The following narrative is from a “brochure” I had in my office helping people understand why wear on their teeth could be an indicator of an underlying problem. I updated some of the information and thought you all might enjoy reading it as if you were a patient. If you find it might be helpful in increasing patient awareness of the things wear could be showing us, consider using the text to create a brochure (I liked calling them "Information Sheets" so I could make them on 8.5 x 11 paper). You might want to add some images of stages of wear. Note: If you feel so inclined, replace all mentions of “your doctor” with your name or your practice’s name.

Gary DeWood, D.D.S., M.S., Spear Faculty and Contributing Author

Dental occlusion information sheet

Dental occlusion is the coming together of teeth  ΜΆ  a meeting of two surfaces made of the hardest stuff in your body and the movement of those surfaces against each other. You probably haven’t devoted a lot of thought to making those surfaces do either of those things because, for most of us, it just happens. Thankfully, your brain is able to coordinate 32 teeth and dozens of muscles into a harmonious movement without telling you what it’s doing. When you’re enjoying dinner with your favorite person, this is a very good thing. If you are grinding your teeth away, it’s not so good. Your teeth were designed to last a lifetime, but there are some things that can get in the way of that happening for you.

There are three diseases that negatively affect teeth: decay (cavities), periodontal disease (gum disease), and occlusal disease (destruction of teeth). Most of us are intimately acquainted with the signs, symptoms and treatment of the first two through either personal experience or being told about them at the dentist. Occlusal disease, pathological pushing of the teeth against each other, tends to get less attention. It is often indicative of an underlying problem, and the usually slow progression of any damage means that the signs of destruction are often experienced as “normal.” 

All dentists are trained in the diagnosis and treatment of decay and periodontal disease in dental school. Through education and experience, the doctor is able to “look into the future” and recommend appropriate treatment to minimize the effects of these diseases by dealing with them as early as possible. Fewer dentists, however, have been trained to “look into the future” of occlusal disease.

Effects of occlusal disease

Wear, sensitivity, cracks, loose teeth, breaking teeth, sore muscles, painful jaw joints, headaches, acid reflux, breathing disorders, and sleep apnea – these and more can be associated with occlusal disease. An obvious injury, like a broken tooth, often hides the underlying cause.  

Your doctor has invested considerable time into developing the ability to recognize the signs of occlusal disease and provide or recommend appropriate treatment to halt, and often reverse, its effects. Recognizing occlusal disease as early as possible increases the probability that you will keep your teeth and have young teeth at an elderly age. 

Not many years ago, most senior citizens wore partials or dentures. Today, that number is a small fraction of what it used to be. Since fewer people suffer loss of their teeth today, the effects of occlusal disease can be seen in an ever-increasing number of adults. In fact, many of the restorations and repairs that adults find necessary might have been avoided if the signs of occlusal disease had been recognized and the underlying problems addressed in the early stages.

occlusal disease bite
occlusal disease alignment

Silent signs of occlusal disease

The interaction of tooth against tooth can cause painful symptoms such as those noted above, but the real dangers are the underlying causes and the changes that produce effects that are not immediately and readily apparent to you. Whether or not you experience pain, the damage to teeth and the progression of the underlying cause are as real as a painful injury. Our bodies adapt to the things we do and often fail to alert us until something is so damaged or broken that it can be difficult to bring things back to health. 

Your doctor routinely incorporates evaluation of the signs and symptoms of occlusal disease into every comprehensive evaluation and periodic examination you experience in this office. He or she knows that “looking into the future” means providing you with information about what’s happening today that will impact your teeth and your life 5, 10, 20 and more years from now.

Keeping your teeth in maximum comfort, function, and esthetics for your entire lifetime depends on us working together to see and address the signs and symptoms of the disease processes that work against that goal. Failure to address them has a profound impact on your overall health and your life. Together we can be an unbeatable team that keeps occlusion working for your health and not against it.  Have a nice dinner with your favorite person.

(Click this link for more dentistry articles by Dr. Gary DeWood.)


Commenter's Profile Image Frederico L.
February 28th, 2021
It makes my heart smile and it gives me hope reading articles like this one -- which have become rarer and rarer nowadays with the eyes and minds of our profession looking towards the digital evolution and many other distractions of our modern world. Don't get me wrong -- I love digital Dentistry and this is such an exciting new frontier for all of us. It's here to stay and it will make Dentistry an entire new profession within a decade or so. But we can't close our eyes to the timeless basic principles. It's been one of my biggest frustrations in the profession and in the specialty of Prosthodontics that, wherever I go, nobody seems to care about occlusal disease. If there's no pain involved and real palpable disfunction most of us won't pay attention. But I gotta tell you that, despite being a restorative dentist, I'm most excited when I'm able to detect early signs of wear in a patient. Because we know that's where a lot of the problems start, right? A little wear that leads to a little more wear. And before we know it, the patient is incorporating interferences in the free movement of his/her mandible due to changes in their mutually protected occlusions. Of course a lot of patients will adapt -- but at what cost? We need to do a better job in preventing our patients to end up in need of massive amounts of reconstructive Dentistry. Paying attention to that little wear and preventing its progression can go long ways in helping our patients. Thanks for such an important article! Fred.
Commenter's Profile Image Gary D.
February 28th, 2021
Thanks Fred!