Dawson's Occlusion: Examples of occlusal disease

A working knowledge of occlusal principles not only improves the planning and execution of full mouth cases but also has an effect on everyday dentistry. It improves the outcomes of:
-Patient comfort: with reduction in post operative sensitivity due to high spots and interferences.
-Restoration longevity: Due to cracks,or fractures
- Occlusal stability: With shifting of teeth, opening of contacts, misalignment
-Treatment planning
-Esthetics: as form follows function

Signs and symptoms of occlusal disease
Occlusal disease is defined as the deformation of disturbance of the function of any structures within the masticatory system that are in disequilibrium with a harmounious interrelationship between the TMJs, the masticatory musculature and occluding surfaces of the teeth. Examples include:

-Attrition: commonly seen as wear on the lower incisors. there are two common causes of this. Posterior deflections causing an anterior shift from CR into MIP will cause the anterior teeth to collide. This will activate bruxism in an effort to remove the colliding forces. The second most common cause is improper anterior restorations or tooth positions interfering closure in CR
-Splaying teeth: The same forces that can cause excessive excessive wear can cause the splaying of anterior teeth. Fremitus and soreness of anterior teeth can be signs of this
-Destroyed dentition: End stage of occlusal disease resulting in severe wear, fractured teeth, elongated alveolar processes
-Anterior guidance attrition: Anterior teeth which interfere with CR closure of functional jaw movement patterns can have early attrition wear on the lingual surfaces of upper anterior teeth. This is often not noticed by the patients until the incisal edges thin and start to fracture
-Sensitive teeth: Occlusal overload causes pulp hyperaemia and/or non carious vervical cracks causing hypersensitivity
-Sore teeth: Compression of PDL with or without pulp hyperaemia can cause soreness to bite. Pain on testing with an empty mouth clench indicates the tooth is in occlusal interference. The cause of the pain may be seperate but it indicates that a deflective contact or occlusal overload is a factor
-Split teeth and fractured cusps: due to occlusal overload on certain parts of teeth likely due to deflective interferences. Look for corresponding wear facets on the undermined cusps
-Painful musculature: Deflective occlusal interferences that require jaw joints to displace (implying pterygoid muscle activation) to achieve MIP are a potent cause of painful musculature leading to occlusomuscle disorder