In a simplified way, the optimal occlusion is if the maxillary teeth marginally overlap the mandibular teeth on the facial areas and all teeth in the maxillary arch are in full touch with the mandibular arch in a certain pattern. Any deviation from the physiologically appropriate relationship of the teeth is considered malocclusion. Several conditions may make dental occlusion to change, for example, tooth extraction. Without replacing a missing tooth, the teeth start to fluctuate and the tip out of the usual occlusion, and the opposing teeth can erupt to fill the gap. One example is post-orthodontic treatment even with adjustable braces or splints, teeth wander, often requiring occlusal adjustments. Besides, as the teeth are still mobile and fragile, the teeth can “relapse” and transform into a malocclusion.

Occlusal conditions often cause discomfort before the advanced stage is reached. The occlusal-related conditions that can cause pain include TMJ symptoms, primary occlusal damage, advanced periodontal cracks, damaged teeth, and gingival regression that has spread into the gingiva connected to the gingival mucosa. Patients may feel pain as a result of primary occlusal trauma induced by high restoration or insertion of a fixed bridge or a partial denture that puts undue force on the abutment teeth.

Changes, involving discomfort, broader periodontal ligament space, and dental resilience, are reversible if the occlusal damage is removed. Lack of basic knowledge of orthodontic care in patients with occlusal injuries can also contribute to loss of tooth structure. Insubstantial tooth structure can involve chipping of teeth in the edge to the edge of the bite and abrasions that are rounded tooth-shaped notches along the gum line. Abfractions that are not normally caused by abrasive brushing teeth or toothpaste can also cause damage in the form of dentin hypersensitivity, where even the teeth can experience specific occlusal trauma.

Several basic tests and patient awareness can prevent many potential complications with occlusal issues. Through identifying these forms of occlusal issues early and motivating patients to correct and comply with care, dental hygienists may help patients prevent expensive recovery in the future.

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