Odontologo

occlusion

PRACTICE

1

What is occlusion?
S. Davies,1 and R. M. J. Gray,2

The aim of this series of papers is to explore the role of occlusion in dental practice. The range of opinion in the dental profession as to the importance of occlusion is enormous.1 It is very important that the profession in general and practising dentists in particular have a balanced view of occlusion. Thisis more important than every patient having a balanced occlusion. The fact that the study of occlusion is characterised by extremes makes it confusing and possibly difficult for individual dentists to find a philosophy which is in line with contemporary good practice supported by evidence from practice-based research.

Patients need a balanced occlusion Dentists need a balanced view on occlusionIn this part, we will discuss: • What ‘occlusion’ is • Why occlusion is important • The significance of ‘ideal occlusion’

1*GDP, 73 Buxton Rd, High Lane,

Stockport SK6 8DR; P/T Lecturer in Dental Practice, University Dental Hospital of Manchester, Higher Cambridge St., Manchester M15 6FH; 2Honorary Fellow, University Dental Hospital of Manchester, Higher Cambridge St., Manchester M15 6FH*Correspondence to : Stephen Davies, 73 Buxton Rd, High Lane, Stockport SK6 8DR email: stephen.j.davies@man.ac.uk
REFEREED PAPER

© British Dental Journal 2001; 191: 235–245

t one end of the spectrum are dentists who believe that they can go through their working lives with scant regard for their patients’ occlusion. They seem to believe that essentially they can conduct their practiceignoring the occlusal consequences of the treatments that they perform daily. Whereas all dentists know of the importance of the good marginal adaptation of their restoration to the health of the adjoining dental and periodontal tissues, some dentists do not appreciate the potential consequences of poor occlusal contact to the opposing teeth and their supporting structures. This is bizarre given thefact that very few dental treatments do not involve the occlusal surfaces of teeth. Conversely there is a body of opinion that considers occlusion to be such a central pillar in our working lives, and to be of such systemic import to the well being of our patients, that ‘occlusion’ takes on an almost mystic importance and attracts a cult like devotion (Fig. 1). This can lead some dentists toadvocate occlusion as being the key to resolving or preventing a range of disorders far removed from the mas-

A

ticatory system, for example prolapsed lumbar discs. Often such enthusiastic fervour is associated with a didactic prescription of ‘occlusal rules’ which must be adhered to in the treatment of every patient. The danger is that both of these approaches leads to inappropriate levels ofpatient care; patients suffer through either over or under treatment. It is not surprising that these two extreme views co-exist so easily within a thinking profession because the one appears to provide the justification for the other. The ‘occlusion doesn’t matter’ group probably justify their reluctance to become ‘involved in occlusion’ on the grounds of what they perceive to be the exaggerated andunsubstantiated claims of the group who believe occlusion to be the central pillar of holistic care. This congregation of opinion in turn may be so frustrated by the apparent disregard of the study of occlusion that they are led to ‘gild the lily’ by overstating the importance of occlusion and then in the absence of what they perceive to be an inability ‘to see the obvious’ they go on to lay downrules.

BRITISH DENTAL JOURNAL, VOLUME 191, NO. 5, SEPTEMBER 8 2001

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PRACTICE

occlusion
‘Occlusion’ There is no escape Dentists cannot: • Repair • Move • Remove It is the objective of this series of papers to explore the role of occlusion in dental practice in a manner based on reason. There is good and bad practice in occlusion as in other aspects of clinical dentistry: we wish,...