Occlusion: What's the big deal?!

Occlusion: What's the big deal?! By Eric Seidel, DMD 

The term occlusion is used widely in dentistry. There are differing schools of thought on how to achieve it, what is ideal and why it is the essence of quality dentistry. There is one thing everyone agrees on: if occlusion is ignored if can cause the breakdown of the teeth, gums, bone, TMJ and even the failure of restorations and crowns that we use to protect teeth.

What is occlusion? Essentially, it is how our teeth come together. Malocclusion, or a "bad bite", is when this relationship is flawed and often destructive. The importance of trying to achieve an ideal bite is often ignored as it is easier to look at the mouth as a tooth by tooth system and discuss where a filling is needed here or a crown there, rather than spending the time to evaluate the entire bite system and create a plan that will correct the malocclusion that plagues so many people. One of the first things we do during a new patient or emergency examination is to evaluate the bite. It gives us an instant understanding of what the individual is facing when trying to become dentally healthy. After their initial emergency or chief concern is addressed, we always revisit the topic of occlusion and what we have available to be able to improve our patient's short and long term dental health. These can include equilibration, or readjustment of the existing bite to get both sides to meet more equally, especially during function. Nightguards are a good idea for anyone that shows signs of bruxing (grinding) or clenching and helps offset the damage that can occur to the teeth and gums while sleeping. Amazingly, most patients are unaware of their bruxism but the signs are very easy to recognize and hard to ignore. Invisalign or braces are an even better way to create ideal occlusion. Through an uprighting and repositioning of the teeth we can get them to function the way they were intended. This improves the health of the mouth during function and during rest. However, if a person is a bruxer a nightguard or retainer is still required at the end of treatment.

Choosing to do nothing results in recession, bone loss and broken or cracked teeth, fillings and crowns. TMJ issues can also result from poor occlusion. Whenever a restoration (filling or crown) fails the first thing that should be evaluated before redoing it is what caused it to fail in the first place. Most often is isn't the bagel they bit into or the gum they were chewing. These were simply the "straws that broke the camel's back". The fillings or crowns were weakened from a repeatedly destructive bite and simply broken during very routine use. Dental materials have improved greatly and are also rarely the problem if placed properly and used for their intended applications. It is important to learn from history and decipher what is the root cause of any failure. Much can be learned from these moments if the proper tests and time are taken.

I should have entitled this article "Occlusion: The Biggest Deal". I would encourage you to have your bite evaluated and see the advances that modern dentistry can provide for your long term dental health. You will be pleasantly surprised how simply, easily and painlessly we can make a profound difference in your dental health.

Eric Seidel, D.M.D. is a general dentist at Drs. Null, Seidel and Dental Associates and an Invisalign preferred provider. 

Drs. Null, Seidel & Dental Associates  
353 York Street Front
Gettysburg, PA 17325
(717) 334-8193