The Dawson Academy Blog

Equilibration or reshaping of teeth is one of the procedures taught at the Dawson Academy.  The equilibration process begins with step 7 in the 10 Step 3D Treatment planning Checklist (Provide Equal Intensity Stops).  The goal of equilibration is to reshape both posterior and anterior teeth until equal intensity contacts are achieved in centric relation.  Like all other procedures, the dental assistant’s (DA) role is vital to the success of the equilibration process. 

Lucia jigs, NTI’s, Cranham deprogrammers, and Dawson B-Splints all fall into the broad category of temporomandibular joint disorder diagnosis appliances.  There are specific reasons as to why you may want to use one type over another when diagnosing a possible TMJ problem, but at their core they all achieve the same goal, getting centric relation by eliminating muscle hyperactivity.

In the practice of complete dentistry the dentist is committed to an examination, diagnosis, and treatment planning process and has developed the skill of recognizing the signs of instability in a patient’s masticatory system.
It is our responsibility to offer the patient the most conservative treatment method to achieve the desired end result- a stable, comfortable, healthy dentition and supporting structures that matches their esthetic desires. The most critical skill to be developed in evaluating a patient’s occlusion is locating and verifying centric relation. If the examination reveals stable healthy TMJ’s and load testing is negative, Centric Relation serves as the starting point to determine the amount of discrepancy between CR and MIP.

Following proper diagnosis and treatment planning, occlusal equilibration can provide selected patients with the most conservative, predictable, and safest treatment possible. Occlusal equilibration can often help avoid the need for more complex treatments. Unfortunately, a rift among dental educators, coupled with confusion in the literature over its safety and effectiveness, leaves many dental professionals questioning whether occlusal equilibration should be used at all.

Contributing to the ambiguity surrounding occlusal equilibration is the fact that some dental continuing education courses have trouble discussing this topic because of faulty research that views occlusal equilibration in a negative light. Therefore, it is of paramount importance that dental professionals choose dental continuing education programs that present an unbiased, scientific-based approach that concentrates on the fundamental principles of occlusion and proper protocols for incorporating occlusal equilibration into clinical practice.

Dentists who have developed proficiency in equilibration universally agree it is one of the most practical skills they use routinely in practice.  Deflective tooth inclines force displacement of the TMJs to achieve complete closure into maximal intercuspation.  This forced jaw displacement can lead to painful jaw muscle hyperactivity, excessive tooth wear, fractured cusps, and a myriad of other signs and symptoms from sore teeth to headaches.  Occlusal equilibration is often the most conservative, time effective, cost effective way to achieve an occlusion free of deflective interferences.  Dentists who have never experienced the predictable effects of equilibration, done correctly on properly selected patients may dismiss the importance of occlusal equilibration.  But learning the fundamentals and developing some necessary skills can be a significant eye opener to the value of a deflective free occlusion.