Understanding the Concepts of Occlusion

by | Nov 12, 2021 | TMJ

Understanding the Concepts of When it comes to dentistry, you may find that there are dentists who focus on different areas. Some dentists specialize in multiple areas. Regardless of which area a dentist focuses on, their goal is always to provide the best results for their patients and help the patient manage their symptoms.

What is Occlusion?

When occlusion is referenced in dentistry, it refers to the way that the teeth meet each other. As in, how both jaws come together. We have two jaws, which are the mandible and maxilla. The mandible is the lower jaw and the maxilla is the upper jaw. How the teeth are in relation to the jaw is important to the proper function of the mouth. If there is not normal occlusion in the mouth, then it is referred to as malocclusion.

When there is an abnormality, this can leave a person with difficulty chewing, speaking, or cosmetically in distress. They may also be more susceptible to diseases. There are different causes of malocclusion, such as genes or trauma to the mouth. Occlusion, and concepts surrounding occlusion, are constantly being studied and added upon.

The Philosophies of Occlusion

There are four main philosophies of occlusion. These are centric relation, functional, gnathology, and neuromuscular. No philosophy is deemed better than the rest, as they all focus on using precise data to perform expert dentistry to provide the best results.

Centric Relation

Centric relation refers to the position of the jaw when your teeth come together. This focuses on how your jaw and teeth are aligned, as well as how this affects the movement of your jaw. While focusing on the jaw, centric relation looks at how different positions of the jawbones affect your bite.

Functional Dentistry

Functional dentistry takes a focus on a person’s overall health, specifically how it relates to their mouth. A functional dentist will look at the patient’s well-being, taking a primary focus on the patient’s diet.


Gnathology focuses on the jaw and how the jaw chews food. Gnathology focuses on issues of the jaw, such as bruxism, jaw pain, and lockjaw. This focus on the masticatory system allows the dentist to provide the patient with solutions to help with re-alignment of the jaw and treatment of symptoms.


Neuromuscular expands further than gnathology. Neuromuscular utilizes technology, while maintaining a focus on the muscular system and nerves, to help with jaw misalignment.

Each concept takes advantage of engaging and important information that focuses on precision dentistry methods. While the concepts may differ in process, the goals inherently remain the same: to give the client the best overall result and improve the health of their mouths.

Most Common Types of Malocclusions

Three types of malocclusions exist:

  • Neutrocclusion 
  • Distocclusion 
  • Mesiocclusion 

Neutrocclusion is the form our dentist sees most often. This occurs when the top teeth overlap the bottom teeth. In these cases, the patient’s bite is still normal. With this type of malocclusion, the first molar sits in the bottom first molar’s groove. The individual can have overcrowded teeth, spacing issues, or under or over eruption in contrast to the other teeth. 

The second type is distocclusion, also known as retrognathism or an overbite. In cases of this malocclusion, the lower teeth protrude further out than the upper teeth. The top molars sit behind the lower molars. The front teeth may protrude. On the other hand, the back teeth on the bottom may sit underneath the central teeth on the top.

The third type is prognathism or mesiocclusion. This happens when the lower front teeth stick out further than the upper teeth in the front. The individual either has a shorter upper jaw or a larger lower jaw. The lower incisors may touch the tissue on the upper arch’s jaw. 

Causes of Malocclusions 

While normal occlusion occurs when the upper teeth are slightly in front of the lower teeth with the upper molars fitting in the grooves of the lower molars, some people are born with their bite different than this. Often, these malocclusions are hereditary, meaning the bite issues are passed down within families. Some hereditary issues include: 

  • Abnormal bite patterns
  • Overcrowding
  • Cleft lip
  • Cleft palate
  • Jaw shape abnormalities

Sometimes, the issue stems from childhood habits, such as:

  • Tongue thrusting
  • Thumb sucking
  • Using a pacifier beyond age three
  • Prolonged bottle usage

It’s also possible for malocclusion to develop as a result of:

  • Missing teeth
  • Impacted teeth
  • Abnormally shaped teeth
  • Extra teeth

In other cases, the issue occurs from ill-fitting crowns, dental appliances, retainers, braces, or crowns.

