July/August 2016
Volume 37, Issue 3

Integrative Dental Medicine: Treatment of Occlusion Reflecting Systemic Disorders

Addressing the “triad” of causative factors of wear

Dentists are the “physicians of the masticatory system,” as Peter E. Dawson, DDS, founder of The Dawson Academy (www.thedawsonacademy.com), has described. Indeed, no other healthcare providers can appreciate the critical role of dental occlusion like dental professionals. Dental malocclusion is associated with many signs and symptoms of instability, including sore, loose, worn, and broken teeth; sore muscles; headaches; temporomandibular joint overloading, stress, and strain; and ear and neck symptoms. Astute dentists need a critical eye for changes in dental occlusion that may reflect the presence of associated systemic disorders. This case study, which highlights bruxism, illustrates this point. It emphasizes how the focus of clinical diagnosis and treatment in dentistry is expanding to address known systemic factors that affect both dental and complete health.

Key Takeaways

• Dental attrition (occlusal/incisal wear facets) has been associated with bruxism, which may be related to sleep-disordered breathing, including obstructive sleep apnea. Dental erosion (smooth surface wear and occlusal cupping) may be associated with gastric reflux.

• Collectively, bruxism, obstructive sleep apnea, and gastric reflux may form a “triad” of causative factors of wear.

• Evaluation, diagnosis, and treatment of these systemic concerns and others expand the practice model to a new level described as integrative dental medicine.

About the Author

DeWitt C. Wilkerson, DMD
Senior Faculty Member/Director of Dental Medicine
The Dawson Academy
St. Petersburg, Florida
Adjunct Professor of Graduate Studies
University of Florida College of Dentistry
Gainesville, Florida
Private Practice
St. Petersburg, Florida

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