May God bless you.. There is nothing I could pay you or humanity could give you for your addition to knowledge of practitioners.. Only God can reward you with joy..peace of mind...fulfilment and health
Thank you. Glad you like the videos. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
Yes they do! Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
Doc I’m in Ohio and I can honestly say you and Dr Shatkin are the 2 best dentist in this country. What I like about you is how you explain in detail, you are definitely the best at it
Thank you. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
I'm a dental technician in Dallas Texas working in all on 4-6 lab the information received in this video is fundamental for the the work I do thank you very much Sr, God bless you.
As a technician working on the prosthetic restoration of all on 4,6 prosthesis where did you learn the basic principles of the occlusion that should be applied when fabricating such a prosthesis? How may years have you been a DT? Are you a CDT?
@@doctoredable 17 years started in a traditional dental lab as a metal finisher escalating to a ceramist position and now recently working in a all on 4-6 dental lab doing everything that I had learned plus pink acrylic gums.
Dr. Steve has such a vast dental knowledge, legend has it he once PFM prepared his own two molars by looking at the mirror. Thank you Doc for unselfishly sharing your lectures.
Thank you. That's not true about the molars, but I did sew my face up with a mirror, with the assistance of an island nurse, after getting bitten in the face by a shark a few years ago.
@@centerforard good god, i didnt even notice. You must've done a remarkable job, Dr Cutbirth. But i must ask, did the shark bite you in centric relation or centric occlusion?
I’m so happy to have found your channel! I am a dental lab technician working my way up and I’m trying to get a better understanding of occlusion and function. (I work on a lot of all-on 4-6 hybrid cases) This video helped me so much!! I have more of your videos saved so I can keep on learning. I want to become better at communicating with the dentists I work with so we can achieve the best outcomes for the patients. Thank you so much for sharing your knowledge. 😊😊😊
Terrific. Subscribe to DentistryMasterClasses.com. There is an organized library of all the Dental Minute videos plus many complete comprehensive cases and important articles. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Glad the video was helpful. I have a lot of training, great mentors and years of experience with occlusion. I find that most dentists do not have fundamental knowledge of occlusion. It seems they are not getting training in occlusion in dental school. I am not sure why that is the situation. In my opinion, occlusion is the foundation of everything else we do in dentistry. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Ha, ha, thank you for the complement. Lots of study, attending many, many seminars with great teachers and many years of personal experience. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
You are welcome. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
You are welcome. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
Thank you. I agree, occlusion is arguably the most important part of dentistry. It is the foundation of almost everything else in dentistry. Glad the video was helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Dr I went in for a full mouth reconstruction. Which had to be entirely redone. When I presented to first Dr I had all teeth present on mandible, but on Maxillary all 6 Anterior teeth were gone (flipper). I had a class 3 aka underbite now. (Mandible longer than Maxillary) Instead of Dr obtaining a proper Anterior guidance, he Retruded my Mandible, to say that was Centric Relation. The day he screwed down the PMA, I noticed immediately, my chin was not in its normal position, tongue biting etc then the most horrible pain I've ever experienced, and I have A high pain threshold. I have my BSN from U of M and was currently in PA school. Unlike alot of pts whom have no medical knowledge, I have a baseline on how the body works, and can easily differentiate my facial pain. My Temporal and Masseter muscles along with lateral and medial pterygoid muscles were firing at 100% non stop, my condyle was in the retrodiscal tissue, its been excruciating. When I presented to new Dr. He literally told me to prove to him, that my max teeth should come out that far and that my Mandible should be that far out. I believe he thought the pain I had was tmj or more superficial. But my entire skeletal alignment was completely off. I didnt know how to articulate to my new dr what was going on bc it was so many things from my official, neurological, etc and didn't understand fundamentals of occlusion, until YOUR VIDEO. AFTER THIS VIDEO, I was able to articulate to my new dr exactly what I was feeling, experiencing, and in healing stage after 2nd sx. Feeling 100% better. Thank you! I had to stop PA school due to the 1st sx, but I will be starting bk up very soon, then heading to dental school!!! Your Teeth and Occlusion is so Very Important, to your overall health. Its time dental and medical is more integrated! Bc my paper and many Specialty Drs I seen for the neck and face pain I was having had no answers! Chronic Pain or unspec pain is how they dx it. I knew the only person that could help me, was one who understood occlusion. Thank you Dr!
Glad it was helpful!Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
Glad it was helpful! Occlusion is critical to excellent restorative dentistry. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
some of your other videos show you using a cotton tip applicator on the anterior teeth and having the patient squeeze when you take a CR bite registration. What is the difference between manually manipulating the mandible, as shown in this video, vs using the cotton tip applicator as a leaf gauge? How do you decide which technique to use when taking the bite registration?