A tumor or an injury could lead to malocclusion as well. 

Symptoms of Malocclusions 

While malocclusions are often apparent because of the way your teeth appear, the malocclusion may never cause any problems. However, sometimes, the malocclusion causes symptoms. For instance, the position of your teeth could change the appearance of your face. You may have difficulty biting or chewing. Some people experience a lisp, although this isn’t common. 

How Occlusion Relates to TMJ 

When you have malocclusion, meaning your teeth don’t line up properly, it’s naturally putting stress on the muscles and other soft tissue in your mouth. As a result, you may experience pain and discomfort.

Additionally, if you have malocclusion, you’re at a greater risk for developing bruxism — a term we use to describe teeth grinding and clenching. When you overwork your joint when you clench or grind, it can lead to jaw pain, headaches, and various other symptoms, in particular when you first wake up. These habits increase the likelihood of you developing TMJ as well.  

Some individuals grind or clench their teeth and never experience any complications like TMJ. However, others aren’t as fortunate and end up with TMJ due to these habits

Treating Malocclusions to Correct TMJ and Bruxism 

One method our dentist has for correcting malocclusions is a dental splint, which is a common treatment used in neuromuscular dentistry. This is a device specially sized to your mouth. Our dentist focuses on where your natural occlusion should be and where it is as of now. 

Using a specialized process and a computerized program, our dentist determines where your teeth should naturally rest. Our dentist accomplishes this by taking a mold of your teeth where they currently rest and determining where your teeth should be at rest.  

Malocclusions FAQ

What Is Malocclusion?

Malocclusion is a misalignment of the upper and lower jaw. Sometimes, the top portion sits further out than it should while other individuals experience the bottom teeth pushing further out than the top. 

What Types of Malocclusions Are There?

There are three types of malocclusions: neutrocclusion, distocclusion, and mesiocclusion, Neutrocclusion is the most common form. This happens when your bite is normal, but your top teeth overlap your bottom teeth slightly while the back teeth sit slightly upward. 

Distocclusions occur when your lower teeth stick out further than your upper teeth. 

Mesiocclusions, however, happens when your lower front teeth stick out further than your top, front teeth. This happens when your lower jaw is larger than the top of your upper jaw is shorter than your lower jaw. 

Do Malocclusions Causes Any Symptoms?

Some people only notice a difference in the appearance of their teeth. It may be a significant enough difference to alter the appearance of your face. 

Malocclusion can cause changes in the function of your teeth. You could experience difficulty or pain when chewing. 

While it’s uncommon, you may speak with a lisp as a result of how your upper and lower jaw matches up. 

Some patients who have malocclusion grind or clench their teeth and may end up with TMJ symptoms as a result. 

What Causes Malocclusion?

Heredity is the most common cause of a misalignment between your upper and lower teeth. Therefore, misalignment may occur from birth. 

Certain habits when you’re younger can change the alignment of your top and bottom teeth, such as thumb sucking or prolonged pacifier or bottle use.

Malocclusion could be from a poorly fitted oral device, such as braces, a crown or filling, or a retainer. On the other hand, missing teeth, overcrowding, or oddly shaped teeth can cause malocclusion. Additionally, an injury or tumor could contribute to a misalignment between your top and bottom jaws. 

Can Malocclusion Be Fixed?

Yes, our dentist uses an oral splint that repositions the jaw that’s out of alignment. In some patients, oral splint will correct the problem completely and permanently. 

How Long Does it Take to Get TMJ Pain Relief With an Oral Splint?

Although some patients notice a difference shortly after they use their splint, it may take between one to two months to notice the full effect. 

Symptoms of TMJ syndrome may seem minimal at first but can lead to serious issues if left untreated. Dr. Sid Solomon at the Center for Cosmetic, Implant & Neuromuscular Dentistry analyzes each patient individually to assess specific pain spots and detect issues of the joint. If you are experiencing symptoms, visit a specialist.

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Dr. Sid Solomon, DDS

Dr. Sid Solomon, DDS

World-renowned expert in the scope of cosmetic, orthodontic, and neuromuscular dentistry for over 35 years.


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