Glossary

Occlusal adjustment is the modification of the biting surfaces of a tooth, or teeth, to improve function or morphology. Occlusal adjustment is often used in conjunction with prosthetic placement and involves the grinding and shaping of selected tooth surfaces to improve contact patterns. Bite adjustments may also be made due to night-grinding issues and the discomfort or disfunction this causes for patients. The results of the occlusal adjustment procedure cannot be reversed, which means significant study of the patient’s mouth, tooth surfaces, and bite must occur before any action is taken. This study is usually accomplished through studying the bite contact within the patient’s mouth as well as through the use of dental impressions. Side effects of dental bite adjustment may include some pain or discomfort, though these are usually mild. Occlusal adjustment cost may vary depending on the dental insurance and the extent of the bite adjustment procedure.

An occlusal guard is often called a night guard or a bruxism guard. It protects against bruxism, which is the clenching or grinding of the teeth that happens primarily at night. Because the jaw puts an extreme amount of pressure per square inch on the teeth, grinding and clenching the jaw at night can result in damage to the teeth and painful symptoms of TMJ, or temporomandibular joint disorder. Occlusal guards can be custom-made by a dentist to fit a patient’s mouth exactly, or they can be purchased over the counter. While over-the-counter occlusal guards are less expensive than custom-crafted, they can have a negative impact on oral health if not used properly. Custom-fitted occlusal guards provide patients with better bruxism relief without the discomfort of ill-fitting plastic or metal parts that are one-size-fits-all. Occlusal guards can prevent jaw strain, fatigue, pain, and the chipping or breaking of teeth.

The occlusal load refers to the amount of force applied by the jaw when closing to a dental implant. Occlusal loading is essentially the process by which the force is applied, e.g. biting or chewing. Because the teeth and jaws can create a great amount of force between them, it’s critical that dental implant hardware be designed to withstand a high occlusal load. Many periodontists will use specialized tools to measure a patient’s occlusal load prior to selecting implant hardware, such as pressure sheets, strain gauges, and piezo-electric sensors. Bite force, or occlusal loading, can also be measured using masticatory computational models. By using three-dimensional occlusal load measurements, dental health professionals can enrich the assessment of a patient’s masticatory performance. In patients with bruxism, or the unconscious habit of grinding the teeth at night, the occlusal load may be much higher than in patients without bruxism. Periodontists should account for any conditions which may cause excess grinding of the teeth, including anxiety and drug use.

Occlusal overload refers to when the amount of “bite force,” or occlusal force, is greater than the teeth can withstand. Often, the term occlusal overload is used in conjunction with other dental implant terminology, however, it can also be used in discussions of bruxism. Bruxism is a condition where the patient unconsciously bites down, clenches, or grinds their teeth, usually at night, which increases their occlusal force exponentially. When discussing implant dentistry, occlusal overload can significantly increase the risk of implant rejection. Occlusal force should be measured by the treating periodontist carefully before selecting the size, shape, material, and surface texture of dental implant hardware. The amount of occlusal force that the implant can withstand must be less than the actual occlusal force of the patient’s jaw. If not, occlusal overload occurs, which can permanently damage the prosthetic crown or potentially even the implant hardware underneath. The patient’s gum and bone tissue can also become injured.

The occlusal table is the surface of a tooth that comes into contact with the opposite tooth. These are the grinding surfaces of the teeth that help break down food and the largest occlusal tables tend to be on the back teeth, or molars. The bicuspid teeth also have an occlusal table, and an occlusal load is the amount of force applied to the occlusal table by the jaw or external force. The jaw can exert a great deal of pressure per square inch, which is why teeth — specifically the enamel — is the strongest substance in the body. Injury can occur to the occlusal table, which is called occlusal trauma. The most common type of occlusal trauma is from bruxism, where the surfaces of the occlusal table become damaged and worn from excessive clenching and biting, usually during sleep. Occlusal trauma can also be caused by external forces, such as a blow to the head.