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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 a native of Kingwood, WV. He attended West Virginia University where he received an undergraduate degree in Chemistry in three years, and he continued his education at the WVU School of Dentistry earning his Doctorate of Dental Surgery Degree. During his time at dental school, he explored the field of dentistry by completing Externships and Honor programs in Oral Surgery and Endodontics. As a further testament to his dedication, he was honored with the following awards: Simon P. Hullihen Scholarship Award for Oral & Maxillofacial Surgery, American Association of Endodontics Student Achievement Award, American Association Oral and Maxillofacial Surgeons Student Award, Whip Mix 2010 Hanau Prosthodontic Award, Delta Dental Student Leadership Award, and the Quintessence Book Award for Restorative Dentistry Since graduation, Dr. Sisler has immersed himself in over 500 hours of Continuing Education. He enjoys traveling to new cities to hear some of the best speakers in the dental profession. Dr. Sisler attends lectures and hands-on courses at the prestigious Dawson Academy where he learns how to properly and predictably restore complex cases not only from a functional standpoint but cosmetic as well. After reaching Scholar status, he was recently selected as a Dawson Academy Ambassador. As an Ambassador, Dr. Sisler will attend seminars to guide and mentor other dentists wanting to learn functional cosmetic techniques. Dr. Sisler has a strong passion for dentistry and the pursuit of excellence in all aspects, particularly cosmetic dentistry. He holds memberships with the American Dental Association, Academy of General Dentistry, Pennsylvania Academy of General Dentistry, Pennsylvania Dental Association, Harrisburg Area Dental Society, American Equilibration Society, and the American Academy of Cosmetic Dentistry. Dr. Sisler was chosen by his colleagues as one of The Top Dentists in the Susquehanna Valley in 2012 and 2015 in the Susquehanna Style Magazine. In addition, Dr. Sisler has also been recognized as one of the Top Dentists in the USA consistently since 2012 by This is a prestigious honor which is only granted to those who were voted upon by their peers.