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What is fremitus and why should you check for it?

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.

Now, what's a cause of fremitus?

Well, the upper anterior teeth could be reclined and they could be encroaching upon the envelope of function. Maybe the teeth need a little freedom of movement in centric and a horizontal position, so as the arc of closure comes, you need to adjust for long centric. Or we have wear on the anterior teeth from a posterior deflective interference from centric relation (CR) to maximum intercuspation (MI).

So what do we do about this?

Well, for a patient, we need to first educate them. We need to express concern and explain to them this isn't normal. And then if they want to take it further, you dive in deeper. You get the records, you get the mounting, you explain the options of what it would take to actually resolve the fremitus and then let them make the decision.

Patients don't know what they don't know. So if they can at least make an educated decision on what to do for their condition, that's a win-win for everyone. And if you were the patient, wouldn't you want to know?

Learn more about fremitus and smile design at our live course, Functional Occlusion- From TMJ to Smile Design.

How to determine Anterior Guidance

Dr. Zachary Sisler is an associate faculty member and Administrative Director of Dawson Study Clubs. He graduated from WVU School of Dentistry earning his Doctorate of Dental Surgery Degree. Dr. Sisler owns and operates his practice in Shippensburg, PA.