Cutting tooth hole

The occlusion is the totality of the contact points and close-up contacts between the upper and lower teeth when biting. These contacts change continuously, but normally so slowly that you don’t notice it yourself:

  1. In children, the tooth contacts of the permanent teeth are initially only punctiform.
  2. In adolescents they have become small areas and lines through chewing and crunching (usually at night).
  3. In adults, some teeth can be dented flat or deep because of grinding, raw food, acids, certain fillings, etc. This can result in close contact, which presses food residues between the teeth.

Sometimes the tooth contacts change rapidly or begin to hurt even without tooth decay:

  • Orthodontists move many teeth in a short time to obtain a beautifully straight row of teeth. This creates a new occlusion. However, it often approaches the old tooth position again after a few years.
  • Acids from apples, salad sauce, drinks such as Coca-Cola and raw vegetables etc. attack the teeth. If they are consumed too often, they can become shorter overall, get painful erosions, trap food leftovers, etc.
  • Crunching and pressing hard (at work or during sleep) and chewing chewing gum for hours causes polished facets (= wide contacts) on the occlusion.
  • Fillings and crowns sometimes have a completely different shape than the neighbouring teeth. This can overload a tooth, make it sensitive to cold and even break it after a while.
  • Acids and crunching together lead to abrasion bites, where all teeth are flat and no longer have cusps or dimples.

Content:

Further influences on occlusion

In severe periodontitis, the teeth loosen and the occlusion changes.

In old age the chewing strength decreases and the teeth begin to wander.

People with severe dementia stop chewing and just suck. Her lips and cheeks push all her teeth inwards.

Helicoidal occlusal surface

This picture was taken by Dr. med. dent. Peter Göllner drew my attention.

Es wurde publiziert im American Journal of Orthodontics, Volume 40, Issue 4, April 1954, Pages 298-312 von P. R. Begg, Adelaide, Australia unter Stone Age Man’s Dentition With Reference to anatomically correct Occlusion, the etiology of Malocclusion, and a technique for its Treatment.

Dentures from the 7th-15th century, Sains-en-Gohelle, Pas-de-Calais, France

Note the extreme tartar attack on all teeth. The gap in the foreground could be caused by gingivitis.

The teeth were only ground off by the food at that time. Today’s stress, sour food and drinks as well as today’s dental procedures were missing.

25-year-old patient (22.03.2017 / 4569)
Class I

A rarely beautiful denture with ideal occlusion. The midlines of the upper and lower teeth are exactly aligned.

Such a beautiful set of teeth is a rare exception. The patient has no advantages except that the dentists are enthusiastic.

The functional occlusion types (according to Weilenmann) describe the angles and surfaces of the tooth contacts in the millimeter range. In unfavourable cases they cause cold sensitive teeth, chewing pain, tooth fractures, etc. They often occur only with high chewing forces when they encounter particularly oblique or wide contact surfaces (= blunt contact surfaces).

Classic occlusion types
Class I the ideal dentition, about 60% of all peopleClass II the lower jaw is shorter than the upper jaw, 20-30% of peopleClass III the lower jaw is longer than the upper jaw, 10% of peopleDiefbissd the lower incisors bite into the palateDeckbissd the upper incisors bite onto the lower gumsKopfbissd the incisors bite “head on head” against each otherCross bite a lower tooth stands further outside than the upper counter tooth
Functional occlusion types (according to Weilenmann)
V-contactin long hump bites into a deep caudel (V=V-shaped)L-contactin tooth bites onto a flat tooth, which still has a high hump (L=L-shaped)T-contacttwo flat teeth meet broadly (T=table-shaped)

1899 Prof. Angle (Wikipedia: Malpositioned teeth):

2019 VLT contacts (acc. to Weilenmann) N = normal toothing with point contacts

75-year-old female patient (22.03.2017 / 45)
Abrasion bite of a crunchy woman

The patient is a strong gnashing woman with typical gnashing muscles. After many decades of grinding, the teeth have become completely flat. The problem is that flat teeth allow many tooth positions.

Complaints with new F¨llungen

The patient now has trouble with every new filling until it fits. The dentist cannot open her mouth for long because of jaw pain, and after the treatment she no longer knows exactly how the teeth fit together. She often notices only at home or the next day that the new filling (or another tooth) disturbs something at a certain tooth position.

70-year-old patient (22.03.2017 / 5038)
Abrasion bite with partial denture

People with partial or full dentures have less strength to bite than people with their own teeth. Nevertheless, they can grind and get temporomandibular joint pain.

left: Lower jaw:from front to back: incisor, canine, amalgam filling, porcelain crown, tooth gap and gold crown. All teeth have a very flat occlusion.

right: maxilla:partial denture with completely flat teeth

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Christina Cherry
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