of people, as they look at The Dawson Academy, think that we have one formula for an occlusal scheme that we're going to apply 100% of the time on our patients.
And I certainly agree that when we are redesigning the occlusion if we diagnose an occlusion that's pathologic, that has signs of instability, such as wear, mobility, migration, and sore muscles, that Dr. Dawson's formula for occlusal therapy can be utilized.
In order to properly describe an occlusion, we must not look at teeth in a vacuum, but as if we're starting at plaster models sitting on a table. We have to understand that teeth are one part of a larger system. Now, if one or both condyles have to displace in order for our teeth to come together in maximum intercuspation, or what we call MI.
Here at The Dawson Academy, we get a lot of questions. Among all of the questions I hear from our students, one of the main questions that we get is why is my dentistry breaking? And what can I do to prevent that from happening again?