You seem to be confusing videos. You can manipulate directly into CR if you know how to do it. If I am taking a CR occlusal registration record, I place some softened green stick compound between the central incisors and have the patient bite gently into the soft compound as I manipulate the mandible into CR. I then cool the compound with my air syringe and squirt fast set PVS between the posterior teeth and have the patient bite back onto the compound with the TMJs in CR, also biting into the soft PVS. It's in the video. The only time I use a cotton tipped applicator stick between the centrals is when I am taking an occlusal registration record in CR at an increased vertical dimension for a wax up when I am going to increase someone's vertical dimension and restore all the teeth.
Glad you think so! Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
As always, good education and really appreciated. I wonder, what if you manipulate your patient into CR and the first contact appears to be on the first bicupids on both sides. I assume the only way for CRO is adding to the other teeth to get contact (like you mentioned primarily mesial on the first molar to the cuspid and lightly on the rest) because filing the bicuspids down to get contact with the other teeth would the jaw move further resulting you are not in CR anymore? Assuming patient got TMJ and need treatment. Best regards,
The key is to have simultaneous contact bilaterally in the cuspid - first molar. All those teeth do not have to contact to have healthy TMJs and facial muscles, so long as both right and left sides contact simultaneously in CR with no CR-CO slide. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
No. Everyone would benefit from an ideal occlusion, but if there are no symptoms and the patient does not perceive a problem, they will probably not want to pay for the equilibration. If you are performing restorative treatment, that is another thing. Many things to consider in dentistry! It's not black and white. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
It is probably fine if the tooth does not have endo and the patient wears a Nightguard while sleeping. If there is concern regarding the strength of the cuspid for working side movements, you might consider group function with one or both of the bicuspids in the working side movement. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
I have a head forward ppsture since my childchood. I'm fine with it. I was not aware, it has anything to do with my bite. Slowly, with treatments I lost my forward bite. Ever since I explaine that my teeth R ratated, that make the middle groove of one tooth to connect with the edge of the next one. Nobody want to do it for me. I can not have an orthodontic treatment because my teeth R trimmed for crowns. Can I be advised what to do? I can not accept teeth in a regular arch line.
Find a dentist who really understands occlusion and have an examination and treatment plan. Possibly, your occuusion can be equilibrated (even the bite).
Terrific! Glad the videos are helpful. I am giving the first webinar this coming Friday morning, 9:00 CST. If that webinar is well received, I may start giving monthly webinars on specific important topics. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
I agree. In my opinion, most dentists do not understand the fundamentals of occlusion. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Thank you Dr Steven for your great presentation. I have a question, however. If we supposedly making a night guard for a patient, can't we start away by just placing the compound and having them close till there is a 2mm distance between molars without manipulating the condyle at first? in other words, what is the point of finding the centric relation when we already know condyle is in CR for the first 5 to 10mm and we want the first 2mm for our splint. Many thanks
I always manipulate the condyle into CR when taking the CR registration record just to be sure the patient is not positioning the mandible protrusively. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
You said "can't get people to stop grinding and clenching" I have been doing this very badly. I opted in for Phase 1 & 2 treatment. Currently on phase 1 finding the relaxed relation with muscle, teeth and bones (TMJ) and been on this for a month i feel great no teeth grinding or jaw clenching. Before I address the bite changes with with dental work I will try this phase further two more months. Hopefully this works and I have stopped grinding teeth and clenching forever within reasons of course. Because these treatments cost a lot . What are your thoughts about phase 1 & phase 2 treatments @Dental Minute with Steven T. Cutbirth, DDS
Absolutely fantastic stuff! Thank you for making this video and demystifying something that is often so confusing. Two quick questions: I have heard some dentists say that if your orthotic only touches in the anterior, in the long term a few patients will develop an open bite, not from supereruption but from the lateral pterygoids relaxing and the condyle seating fully and staying there. Have you seen this? Should I not worry about it? Also, do you prefer and maxillary or mandibular guard and why? You have been one of my greatest mentors in dentistry, although I’ve never met you. Thanks again!
