How is an occlusal analysis performed, exactly, and what is involved in the process?

Well, first, a mold of your teeth is taken so an accurate plaster or stone model of your bite can be examined. Using what’s called a facebow transfer, the dentist will find the center of your jaw joint’s rotation, and then take measurements to see how it relates to your upper jaw.

Imprints of your teeth are then taken for a bite registration. A bite registration shows the dentist how your teeth come together when you are biting down completely. Also, the pattern of your jaw’s movement when chewing is unique to every individual. This pattern is also recorded.

There is a device called an articulator that a dentist uses to view your exact bite without having to use your head (which translates into countless hours in a dentist’s chair for you, the patient). It looks like this. The models previously made of your teeth are installed into the articulator, along with all the measurements of your jaw’s exact movements and how your teeth come together when you bite down.

After some examination (and long after your appointment is finished and you’ve driven home in time for dinner, don’t worry), the dentist will do some analyzing and will determine what is causing problems with your bite. Is it a TMJ disorder? Are crowns that were formed years ago getting in the way of proper chewing? What needs to be done in order to make the next procedure(s) successful?

Your dentist will be able to tinker with the articulator and find the ideal form of chewing system for you. A wax model will be made, and your dentist will move towards making these changes before moving on to the aforesaid procedure(s).

And, voila! Not only will you have some super treatment coming your way, but you’ll be comfortable knowing that your entire chewing system will be working the way it is supposed to.

Dr. Sperbeck, West Los Angeles

The occlusal analysis, when getting ready to perform any kind of orthodontic surgery, is crucial for a dentist or orthodontist to make the best possible choices for your oral health; a substantial number of problems are avoided when we know to not move a tooth in a certain direction, or design a mouthguard that will tire the jaw in an unhealthy manner. This is comprehensive dentistry; everything works together, and everything is related! An occlusal analysis is absolutely necessary before any of the following procedures:

- Crown, bridge, denture, or implant treatment

- Fabrication of a bite guard

- Orthodontic treatment (an occlusal analysis should be performed after this as well)

- Any other time a poor bite is suspected. Pay attention to symptoms like worn, chipped, or broken teeth; gum sensitivity and/or recession; pain in facial muscles; and other symptoms similar to prolonged gum disease, such as loose teeth, bone loss, and even tooth loss.

As a small side note, gum disease can, in fact, be evidence of a poor bite. But that’s a topic for another day.

Dr. Sperbeck, West Los Angeles

“Occlusal” is basically a fancy, dental-scientific word for “bite.” I have mentioned occlusal (bite) analysis in an earlier post, but if you don’t remember it, I shall reiterate:

Occlusal analysis takes a look at your bite, your entire chewing system, comprehensively observing, recording, and adjusting small areas where your bite can reach its full effective, comfortable, and long-lasting potential. This approach — analyzing the whole mouth, jaw, teeth, and their movements — is far superior to adjusting each individual tooth. Adjusting the individual teeth can lead to painful jaw malfunctions and TMJ disorders over time because of prolonged crooked movement (slight though it may be) and repetitive clenching or grinding.

Does your dentist give occlusal analyses? Should you go in for one?

Dr. Sperbeck, West Los Angeles

Apexification is the procedure needed when apexogenesis fails to restore the health of an injured, immature tooth.

The first part of the process includes removal of all tooth pulp tissue. A medication is placed in the apex to seal off the opening; the root is then filled back up with a hardening material and sealed off, and any damage to the crown is also restored. The pulp will never be restored, but the natural tooth is saved and light monitoring will ensure it stays healthy in your mouth.

Because the tooth is filled with synthetic material and has not yet been as strongly established as the other adult teeth will become, the tooth will be more susceptible to fractures later. But apexification treatment done properly and carefully will lessen this possibility.

Dr. Sperbeck, West Los Angeles

Apexowhat?! Yes, this is definitely quite a new word to wrap our heads around. What can I say? It’s a two-for-one deal: learning a little bit about dentistry while simultaneously sharpening your vocabulary skills. How convenient, right?

Anyway, in the previous post, I introduced the concepts of apexogenesis and apexification. Apexogenesis will be briefly discussed in this post.

Apexogenesis is a procedure performed after an injury that helps a young adult tooth root to continue growing and the the pulp to heal correctly. Medication is used on the surrounding soft tissues to prevent infection and ensure proper recovery. If the procedure is successful, the apex (remember, the root’s tip which has a slight opening) continues to close as the tooth grows, and the root canal walls thicken. A successful operation also relieves the patient of any further endodontic treatment, provided the pulp heals completely and the tooth’s life is fully preserved.

If, however, the apexogenesis therapy did not prove to be successful, apexification may be required. Details coming!

Dr. Sperbeck, West Los Angeles