Functional Occlusion in Restorative Dentistry

Treatment Planning for Functional Occlusion

What is Functional Occlusion?

Functional occlusion is about the occlusal connection of your maxillary and mandibular teeth when they are functioning during daily tasks. This includes how they work during speech, mastication, and swallowing. Imagine your bite when your teeth fit together perfectly. That’s your intercuspal position. It’s basically the most stable and comfortable spot where your upper and lower teeth meet.

Smiling, chewing, talking, shapping your face, laughing – your teeth do a lot! Making sure they work together smoothly is called functional occlusion.

Our approach includes explaining the benefits of possible solutions to different occlusal problems – and specifically, yours. Seniors seeking restorative dentistry may have unique questions while we take your overall health into consideration.

What do comprehensive dental examinations typically include?

  • An insightful review of your medical and dental history.
  • Listening to what your smile design goals and expectations are.
  • Review of your past and current available radiographic and photographic documentation.
  • An assessment of your periodontal, biomechanical, functional, and dentofacial conditions.

What Dr. Marc Montgomery learns as we discuss decision-making factors helps establish both any immediate oral issues and a long-term plan for your healthy bite and healthy smile.

Good Functional Occlusion Means Long-term Stability of Restorative Dentistry

Think of your mouth like a team: Teeth, muscles, and joints all work together. This approach makes sure everything works in harmony. While there may be several options to gain a healthy bite, we’ll offer you the best restorative dentistry method based on our proven work.

No need to worry about confusing terms as we discuss just how functional occlusion! It’s important that you understand your oral health investment. We’ll use clear language and provide digital visualizations to help you understand what’s happening in your mouth. It’s easy to understand when it breaks it down into “Three P’s.”

Basic terminology for occlusal management:

  1. Position.
  2. Place.
  3. Pathway.

What are the two top considerations in achieving a normal occlusion?

Normal occlusion has two key components:

  1. Proper closure of the jaw joints with all teeth touching. This may include anterior guidance providing posterior disclusion to gain a relaxed jaw position.
  2. Identifying any thing that prevents good occlusion. Diagnosis of what, if any, adverse occlusal contacts prevent the best functional connection points between your top and bottom teeth.

Successful occlusal includes many important considerations. Considerations from your bite, how your maxillary and mandibular jaw are fixed, if pharmaceuticals may be needed, etc., are all thought through by your dentist. A successful design of your occlusal scheme provides a result that is more esthetically pleasing.

What is “Centric Relation” in restorative dentistry?

The jaw functions like a hinge, like on a door. Think of the position where this jaw hinge opens the widest in your mouth. That’s kind of like centric relation in dentistry!

Technical elements of oral centric relation:

  • Jaw position: We take into account the position of your lower jaw when the condyles (rounded ends) rest as far back and up as possible in your jaw joints.
  • Independent of teeth: Unlike your bite (where teeth touch), this position doesn’t involve your teeth at all.
  • Repeatable and stable: Even if your teeth shift or wear down, this position stays consistent.
  • Practical application: Understanding your centric relation helps us ensure that your restored teeth function goes smoothly and will last long.
  • Advanced dental technology: We’ll blend the best of both worlds by incorporating improved refinements on traditional methods. This empowers us to assess related issues like gingival thickness, jawbone health, and more.

Centric relation isn’t necessarily the position you use when chewing or talking. Finding a centric relation might involve gentle manipulation by your dentist. Some people have jaw conditions that make achieving centric relations difficult. [1]

When your jaw is in centric relation, it’s in its most relaxed and stable position.

What questions might my dentist ask about functional occlusion?

To best diagnose jaw joint problems or bite issues, we may ask the following questions:

  • Do you notice unusual jaw movement when bringing your back teeth together?
  • Have you ever had broken teeth, chipped teeth, or had a severe toothache or cracked filling? A recommendation for porcelain veneers to resolve them?
  • Are your teeth developing spaces?
  • Do you unconsciously place your tongue between your lips? Or close your teeth on it?
  • Have you ever had a loose dental implant restoration?
  • Do you hear jaw-clicking or popping sounds?
  • Do you have oral habits that need improving? (Biting your nails, chewing ice, using your teeth to open hard objects?)
  • Is it challenging to chew harder food items? (Nuts, steak, popcorn, carrots, etc.)
  • Are you restless at night and grind your teeth?
  • Have you ever tried an oral split or bit appliance?
  • Are you noticing if your teeth seem thinner, darker, or more worn in appearance?
  • Have you ever had peri-implantitis complications?

Which procedure might my dentist recommend to obtain correct occlusion?

Occlusal equilibration may be best gained by subtly reshaping your teeth in order to correct the alignment of your bite. Once you’ve had an occlusal adjustment, your teeth should all come into contact at the same time. This will reduce stress on certain areas of your mouth and jaw.

Every dental patient’s oral history, teeth, and smile design goals are unique. The main procedure your dentist will recommend depends on factors like these.

How to Plan an Initial Occlusion Dental Office Visit?

  • Bring a written list of your questions. We want you to have an understanding of your condition so you may participate in deciding what are your best options
  • Possible restorative procedures being recommended like crowns, bridges, or dental implants.
  • Ways you can learn to become more involved in your daily oral care.
  • A possible discussion of a temporary oral appliance that will fit comfortably and function well.
  • Be prepared to discusscomplex treatment plans if needed. Sometimes restorative dental treatments are best if sequenced in phases, including an urgent phase, installment phase, re-evaluation phase, and maintenance phase.

We may discuss normal and abnormal attrition of teeth, including: what is acceptable function, frictional chewing patterns, constricted chewing patterns, occlusal dysfunction, parafunction, and possible neurological issues.

We work with a modern dental lab so that we can fabricate dental products, deliver, and follow-up with any recommended adjustments during your experiences in our office.

“The final aesthetic outcome of periodontal and restorative treatment methods depends on a variety of factors. The evaluation of the surrounding soft and hard tissues, which will be crucial to the success.

Positive correlations exist between gingival thickness, keratinized tissue, and bone morphotype and treatment outcomes in periodontics and restorative dentistry.” – Importance of periodontal phenotype in periodontics and restorative dentistry

NOTE: Periodontics is the specialty of dentistry that treats supporting structures of teeth, as well as diseases and conditions that affect them.

When you trust your teeth to us, you reach your final destination and look back to realize it was a fun, predictable (financially and clinically) process. We love it when our patients are happy in the end!

SUMMARY: Chewing Abilities and Oral Health

We care that your chewing abilities and overall oral health influence your quality of daily life. Montgomery Dental Care always seeks to minimize the risk and maximize long-term success of every functional occlusion treatment plan.

Resources:

[1] Nikolina Holen Galeković, et al., “Reproducibility of Centric Relation Techniques by means of Condyle Position Analysis”, 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506257