It make no difference whether the night guard is maxillary or mandibular. Dr. Henry Tanner was a renowned occlusal expert and he developed the Tanner appliance, which was a nightguard for the mandibular arch. I normally place the nightguard on the maxillary teeth unless the mandibular teeth are mobile or there are missing mandibular teeth we want to stabilize and prevent their movement. I have placed night guards like the one I am teaching with only anterior contacts for 40 years and have never, to my knowledge, had an issue with teeth in the opposing arch super erupting. I feel anterior contact only with the splint outweighs other considerations because 90% of the muscle fibers of the muscles of mastication do not contract if only the cuspids contact in CRO and only the anterior teeth contact in eccentric movements.The patient should not wear the only anterior contacting splint more than 8 hours at a time. If the splint is worn 24/7, with only anterior contacts, the opposing teeth will begin to super erupt after 24-48 hours. I have had some fabulous occlusal mentors, including L.D. Pankey, Pete Dawson, Bill Bryant, Mel Steinburg and Guy Haddux to name a few. With all the complex cases I see and restore, occlusion is the foundation of my dental practice. As dentists, we must be experts in occlusion to perform restorative dentistry correctly. Where do you practice? I am glad the videos are helpful. I love practicing comprehensive dentistry. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
I am not familiar with the term C2. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Glad you liked the video. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
Sir your lecture is great, in fact best...I have a question....if we have to made a night guard to prevent clinching,we need prepare a mouth guard only on anterior teeth?
I normally have the Nightguard cover all the teeth in an arch so it doesn't come loose while the patient is sleeping. The occlusal contacts are only on the anterior teeth. Covering all the teeth in the arch is to secure the appliance and prevent it from coming loose. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
I really appreciate dear doctor. Very applicaple and scientific explanation on occlusion. Your work and effort is honorable. Question?? 1. Should middle of upper teeth(the line between two middle incisal) and middle of lower teeth, concide during central occlusion? 2. My mandible travels a long way from left to right and viceversa, associated with facial muscles pain and fatigue. My teeth also slides about less than 2mm and finally all contacts miss except for one of my upper anterior incisal tooth which holds all the pressure of jaw and is gradually moving forward due to this pressure.
Sorry, it is very difficult to diagnose a condition without examining you. I suggest you find a good dentist knowledgeable in occlusion and the diagnosis and treatment of facial pain and disfunction.
@@centerforard You are such a responsible and generous doctor. I truly appreciate your reply. Kindly recommend to me, if you have any fellow dentist in Philippines.
Dr. Steven, I'm reading a lot about the Dahl principle and lot of dentists are doing deprogrammer without posterior contact so the teeth can move and close the space. Their patients are wearing them only while sleeping and there is a teeth movement after aprox. 6 months. I watch your video and you say that the 8 hours of no contact between the teeth cannot lead to a passive tooth eruption. I'm doing such night guards with great results, the patients have an immediate response to it and say that the muscles are relaxed, even the neck muscles. But what you're saying and what the other doctors are saying is the opposite so I'm confused. Can you please share your opinion about this and the Dahl principle? Thank you!!
Teeth begin to move after 24 hours, and only slightly then. The principle is you do not want opposing teeth to be out of contact more than 24 hours straight. So posterior teeth not contacting for 8 hours will not affect the occlusion.
You are welcome. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
There are several full mouth restoration cases in the library of DentistryMasterClasses.com. I am currently filming several more full mouth restoration cases that will be in the DMC.com library soon. A full mouth restoration is not easy and requires a systematic approach, plus an understanding of what you are getting into. If the patient has severe wear, that is a completely different situation vs. a patient who has just broken down teeth. If you are going to restore complex cases, you should have expertise in most areas of dentistry, or you will be constantly referring the patient out for endo, extractions, perio., etc. Being qualified to sedate is also most helpful. We are filming a "live" case in the morning (Friday) at 8am, CST. You might want to watch it. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
@@centerforard Could you recommend a dentist in the Houston/Galveston area who specializes in occlusion problems & full mouth rehabilitation? I’ve had problems with grinding & clenching since I was a teen. I have crowns on all upper teeth & a few bottom teeth but feel my occlusion is still off. Thank you!
cutbirthdds@gmail.com. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
@@centerforard sadly doc I find most dentist don’t that’s why I’m drawn to the ones that do like you. I had a filling placed yesterday and it’s too high, had instant tmj pain on that side, headache, dizziness, nausea it was rough all night. I want her to take it down a lot, but I’m scared. Do you know any good dentist from Philadelphia that’s about occlusion?
@@centerforard one other question if you can please 🙏 I have a molar (last one in the back on my right side wisdoms removed) that’s been drilled on a bit too much over the years...chasing the fit of this filling, and the tooth has pretty much lost its natural shape. I feel so because it doesn’t fit quite well with the tooth above it, hits too hard in some areas and I have jaw pain on that side. I have moulds of my teeth before being touched, do you think I could have an on-lay made from my original tooth shape mould, and if so do you think it will fit together again, and in return stop my jaw pain or it’s not that simple? That’s my main concern before I take away my enamel for good! I would love the opinion of an occlusion specialist like yourself, not a general dentist, too many that don’t study the bite and occlusal just don’t know certain things
@@centerforard Thank you. My mandible needs to be distalized if I need to achieve centric occlusion. It causes a bit of discomfort around my ear when I chew food.
