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Diagnoses

Primary occlusal trauma

Establishing this diagnosis

Establishing a diagnosis involves examination, review of medical and dental history, clinical data analysis, and tests that are specific to your condition. Only a dentist can evaluate your signs and symptoms to establish a diagnosis.

Tooth enamel is extremely durable, and is normally thick enough to withstand a lifetime of chewing forces. If the dentist notices abnormal wear ("attrition"), chipping or cracking, he/she may suspect a "bruxing" (clenching or grinding) habit, or "factitious habit" (use of the teeth for purposes other than chewing for nutrition). If it is apparent that the wear, chipping, and/or cracking are not due to external trauma, a diagnosis of "occlusal trauma" is supported.

It is possible to develop wear on the teeth with normal chewing forces if the teeth are poorly aligned ("malocclusion"). The dentist will evaluate the bite relationship between the upper and lower teeth when abnormal wear is noted.

The dentist will also evaluate the condition of the periodontal structures (gums and bone) around your teeth. A periodontal measuring probe is used to measure the depth of gum pockets around the teeth. Measurements of 4 millimeters or more support indicate attachment loss, which support a diagnosis of "periodontitis" (or "periodontal disease"). If there is inflammation (red, puffy gums that bleed easily when gently stimulated) and attachment loss, active periodontal disease is diagnosed. If the teeth are also loose, abnormally tipped, and/or have moved, the "secondary occlusal trauma" diagnosis will also be established. It is possible to have both diagnoses simultaneously.