Fremitus

Fremitus as it relates to teeth is the movement observed on closure into the bite. Generally fremitus is observed in upper anterior teeth in traumatic occlusion due to their labial inclination. Lower incisors and posterior teeth tend to have a more vertical force from the opposing tooth whereas upper anteriors will be forced labially due to their contact on the palatal surface.

Overerupted lower teeth, anterior RCP-MIP slide and bulky upper restorations can cause traumatic occlusion that can be exaggerated in chronic periodontitis. This force and muscular forces out of the neutral zone can cause anterior teeth to tip and diastemas to open.

In case where the teeth are drifting forwards or are mobile, check for fremitus by placing your finger on the labial surface of the upper teeth and have the patient tap together into MIP then grind into excursive movements. Movement of your finger in MIP is a sure sign that there is a traumatic occlusion and this can be adjusted easily with a bur. adjusting the labial surface of the lower anterior teeth at the point of occlusion can correct this. Where there is adequate aesthetics of the lower incisors with no overeruption, you may think about adjusting the upper palatal surfaces. Where the teeth are in good condition and alignment but there is a poor anterior posterior position of the teeht, orthodontics can correct the position of the teeth.