At least get a flat plane, hard acrylic centric relation occlusal orthotic appliance made by a dentist who is excellent in occlusion to wear while sleeping. Watch my video on how to make an OOA or proper night guard.
I’m interested to hear what more experienced dentists like you have to say . I’ll first just say my understanding of occlusion is very basic. Let’s assume that you do not have canine guidance. What would that mean? It would mean that on lateral excursions (side to side jaw movements) you do not have your canines discluding your maxillary and mandibular posterior teeth (discluding means separating, basically). On lateral excursions, your posterior teeth would be grinding against each other. Canine guidance helps protect your posterior teeth from destroying themselves and grinding eachother flat during side to side movements. So… without canine guidance, your back teeth are destined to be ruined and ground flat, right? Wrong. These occlusal concepts dentists are taught (canine guidance, protrusive guidance, mutually protected occlusion, etc.) are primarily relevant *in the presence of parafunction.* Oral parafunction is the function of your teeth when they are not being used for what they are meant for (i.e. chewing food). For example, bruxism/tooth grinding is parafunction. In the presence of bruxism, canine guidance would absolutely lend protection to your posterior teeth from themselves (until you grind your canines down to nubs and they can’t guide your occlusion anymore). In short, it probably is not important at all especially if you do not have parafunctional habits. If you do have parafunctional habits, it may affect things but a dentist would need to see your occlusion in person to assess if you have canine guidance. And even if you do have bruxism, you can just wear an occlusal guard and it’ll never be an issue.
Nice comment. Most of what you are writing is correct. Definitely, if a patient does not grind their teeth during the night while sleeping (bruxism) or during the day, they will not wear their teeth away or develop myofacial pain and limitation of opening or TMJ issues. Stress on an imbalanced system causes most of the problems. If the system is not imbalanced (CR-CO slide), then the patient will probably just develop myofacial pain and muscle tightness and teeth wear if they are a bruxer/grinder/clincher. That is the reason most of my patients are given a CRO flat plane, hard acrylic nightguard, girls when they are around 16 and boys when they are in their low 20s (when they stop growing). Most people grind their teeth when they are sleeping. Don't wait until they have worn down their anterior teeth to provide then with a proper nightguard. My daughters received nightguards when they were around 16 and had stopped growing. Occlusion is a fascinating and most important dental topic. I do not know how a dentist practices dentistry at more than a very basic level (tooth extractions) without a thorough knowledge of occlusion and function. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Glad you like the video. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
Thank you. Occlusion is probably the heart of dental treatment. If a dentist does not understand occlusion, he/she and their patients are at a huge restorative disadvantage. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Sorry, what is the question? Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
Dr if you put the maxillary model and the mandibular model on the articulator with an open bite in centric relation. how did you knew the first tooth contact on the model in centric relation? Thank you
You have asked a question that takes a significant part of a lecture to answer. The short answer is to mark the first contact in CR in the mouth with articulating paper, then find the first contact on the CR mounted models on the articulator with articulating paper. There may be some minor adjustment of the mounted models to have the first contact in CR be the exact same as that first contact in CR in the mouth. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513
May God bless you.. There is nothing I could pay you or humanity could give you for your addition to knowledge of practitioners..
Only God can reward you with joy..peace of mind...fulfilment and health
Thank you. Glad you like the videos. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
That was very interisting and fun ! THESE PROCEDURES WORK AND THEY WORK EVERY TIME !
Yes they do! Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
Doc I’m in Ohio and I can honestly say you and Dr Shatkin are the 2 best dentist in this country. What I like about you is how you explain in detail, you are definitely the best at it
Thank you.
Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month.
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I'm a dental technician in Dallas Texas working in all on 4-6 lab the information received in this video is fundamental for the the work I do thank you very much Sr, God bless you.
As a technician working on the prosthetic restoration of all on 4,6 prosthesis where did you learn the basic principles of the occlusion that should be applied when fabricating such a prosthesis? How may years have you been a DT? Are you a CDT?
@@doctoredable 17 years started in a traditional dental lab as a metal finisher escalating to a ceramist position and now recently working in a all on 4-6 dental lab doing everything that I had learned plus pink acrylic gums.
Glad it was helpful!
@@centerforard what other videos do you recommend for function and esthetics?
