Dr. Jose-Luis Ruiz has initiated the move toward easy education for even the busiest of clinicians in hopes of preventing occlusal disease from going undetected. He has created a comprehensive and informative outline in his “7 Signs and Symptoms Guide for Occlusal Disease Diagnosis,” as featured in Dentistry Today.
In his article published in Dentistry Today (2009), Dr. Ruiz addresses the fact that occlusal disease often goes undiagnosed due to a lack of dentist expertise on the destructive, debilitating disease. OD can create cold sensitivity affecting eating, drinking, brushing teeth and, if left undiagnosed, can lead to a need for rehabilitation and restorations.
Many courses on occlusion, Dr. Ruiz reports, are arduous for busy dentists, are expensive, and simply make diagnoses complicated. With his system, Dr. Ruiz has made the complicated much more simple so that disease can be found and treated more effectively. This easy-to-use system provides stages of diagnosis while taking into account levels of severity and patients’ willingness to treat their disorder.
Stage I of Diagnosis
- Look for signs and symptoms
- Educate and motivate patient towards treatment
Stage II of Diagnosis
- Perform a more comprehensive examination
- Mounted casts
- Advanced occlusal and TMJ diagnosis
- Protective night guard can be offered in event of patients denial of further treatment
The 7 Signs and Symptoms of Occlusal Disease
1. “Pathological occlusal wear and fractures of teeth/restorations”
Dentists should look for chips, tooth loss, erosion and abrasion
Where evident, dentists should suspect OD regardless of possible causation
2. “Cervical dentin hypersensitivity (CDH)”
OD is most likely the cause of CDH
CDH can be successfully treated with occlusal therapy
3. “Tooth hypermobility”
Unbalanced occlusion will overload teeth and, despite visible bone support, will lead to tooth mobility
Rather than extracting mobile teeth, occlusal therapy can restore stability
4. “Fremitus”
Found by vibration experienced by patient when biting down
If experienced in canines or incisors, it is most likely caused by pathological occlusion
5. “Abfractions”
Non-carious lesions that are multifactorial but typically caused by pathological lateral forces
Often found in an acidic environment and can point to an occlusal etiology
6. “Vertical bone loss or localized bone destruction (secondary to periodontal disease)”
Teeth with accelerated bone loss can be traced to occlusal trauma
7. “Pain and tired facial and masticatory muscles or TMJ pain”
Most common symptom linked to OD diagnosis
Sore and tired muscles often cause headaches as well
Patients rarely report this symptom, making it an important question to ask
By creating a comprehensive and informative system for occlusal disease diagnosis, Dr. Ruiz is leading the way toward dental education and long-term health for patients. When dentists take time to understand and recognize the 7 signs and symptoms, they will open the opportunity to provide better care for their patients.