Functional dentistry and dental occlusion are areas replete with misinformation and uncertainty. The difficulty in sussing out true causes of certain problems makes occlusion a headache for clinicians. Luckily, it doesn’t have to be this way, especially when you have a clear template for moving through a case and familiarity with common diagnoses.

Here, we’ll present three different case images and lead you through the necessary questioning process to determine what the problem actually is. Understanding the nature of the issue is crucial to guiding the rest of your treatment planning and leading a patient to say ‘yes’ to treatment.

When you can correctly categorize occlusion, you can treatment plan the case properly and present it to your patient in a better way. Improved clarity in a case is never a bad thing!

3 Common Dental Occlusion Scenarios & Important Considerations

Abfraction and erosion due to swishing - dental occlusion

1. Abfraction & Erosion

For the image above, it’s valuable to consider what came first: the decay or the abfraction? It’s common for dentists to restore many cases that look like this, but never truly pinpoint what has caused the underlying problem. Here, abfraction and erosion are a result of swishing.

Bulimia - occlusion

2. Bulimia

This image leads to the question of whether it is a case of erosion, parafunctional wear, or bulimia. In this situation, the answer is bulimia, but without knowing this, treatment might overlook essential long-term outcomes. You don’t want to get started on the wrong track and find your time is invested poorly.

GERD - occlusion

3. GERD/Acid Reflux

Looking at the teeth here, it’s difficult to say whether the patient is suffering from acid reflux or occlusal abfraction. Getting the diagnosis right can influence the success of your case and prepare you for an effective restoration geared toward the patient’s specific goals.

How often do you test your knowledge of dental occlusion or run into problems of diagnosis at the outset? Let us know your thoughts in the comments!