Subscribe to DentistryMasterClasses.com. There is an organized library of all the DM videos plus many complete comprehensive cases. Only $20/month.
Dr. Steve has such a vast dental knowledge, legend has it he once PFM prepared his own two molars by looking at the mirror. Thank you Doc for unselfishly sharing your lectures.
Thank you. That's not true about the molars, but I did sew my face up with a mirror, with the assistance of an island nurse, after getting bitten in the face by a shark a few years ago.
What a man #DentalChuckNorris
@@centerforard good god, i didnt even notice. You must've done a remarkable job, Dr Cutbirth.
But i must ask, did the shark bite you in centric relation or centric occlusion?
I’m so happy to have found your channel! I am a dental lab technician working my way up and I’m trying to get a better understanding of occlusion and function. (I work on a lot of all-on 4-6 hybrid cases) This video helped me so much!! I have more of your videos saved so I can keep on learning. I want to become better at communicating with the dentists I work with so we can achieve the best outcomes for the patients. Thank you so much for sharing your knowledge. 😊😊😊
Terrific. Subscribe to DentistryMasterClasses.com. There is an organized library of all the Dental Minute videos plus many complete comprehensive cases and important articles.
Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
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The best lecture on occlusion I've ever seen
Glad the video was helpful. I have a lot of training, great mentors and years of experience with occlusion. I find that most dentists do not have fundamental knowledge of occlusion. It seems they are not getting training in occlusion in dental school. I am not sure why that is the situation. In my opinion, occlusion is the foundation of everything else we do in dentistry.
Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month.
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How did you get so super knowledgeable about everything!?!? You are my example! Thank you!
Ha, ha, thank you for the complement. Lots of study, attending many, many seminars with great teachers and many years of personal experience. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
In dental hygiene school & you gave me a deeper and easier understanding of occlusion!
You are legend in dentistry i can say that!
What a nice thing to say. Thank you. Are you in dental practice or a dental student?
Thanks!
You are welcome.
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Doctor I want to be like you how knowledgeable you're ❤️ thankyou for sharing
Thank you. You are very kind.
Thank you so much Dr Cutbirth!
You are welcome. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
Best video ever!!! Ty!!! Occlusion is soooooo important
Thank you. I agree, occlusion is arguably the most important part of dentistry. It is the foundation of almost everything else in dentistry. Glad the video was helpful.
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Dr I went in for a full mouth reconstruction. Which had to be entirely redone. When I presented to first Dr I had all teeth present on mandible, but on Maxillary all 6 Anterior teeth were gone (flipper). I had a class 3 aka underbite now. (Mandible longer than Maxillary) Instead of Dr obtaining a proper Anterior guidance, he Retruded my Mandible, to say that was Centric Relation. The day he screwed down the PMA, I noticed immediately, my chin was not in its normal position, tongue biting etc then the most horrible pain I've ever experienced, and I have A high pain threshold. I have my BSN from U of M and was currently in PA school. Unlike alot of pts whom have no medical knowledge, I have a baseline on how the body works, and can easily differentiate my facial pain. My Temporal and Masseter muscles along with lateral and medial pterygoid muscles were firing at 100% non stop, my condyle was in the retrodiscal tissue, its been excruciating. When I presented to new Dr. He literally told me to prove to him, that my max teeth should come out that far and that my Mandible should be that far out. I believe he thought the pain I had was tmj or more superficial. But my entire skeletal alignment was completely off. I didnt know how to articulate to my new dr what was going on bc it was so many things from my official, neurological, etc and didn't understand fundamentals of occlusion, until YOUR VIDEO. AFTER THIS VIDEO, I was able to articulate to my new dr exactly what I was feeling, experiencing, and in healing stage after 2nd sx. Feeling 100% better. Thank you! I had to stop PA school due to the 1st sx, but I will be starting bk up very soon, then heading to dental school!!! Your Teeth and Occlusion is so Very Important, to your overall health. Its time dental and medical is more integrated! Bc my paper and many Specialty Drs I seen for the neck and face pain I was having had no answers! Chronic Pain or unspec pain is how they dx it. I knew the only person that could help me, was one who understood occlusion. Thank you Dr!
My apologies I think auto correct mis corrected some words official should be myo facial and neurological and I seen my Pcp and specialty drs
Thank you very much! I really needed this fabolous explanation :)
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Really thorough explaination. Nice work
Glad it was helpful! Occlusion is critical to excellent restorative dentistry. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
some of your other videos show you using a cotton tip applicator on the anterior teeth and having the patient squeeze when you take a CR bite registration. What is the difference between manually manipulating the mandible, as shown in this video, vs using the cotton tip applicator as a leaf gauge? How do you decide which technique to use when taking the bite registration?
