Unlocking the Steps to Veneer Occlusion

Is occlusion confusing for you? Don't know where to start when dealing with occlusion for veneers? Start thinking of occlusion like the alignment of the wheels in your car. The car body/chassis is the muscles of mastication, the steering wheel is the TMJ and the wheels are the teeth.

Now ask yourself, what order would you fit the car body, steering wheel and the wheels together? Would you put the wheels on the ground first and then sit the car body to fit where the wheels stand? Off course not, you need to fit the wheels to a straight steering wheel and to the car body.

However, the masticatory system has it the other way around. The muscles and TMJ will often compensate for teeth in the wrong positions.

Teeth in the wrong position will always lead to pain in the TMJ/muscles or teeth breaking/cracking/wearing/moving.

Knowing this now, during the rest of your week keep an eye out for signs and symptoms that this is occurring in your patients. These are the clues to tell you that perhaps the patients car body/steering wheel and wheels are not aligned properly.

Let's start off with some of the big clues that will tell you something is not quite right:

• Muscular hypertrophy - enlarged masseter or temporalis muscles.
• Presence of pain in the muscles of mastication or TMJ
• Tooth wear into dentine - this could be attrition or abfraction lesions
• Presence of large restorations replacing cusps in localised areas
• Past history of cracked teeth
• Mobile teeth without periodontal concerns

Occlusion for veneers is a difficult concept to understand. I'm a firm believer that strong foundations in occlusion starts by training your eyeballs so they can see the clues for occlusal problems.