![]() ![]() Even when a Class V filling is performed, not accepting the occlusal etiology makes treatment less successful. In these cases, failure to recognize the etiology of the complaint may deprive the patient of appropriate treatment-for example, performing a filling when occlusal adjustment would be the correct treatment. 3-6 Many of these restorations are performed every year to treat cervical abfractions, usually without properly diagnosing or treating the primary cause of this problem, which is often OD. 2 Sometimes a tooth may develop pain so severe that it seems to require an endodontic procedure ( Figure 4), when in fact the etiology is occlusal trauma.Ĭlinical experience and literature suggest a link between Class V restorations and occlusal trauma. Millions of dollars are spent treating hypersensitivity with ineffective techniques, when the literature points to the fact that tooth sensitivities can be controlled with appropriate occlusal treatment. Severe hypersensitivity may make brushing or eating normal food painful. Just because people with OD continue to eat-as do those with periodontal disease, whose ravages are undisputed-does not mean they have normal function. Finally, social/esthetic function is impaired due to disfiguring tooth wear and tooth loss caused by fractured teeth. Phonetic function is impaired when fractures, extreme mobility, and bone loss lead to missing teeth. Masticatory function is impaired by making eating difficult due to muscle pain, painful tooth fractures, and missing teeth, leading to impaired chewing and tooth sensitivity. ![]() The American Heritage Dictionary’s definition of disease is an “abnormal condition of an organism as a consequence of infection, inherent weakness or environmental stress that impairs normal physiological function.” 1 Teeth have multiple functions-masticatory, phonetic, and esthetic-and OD impairs normal function of each of the dentition’s functions. Yet despite the human cost of this condition, some question whether it fits the definition of a disease. Some patients wake up in pain or with tired facial muscles. Patients needing to repair fractured teeth every year or so may incur extensive long-term costs as well as tooth loss, which can cause them to slowly become dental cripples ( Figure 3). OD patients may experience tooth sensitivity that leads them to avoid cold food and beverages or use warm water to brush their teeth, for example. In some cases, the signs and symptoms of OD are chronic in nature, whereas other times they are acute and debilitating. Dentists regularly see patients with signs and symptoms of OD that has mutilated their teeth to the point of requiring expensive restorations or extensive rehabilitation ( Figure 1 and Figure 2). This may be due to the lack of a simple and logical implementation protocol, or is perhaps a result of skepticism about the magnitude of its destructive impact on the dentition. In many patients, this tremendously underestimated disease is more destructive than both caries and periodontal disease combined, yet the vast majority of dentists do not include routine screening for OD. It has specific signs and symptoms, and like other chronic diseases, it can only be be managed and not cured. OD is a chronic destructive process that can affect every part of the masticatory apparatus (ie, joint, muscles, periodontium, or teeth) as a consequence of occlusal disharmony and parafunction. In this article, he describes a simple technique for OD diagnosis to begin the process of dealing with this disease. The author believes that occlusal assessment should be a new standard of care for all patients. In some instances, patients referred to endodontists for root canal therapy on painful teeth need only occlusal adjustment or therapy.įew dentists routinely include an occlusal evaluation for all patients, and even fewer are confident of their ability to perform occlusal therapy. Similarly, OD may not be considered but is often implicated in cases of broken or fractured fillings (or other types of restorations), cracked tooth syndrome, Class V fillings, or even mobile teeth. Although they frequently see patients with cervical tooth sensitivity and offer treatment for it, for example, many clinicians do not recognize that it may be caused by OD. On a daily basis, they treat and repair the damage caused by OD, but may be unaware of the disease’s etiology. ![]() Unfortunately, even dentists may be surprised to hear how destructive OD can be. In addition, patients may think that tooth wear is a normal process. Many patients are surprised to learn that occlusal disease (OD) can be among the most destructive enemies of human dentition, because its silent and insidious damage often goes unrecognized. Diagnosing and Educating Patients About Occlusal DiseaseĪ new standard of care for recognizing this highly destructive, little-understood problem ![]()
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