You seem to be confusing videos. You can manipulate directly into CR if you know how to do it. If I am taking a CR occlusal registration record, I place some softened green stick compound between the central incisors and have the patient bite gently into the soft compound as I manipulate the mandible into CR. I then cool the compound with my air syringe and squirt fast set PVS between the posterior teeth and have the patient bite back onto the compound with the TMJs in CR, also biting into the soft PVS. It's in the video. The only time I use a cotton tipped applicator stick between the centrals is when I am taking an occlusal registration record in CR at an increased vertical dimension for a wax up when I am going to increase someone's vertical dimension and restore all the teeth.
this is better than D school. Thank you Dr!!
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As always, good education and really appreciated.
I wonder, what if you manipulate your patient into CR and the first contact appears to be on the first bicupids on both sides. I assume the only way for CRO is adding to the other teeth to get contact (like you mentioned primarily mesial on the first molar to the cuspid and lightly on the rest) because filing the bicuspids down to get contact with the other teeth would the jaw move further resulting you are not in CR anymore? Assuming patient got TMJ and need treatment.
Best regards,
The key is to have simultaneous contact bilaterally in the cuspid - first molar. All those teeth do not have to contact to have healthy TMJs and facial muscles, so long as both right and left sides contact simultaneously in CR with no CR-CO slide. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
Hello dr i have a question,
Should you adjust the occlusion of every patient that visits your office?
No. Everyone would benefit from an ideal occlusion, but if there are no symptoms and the patient does not perceive a problem, they will probably not want to pay for the equilibration. If you are performing restorative treatment, that is another thing. Many things to consider in dentistry! It's not black and white.
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Hello Doctor , thanks a lot . If the Cuspid has a crown, will it be considered as a weakned tooth when performing the slide movement?
It is probably fine if the tooth does not have endo and the patient wears a Nightguard while sleeping. If there is concern regarding the strength of the cuspid for working side movements, you might consider group function with one or both of the bicuspids in the working side movement.
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Thanks a lot
I have a head forward ppsture since my childchood. I'm fine with it.
I was not aware, it has anything to do with my bite.
Slowly, with treatments I lost my forward bite.
Ever since I explaine that my teeth R ratated, that make the middle groove of one tooth to connect with the edge of the next one.
Nobody want to do it for me.
I can not have an orthodontic treatment because my teeth R trimmed for crowns.
Can I be advised what to do?
I can not accept teeth in a regular arch line.
Find a dentist who really understands occlusion and have an examination and treatment plan. Possibly, your occuusion can be equilibrated (even the bite).
Sikkim
India
That's how far how have reached...
Big fan
Terrific! Glad the videos are helpful. I am giving the first webinar this coming Friday morning, 9:00 CST. If that webinar is well received, I may start giving monthly webinars on specific important topics.
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This video is underrated 🎉
I agree. In my opinion, most dentists do not understand the fundamentals of occlusion.
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Thank you Dr Steven for your great presentation.
I have a question, however. If we supposedly making a night guard for a patient, can't we start away by just placing the compound and having them close till there is a 2mm distance between molars without manipulating the condyle at first? in other words, what is the point of finding the centric relation when we already know condyle is in CR for the first 5 to 10mm and we want the first 2mm for our splint.
Many thanks
I always manipulate the condyle into CR when taking the CR registration record just to be sure the patient is not positioning the mandible protrusively.
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You said "can't get people to stop grinding and clenching" I have been doing this very badly. I opted in for Phase 1 & 2 treatment. Currently on phase 1 finding the relaxed relation with muscle, teeth and bones (TMJ) and been on this for a month i feel great no teeth grinding or jaw clenching. Before I address the bite changes with with dental work I will try this phase further two more months. Hopefully this works and I have stopped grinding teeth and clenching forever within reasons of course. Because these treatments cost a lot . What are your thoughts about phase 1 & phase 2 treatments @Dental Minute with Steven T. Cutbirth, DDS
Absolutely fantastic stuff! Thank you for making this video and demystifying something that is often so confusing. Two quick questions: I have heard some dentists say that if your orthotic only touches in the anterior, in the long term a few patients will develop an open bite, not from supereruption but from the lateral pterygoids relaxing and the condyle seating fully and staying there. Have you seen this? Should I not worry about it? Also, do you prefer and maxillary or mandibular guard and why? You have been one of my greatest mentors in dentistry, although I’ve never met you. Thanks again!
