Demystifying Occlusion

I’ll admit that for a portion of my professional career I didn’t think twice about occlusion.

Today occlusion is as well integrated into my thought process as caries, perio or restorative considerations. What role does occlusion play in your practice? Is it part of your routine diagnostics? Is it fully integrated with your esthetic and restorative treatment planning? Or do you only wonder about it when a patient breaks something or you are concerned about moving forward with a severe wear case?

Early in my career occlusion would show up as a frustration.

One example is when I would prepare a second molar being very careful about creating adequate occlusal clearance, using both depth-cutting burs and checking the result with bite registration, just to have my assistant come and tell me she didn’t have enough clearance to make the provisional. It was a relief years later in my first CE course with a focus on occlusion to learn this was not rapid super-eruption or a mistake on my part, but muscle release due to removal of a key occlusal contact, and I could predict this before I prepped the tooth.

How about the patient who would come into my office for a hygiene visit or a buccal pit restoration with no joint sounds and call the next day concerned that their jaw had been clicking ever since they left the office the day before? What a relief when I learned these patients had an underlying risk for disc displacement called ligament laxity, and I could diagnose it quickly at an exam appointment.

An everyday occlusal issue I run into is the patient with a limited opening who needs posterior dentistry.

Perhaps, they can open at the beginning but rapidly fatigue and their jaw begins to shake and close as we work. What a gift it is today that I can identify this as a symptom of overuse of the elevator muscles, treat it easily and quickly at a restorative appointment with a deprogrammer, and offer the patient options for relaxing their muscles and allowing them to stay healthy.

The process of demystifying occlusion and having it become an everyday reality for me required committing to a series of hands-on CE programs, being willing to manage my learning, and then taking it back to my patients and beginning to use what I was learning in small steady steps. The benefit has been less frustration, increased confidence with my patients, and an ability to help patients in new and profound ways I didn’t have before.

My appreciation for occlusion didn’t stop with my practice.

It became a passion and is a huge piece of the continuing education I teach with The Pankey Institute to demystify occlusion for others.

Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

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