It make no difference whether the night guard is maxillary or mandibular. Dr. Henry Tanner was a renowned occlusal expert and he developed the Tanner appliance, which was a nightguard for the mandibular arch. I normally place the nightguard on the maxillary teeth unless the mandibular teeth are mobile or there are missing mandibular teeth we want to stabilize and prevent their movement. I have placed night guards like the one I am teaching with only anterior contacts for 40 years and have never, to my knowledge, had an issue with teeth in the opposing arch super erupting. I feel anterior contact only with the splint outweighs other considerations because 90% of the muscle fibers of the muscles of mastication do not contract if only the cuspids contact in CRO and only the anterior teeth contact in eccentric movements.The patient should not wear the only anterior contacting splint more than 8 hours at a time. If the splint is worn 24/7, with only anterior contacts, the opposing teeth will begin to super erupt after 24-48 hours. I have had some fabulous occlusal mentors, including L.D. Pankey, Pete Dawson, Bill Bryant, Mel Steinburg and Guy Haddux to name a few. With all the complex cases I see and restore, occlusion is the foundation of my dental practice. As dentists, we must be experts in occlusion to perform restorative dentistry correctly. Where do you practice? I am glad the videos are helpful. I love practicing comprehensive dentistry.
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What do you think about the relation of the jaw and C2 positions?
I am not familiar with the term C2.
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I came because I thought: let me see what is he going to do in 38 min with this video title.... my mouth was shut ! great video!
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Sir your lecture is great, in fact best...I have a question....if we have to made a night guard to prevent clinching,we need prepare a mouth guard only on anterior teeth?
I normally have the Nightguard cover all the teeth in an arch so it doesn't come loose while the patient is sleeping. The occlusal contacts are only on the anterior teeth. Covering all the teeth in the arch is to secure the appliance and prevent it from coming loose.
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I really appreciate dear doctor. Very applicaple and scientific explanation on occlusion. Your work and effort is honorable. Question?? 1. Should middle of upper teeth(the line between two middle incisal) and middle of lower teeth, concide during central occlusion? 2. My mandible travels a long way from left to right and viceversa, associated with facial muscles pain and fatigue. My teeth also slides about less than 2mm and finally all contacts miss except for one of my upper anterior incisal tooth which holds all the pressure of jaw and is gradually moving forward due to this pressure.
Sorry, it is very difficult to diagnose a condition without examining you. I suggest you find a good dentist knowledgeable in occlusion and the diagnosis and treatment of facial pain and disfunction.
@@centerforard You are such a responsible and generous doctor. I truly appreciate your reply. Kindly recommend to me, if you have any fellow dentist in Philippines.
I wish I knew a dentist in the Philippines.
Dr. Steven, I'm reading a lot about the Dahl principle and lot of dentists are doing deprogrammer without posterior contact so the teeth can move and close the space. Their patients are wearing them only while sleeping and there is a teeth movement after aprox. 6 months. I watch your video and you say that the 8 hours of no contact between the teeth cannot lead to a passive tooth eruption. I'm doing such night guards with great results, the patients have an immediate response to it and say that the muscles are relaxed, even the neck muscles. But what you're saying and what the other doctors are saying is the opposite so I'm confused. Can you please share your opinion about this and the Dahl principle? Thank you!!
Teeth begin to move after 24 hours, and only slightly then. The principle is you do not want opposing teeth to be out of contact more than 24 hours straight. So posterior teeth not contacting for 8 hours will not affect the occlusion.
awsem doc ❤️
TY.
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Great sir, I'm from india.
Sir could you pls guide for fmr cases from start, since I m really weak in case selection and treatment planning
There are several full mouth restoration cases in the library of DentistryMasterClasses.com. I am currently filming several more full mouth restoration cases that will be in the DMC.com library soon. A full mouth restoration is not easy and requires a systematic approach, plus an understanding of what you are getting into. If the patient has severe wear, that is a completely different situation vs. a patient who has just broken down teeth. If you are going to restore complex cases, you should have expertise in most areas of dentistry, or you will be constantly referring the patient out for endo, extractions, perio., etc. Being qualified to sedate is also most helpful. We are filming a "live" case in the morning (Friday) at 8am, CST. You might want to watch it. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
@@centerforard Could you recommend a dentist in the Houston/Galveston area who specializes in occlusion problems & full mouth rehabilitation? I’ve had problems with grinding & clenching since I was a teen. I have crowns on all upper teeth & a few bottom teeth but feel my occlusion is still off. Thank you!
I’m from Middle East, you are amazing, do you have an email prof. ? I have some questions related to that topic
cutbirthdds@gmail.com.
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I’m not a dentist but when you suffer from improper occlusion you learn some things and yes occlusion is EVERYTHING
I agree occlusion is of critical importance in all phases of dentistry. It is the foundation of everything we do in dentistry.
@@centerforard sadly doc I find most dentist don’t that’s why I’m drawn to the ones that do like you. I had a filling placed yesterday and it’s too high, had instant tmj pain on that side, headache, dizziness, nausea it was rough all night. I want her to take it down a lot, but I’m scared. Do you know any good dentist from Philadelphia that’s about occlusion?
Sorry, I do not know any dentists in Philadelphia.
@@centerforard ok, thanks for answering
@@centerforard one other question if you can please 🙏
I have a molar (last one in the back on my right side wisdoms removed) that’s been drilled on a bit too much over the years...chasing the fit of this filling, and the tooth has pretty much lost its natural shape. I feel so because it doesn’t fit quite well with the tooth above it, hits too hard in some areas and I have jaw pain on that side. I have moulds of my teeth before being touched, do you think I could have an on-lay made from my original tooth shape mould, and if so do you think it will fit together again, and in return stop my jaw pain or it’s not that simple? That’s my main concern before I take away my enamel for good! I would love the opinion of an occlusion specialist like yourself, not a general dentist, too many that don’t study the bite and occlusal just don’t know certain things
My anterior teeth touch when my mandible is in the centric relation position.
Have a qualified dentist examine you and adjust the problem.
@@centerforard Thank you. My mandible needs to be distalized if I need to achieve centric occlusion. It causes a bit of discomfort around my ear when I chew food.
At least get a flat plane, hard acrylic centric relation occlusal orthotic appliance made by a dentist who is excellent in occlusion to wear while sleeping. Watch my video on how to make an OOA or proper night guard.
I’m interested to hear what more experienced dentists like you have to say . I’ll first just say my understanding of occlusion is very basic.
Let’s assume that you do not have canine guidance. What would that mean? It would mean that on lateral excursions (side to side jaw movements) you do not have your canines discluding your maxillary and mandibular posterior teeth (discluding means separating, basically). On lateral excursions, your posterior teeth would be grinding against each other.
Canine guidance helps protect your posterior teeth from destroying themselves and grinding eachother flat during side to side movements. So… without canine guidance, your back teeth are destined to be ruined and ground flat, right?
Wrong. These occlusal concepts dentists are taught (canine guidance, protrusive guidance, mutually protected occlusion, etc.) are primarily relevant *in the presence of parafunction.*
Oral parafunction is the function of your teeth when they are not being used for what they are meant for (i.e. chewing food). For example, bruxism/tooth grinding is parafunction. In the presence of bruxism, canine guidance would absolutely lend protection to your posterior teeth from themselves (until you grind your canines down to nubs and they can’t guide your occlusion anymore).
In short, it probably is not important at all especially if you do not have parafunctional habits. If you do have parafunctional habits, it may affect things but a dentist would need to see your occlusion in person to assess if you have canine guidance. And even if you do have bruxism, you can just wear an occlusal guard and it’ll never be an issue.
Nice comment. Most of what you are writing is correct. Definitely, if a patient does not grind their teeth during the night while sleeping (bruxism) or during the day, they will not wear their teeth away or develop myofacial pain and limitation of opening or TMJ issues. Stress on an imbalanced system causes most of the problems. If the system is not imbalanced (CR-CO slide), then the patient will probably just develop myofacial pain and muscle tightness and teeth wear if they are a bruxer/grinder/clincher. That is the reason most of my patients are given a CRO flat plane, hard acrylic nightguard, girls when they are around 16 and boys when they are in their low 20s (when they stop growing). Most people grind their teeth when they are sleeping. Don't wait until they have worn down their anterior teeth to provide then with a proper nightguard. My daughters received nightguards when they were around 16 and had stopped growing. Occlusion is a fascinating and most important dental topic. I do not know how a dentist practices dentistry at more than a very basic level (tooth extractions) without a thorough knowledge of occlusion and function.
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Amazing
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Fine 💙
Thank you. Occlusion is probably the heart of dental treatment. If a dentist does not understand occlusion, he/she and their patients are at a huge restorative disadvantage.
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What if all you know is not what it is ..
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Botox on the masseter can stop the person grinding right
I don't think so.
Dr if you put the maxillary model and the mandibular model on the articulator with an open bite in centric relation. how did you knew the first tooth contact on the model in centric relation? Thank you
You have asked a question that takes a significant part of a lecture to answer. The short answer is to mark the first contact in CR in the mouth with articulating paper, then find the first contact on the CR mounted models on the articulator with articulating paper. There may be some minor adjustment of the mounted models to have the first contact in CR be the exact same as that first contact in CR in the mouth. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
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